The fight against fake medicines requires a united public-private front to overcome people's resistance to health warnings and to dismantle increasingly sophisticated trafficking networks, medical professionals said at a meeting in the Togolese capital Lomé.
The deadly industry of counterfeit medicines thrives because the products sell well, despite health warnings, sub-Saharan Africa health officials said at the 27-28 January meeting aimed at reinforcing public and private efforts against fake drugs.
The event was organized by Leem, a body representing French pharmaceutical companies, and brought together government health officials from francophone African countries.
“Some people scoff at those who advise against street medicines,” Sophie Bipolo, national pharmaceutical director in Gabon, told IRIN. “People say we denounce those medicines because we are in competition with them, but unfortunately people do not realize the dangers these products pose to their health.”
While counterfeit medicines are sometimes sold in pharmacies, they are more frequently found on roadside stalls, which are barely regulated yet common in most African states.
Although accurate data is hard to come by, more than half of medicines sold in some sub-Saharan African states are reportedly counterfeit.
Many buyers say street vendors of pharmaceuticals are their only option. “This is what I and my family have always used, and we have never had a problem,” said Da Béa, who sells clothes in Lomé.
“I cannot afford medicines in the pharmacy. So the day the authorities eradicate the street market they will be signing our death warrant.”
But with street medicines people never know what they are taking, said Manda Opondjo Fernand, national pharmacy director in Democratic Republic of Congo.
“When people buy these products they are buying complications, and quite possibly death,” he told IRIN.
Manda said countries must step up awareness and education campaigns. “We cannot force people against their will not to buy street medicines. The only means to help change people’s behaviour is to continue educating them about the dangers.”
Fake and substandard products often prolong illness or create resistance. “At a time when we are working to reduce poverty, fake medicines exacerbate it,” Manda said.
Togo Health Minister Komlan Mally told participants the fake drug market is a major worry because it is run by “a ruthless mafia”.
Dealer networks are generally steps ahead of regulators. The World Health Organization said in a January 2010 fact sheet: “Counterfeiters are extremely flexible in the methods they use to mimic products and prevent their detection” – methods that can change daily.
“Every step the authorities take to combat this network, the dealers develop ways to get round it,” said François Chevillard, head of Leem’s Africa committee.
Chevillard and others at the meeting said all this points to the need for constant collaboration among authorities throughout the region and strong regulations. “One of the principal reasons these products continue to circulate is an absence of regulation and strong sanctions,” he said.
Chevillard said countries must devote development funds specifically to this fight.
Participants also called on drug companies to make medicines affordable.
Some fake or substandard medicines in Africa come from India and China, but some are made locally, where the industry is “seriously under-regulated", according to a UN Office on Drugs and Crime (UNODC) report on West Africa.
UNODC says despite the “devastating effect” of bogus medicines the crime is not taken as seriously as other forms of smuggling.
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