Fake drugs: How bad is Africa’s counterfeit medicine problem?

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The proliferation of fake medicines in Africa is a public health crisis that can no longer be ignored, according to a UK charity.

There’s a meeting of seven African countries, in Togo, this week, to combat the problem.

Congo, Niger, Senegal, Togo, Uganda, Ghana and The Gambia will discuss measures to clamp down on trafficking in fake medicines, says the Brazzaville Foundation.

But how big a problem is counterfeit medicine in Africa, and what impact does it have?

How many counterfeit drugs are there?

Globally, the trade in counterfeit pharmaceuticals is worth up to $200bn (£150bn) annually, with Africa among the regions most affected, according to industry estimates.

The World Health Organization (WHO) says 42% of all fake medicines reported to them between 2013 and 2017 were from Africa.

The European region and the Americas (North and South) accounted for 21% each.

But how reliable are these figures?

The WHO has a reporting mechanism that relies on national or regional regulatory authorities around the world to notify it of seizures. So the data for 2013-17 is only as good as the surveillance and reporting systems in the countries or regions concerned.

Fake medicine seizures 2013-17

The WHO has itself noted that as more officers were trained and national regulators became more aware, the numbers of drug seizure reports went up. So it’s possible areas with weak regulation and enforcement may be under-reporting the extent of the problem.

Bright Simons, who set up a mobile system to verify drugs in Ghana, says it’s not possible to produce a precise estimate, as the trade is underground.

But there’ve been several seizures in recent years, which give an indication of the size of the problem in West Africa:

  • Ivory Coast, Guinea-Bissau, Liberia and Sierra Leone seized 19 tonnes of counterfeit medicines in 2018
  • Smugglers in Ivory Coast were intercepted trying to bring in 12 tonnes of counterfeit pharmaceuticals from Ghana in 2019
  • An Interpol-led operation in seven West African countries seized more than 420 tonnes of illicit pharmaceutical products in 2017
  • Nearly 19.88 tonnes of fake medicines were seized in Mali between 2015-18

The accounting firm PwC says the proportion of fake pharmaceuticals in some countries can be as high as 70%, in developing regions such as Africa.

The WHO estimates one out of every 10 medical products in low- and middle-income countries, which includes most of Africa, is sub-standard or fake.

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