By Patrick Egwu
Counterfeit medicines have killed thousands in Nigeria because manufacturers placed a higher premium on profitability than saving lives. But a digital technology by the National Agency for Food and Drugs Administration (NAFDAC), Nigeria’s national medicine regulator, has come to the rescue.
Clutching a photograph of her child, Hannah Ikem, 40, recalls the traumatic events of 2008. Her seven-month-old son Chisom had been suffering from teething problems. Ikem tried to ease his pain by giving him a paracetamol-based syrup.
Tragically, the medicine was counterfeit. Instead of glycerine, the mixture contained diethylene glycol, a cheaper chemical commonly used as engine coolant. When ingested, diethylene glycol attacks the central nervous system, kidneys and liver. Chisom died – along with 83 other children who took the same syrup.
“I didn’t think I could live knowing that he was no more,” said Ikem.
Barewa Pharmaceuticals, the company behind My Pikin Baby Teething Mixture, was shut down, and a court sentenced two of its employees to seven years in prison.
At that time, fake drugs were widespread in Nigeria. The market was saturated with medicines from manufacturers, mostly from India and China, who would either cut corners or make fake products, thus endangering millions of lives.
A World Health Organisation (WHO) report estimated that a huge 64% of anti-malarial drugs in circulation in Nigeria were either fake or sub-standard. Anti-malarial medication in the country was therefore more likely to fail the standards needed to be effective than meet them. Of the six African countries that the WHO evaluated, Nigeria came last by a long way.
Since then, however, Nigeria has launched an impressive counter-offensive against fake drugs. By utilizing a range of technologies, the country has become an innovator and trailblazer that other parts of the world are now looking to emulate.
These efforts have come too late for Ikem, but she is hopeful that others will not have to endure the tragedy she faced.
“I’m happy that the fight against fake drugs is still on and that, when caught, perpetrators are paying the price for their crimes,” she says.
Nigeria’s pharmaceutical industry is currently worth USD3 billion. Still, last year alone, Nigeria’s National Agency for Food and Drug Administration and Control (NAFDAC), the country’s national medicine regulator, seized counterfeit drugs and unwholesome regulated products worth more than N12 billion.
In contrast, N2,3 billion worth of counterfeit drugs and unwholesome regulated products were destroyed, according to Yetunde Oni, a director, and administrator at the agency.
Technology to the rescue
The main weapons that NAFDAC has employed in its endeavors are technological: Through its Mobile Authentication System (MAS), consumers can scratch off a panel on the packaging of medication to reveal a number. By texting this code to a toll-free number, the buyer can immediately verify whether the product is genuine or fake.
Other effective technologies in use include the Radio Frequency Identification (RFID) system, which helps tag and track genuine products; Black Eye, a machine that can examine the components of several drugs at the same time; and TruScan, a handheld spectroscope that can quickly and easily detect counterfeit products.
In an interview, the former head of NAFDAC, Paul Orhii, reportedly said that Nigeria was the first country to use the Truscan to check for counterfeit drugs at its borders.
“These devices go through tests and various experiments to ensure their effectiveness,” says Chioli Pascal Chijioke, a consultant physician in Pharmacology and Therapeutics at the University of Nigeria Teaching Hospital.
Nigeria has made strides in reducing the prevalence of counterfeit drugs by using a range of technologies to help track genuine products and detect fake ones.
An extensive study of antimalarials purchased in the Nigerian city of Enugu in 2015 found that less than one in 10 were of poor quality.
“In NAFDAC, the radical departure from a primordial to a digitalized era and the new approach to combating the age-old menace of drug counterfeiting in Nigeria is indeed a highly applaudable change initiative,” said Mr Martins Ikhilae, a public health analyst.
“It has been recorded and noted globally that this singular, bold, patriotic move in the nation’s healthcare regulating sector has helped to reduce the prevalence of fake drugs from a whopping 64% to a paltry 3% or less,” he added.
Call for greater awareness
Following Nigeria’s successes, other countries in Africa and Asia have adopted similar SMS-based technologies, while the US, Germany, Sweden and Canada now make use of TruScan too.
“The war is real and it’s still on,” Ikhilae said. “This is evident from the fact that our efforts are attracting the attention of other countries, especially neighbouring countries, who come and learn what we are doing in Nigeria.”
There have, however, been further calls for the creation of awareness and the provision of training in the use of these technologies among citizens. Although they are already successful in combating fake drugs, health experts believe that technological devices could be tricky, and people need to be in tune with the latest upgrades and developments.
This may be particularly problematic for people who live in rural areas and are predominantly farmers and petty traders.
The Director of Regulatory Policy at Nigerian Law Intellectual Property Watch (NLIPW), Ufuoma Akpotaire, said that her organisation is devoted to promoting awareness and giving legal advice on counterfeit drugs and deepening discussions on the problems of counterfeiting in sub-Saharan Africa.
“We create awareness and independently monitor such cases (of fake drugs) because they affect trademarks and brands and, ultimately, lead to the death of consumers,” said Akpotaire.
Caleb Ugwu, a consumer who lives in a rural village in Enugu State, South Eastern Nigeria, said, “I think more needs to be done in the local areas to educate people through seminars and workshops on how to use these technologies. Many people here are illiterate and can neither read nor write. I personally found it difficult to use the technology at first, until someone showed me how to use it.”
With the right awareness in place, the NLIPW, which is at the forefront of creating awareness of counterfeiting, believes that Ms Ikem and other unsuspecting consumers will be protected in the future.
“If I had these technologies, my son would still be alive today,” said Ms Ikem. “Now that they are available, I’m sure lives will be saved.”
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