Fake Drugs Rampant in Developing Countries; WHO says
1 in 10 medical products in the developing world are fake.
The counterfeit drugs industry is estimated to be a multi-billion dollar a year global trade. These are startling statistics, especially in a country such as Kenya where many people self-medicate.
A report released by the WHO on the 28th of November 2017 states that anti-malaria and antibiotics are the most counterfeited drugs in the world. Other drugs prevalent in falsification include birth control pills – especially emergency contraceptives pills – vaccines and diagnostic kits.
False vs Substandard
Fake drugs either do not contain any active ingredients or contain ingredients other than what’s stated in the packaging. Falsified drugs can therefore be either useless or toxic. For example, there have been prior reports of antimalarials made of potato or cornstarch. The WHO has previously reported cases of cough syrups targeted for children that contain powerful opioids – addictive substances (some legal and others illegal) of which morphine and heroine are among.
On the other hand, substandard drugs are of poor quality – they might be expired or contain insufficient dosages of active ingredients. Substandard drugs can be just as deadly as the fake ones because their unregulated dosages increase the likelihood of resistance to medication. This is a tragic scenario in regions affected by diseases such as Malaria and Tuberculosis.
Can fake medicine kill?
In 2014-2015, more than a thousand people in the DRC (Democratic Republic of the Congo) were hospitalized because of what looked like an outbreak of meningitis. On further investigation, a 2017 report in the Lancet Journal stated that ‘this large outbreak…was caused by the consumption of tablets labeled as diazepam but which in fact contained undeclared haloperidol…it is most likely that these were falsified medicines, deliberately and fraudulently mislabeled.”
Diazepam (valium) is prescribed for anxiety and seizures, but for this remote (and often unstable) part of Africa where access to drugs is limited, it is prescribed for wide range of illnesses, from headaches to sleeping disorders and even malaria.
With a rise in prescription pill abuse in Kenya, this story strikes close to home. For example, valium is the most abused prescription drug in Nairobi, with more people reported to use it for recreational purposes. Even in the developed world, falsified Valium has been linked to deaths. In fake valium pills, diazepam is replaced with etizolam, a deadly substance when taken with other substances.
A global network
Unfortunately, fake drugs are not found only on the ‘streets’ or in fraudulent pharmacies. The WHO report indicated that this industry is a regrettable collaboration of unscrupulous manufacturers, suppliers, distributors, retailers, government regulators and health care workers. This is to say that as long as there is inadequate regulation and unethical practices, it is possible to be handed a counterfeit drug at your local clinic. So how do you protect yourself?
How to spot fake medication
- Be skeptical of wonder drugs
Desperate patients can be easily lured by the promise of new ‘alternative’ remedies; most of which are untried and off label. Most of us use them in conjunction with prescribed medicine without caring how the ingredients will interact. If you want to try a new ‘wonder drug’, and especially if you have a chronic disease and are under other medication, at the very least have a chat with a medical practitioner and see what they think.
- Check the approval
Every type of medicine and dispenser must be registered and approved by the Kenya Pharmacy and Poisons Board (KPPB). If they are not, there is reason to be skeptical. To check if the drug you are taking is approved, go to the Kenya pharmacy and poisons board website/medicine information/registration, retentions, variation/list of retained products and search for the name of the drug or follow this link.
- Buy safely
When is the last time you checked whether your local pharmacy is registered? You can verify their registry at the KPPB website above. On a global scale, studies show that the internet is the riskiest place to purchase medicine. So unless a website has an actual physical address and an operational phone number, it is best to exercise caution.
All bona fide pharmacies, on or offline, should ask for a prescription. If they don’t, there’s reason to doubt their trade operations’ ethics.
- Inspect the product
Companies take a lot of care in packaging their brand. Shoddy looking packaging is a huge giveaway. Here are some things to look out for:
- If it looks as if it has been opened and tampered with; the closure seal looks slit or like it has been replaced, there’s some glue residue, the sleeve around the neck of the bottle doesn’t look original etc.
- Does the product look dirty; as if it has been recycled? Genuine products are transported carefully and normally arrive at the distributors in good shape.
- Most counterfeits are very good copies of the original, but they are not perfect. Look for small differences. Is the label straight, is the print poor and/or blurred, are there spelling mistakes, is the font and text size and color shade different…? If a product sold in Africa is not labeled in English, French or Portuguese, then there is reason to cast doubt on it.
- Manufactures are not allowed to change the appearance of their product without a formal regulatory process, so check if the product itself (pill, syrup, powder, and syringe) looks different. An unexplained change could indicate a substandard or counterfeit product. Check for things such as the shape and the size, or whether all the pills in the pack look the same etc.
- Often, counterfeit drugs are coarse-grained, gritty and crumbly because they will be made with a different press and material. If dealing with a liquid, check the precipitates, cloudiness, color, greyness or specks; any subtle change that is not usually present should be a warning sign.
- When taking the drug, does it taste or smell different? Is there a noticeable unpleasant odor? Does it dissolve differently? Does it crumble on the tongue while it usually goes down whole?
- After taking the drug, do you notice any side effects that are not listed on the information leaflet? Have you taken the drug before without any problems but happen to get adverse after effects on a consecutive batch? If you feel unexpected nausea, headache, dizziness, palpitations and shortness of breath, seek medical advice. Keep some of the drugs as evidence in case you need to make a formal report to the Kenya Pharmacies and Poisons Board.
Rachel is a prolific Kenyan writer, with over 15 years’ experience in the print media industry and has been part of editorial teams in major publications. Her specialties are health, community development, children and women’s affairs, global current affairs and lifestyle. She currently runs a content and creative consultancy outfit and holds an almost full-time gig at Kenya’s leading Newspaper, The Nation. When she is not creating content for her clients and has finally caught up with newspaper deadlines, she can be found at home reading or trying to (finally) work on her ‘Great African Novel’.