The problem of counterfeit drugs in the global community and trade engagements has been a worrisome phenomenon for years now and developing economies are said to be the hard hit by the canker.
The world indeed has moved from a period of inevitable deaths from undiscovered medication for strange diseases to self-inflicted deaths from human greed. The production, distribution and consumption of fake and sub-standard drugs no matter the form, reason or quantity, approach taken can be titanic in consequences to the entire human race and must not be condoned or trivialized.
In a commitment to help curb the menace, 29 of the world’s largest pharmaceutical companies vowed to provide a total of $5.9 million in the next three years to the international police agency Interpol to crack down perpetrating synergies and syndicates in the business of counterfeit drugs, a report says. And this move is generally welcomed as an essential initiative. The world seemingly has lost its conscience and sense of human ethics to commercial desires and business cravings and therefore needs to be called to order!
The menace is said to have presented a formidable front and overwhelming penetrating edge to national and international regulatory frameworks mainly as a result of its lucrative nature and profitable character. The financial returns to promoters is generally known though cannot be properly documented because of the undisclosed nature of the business. Currently trafficking of counterfeit drugs that contribute to health hazards is estimated at $75 billion per year by the International Policy Network.
In a report by the International Policy Network in 2009 the World Health Organization estimates for counterfeit drugs constitute up to 25 per cent of the total medicine supply in less developed countries (LDCs) and a more detailed sampling found that between 30 and 60 per cent of medicines in Africa and South East Asia were substandard.
The consequences of dealings in counterfeit drugs are however as extensively dangerous and enormously destructive to victims as they are tremendously rewarding to perpetrators. It does not only increase mortality and morbidity but also increase levels of drug resistance. For instance, according to IPN (2009), fake tuberculosis and malaria drugs alone are estimated to kill 700,000 people a year and that paracetamol cough syrup contaminated with antifreeze (chemical names: ethan-1,2-diol or diethylene glycol) has killed hundreds of patients, including 339 children in Bangladesh in 1990, 85 children in Haiti in 1995, over 100 children in Panama in 2007.
Also as of March 2009, more than 80 children are reported to have died in Nigeria after ingesting a teething mixture according to the IPN report. However, the business of counterfeit drugs is generally indicated to be underestimated as those successfully traded are unknown and therefore unaccounted for, but cumulative impact of fake drugs is indicated to be higher.
This precarious interface of deadly consequences for victims and lucrative rewards for dealers is what calls for strong political commitment at both national levels and the entire international community to curb the menace. In effect, the profitable nature of the business presents a very formidable front though not insurmountable to national and international regulatory mechanisms aimed at curbing it.
In fact as the world grows and empowers populations with focus on traditional development concerns such as food security, poverty and conflicts, it is only essential to give attention to the menace of counterfeit drugs to ensure gains made with respect to these development concerns are not eroded.
China is said to be second to India in the production and export of substandard drugs in the world. The WHO estimates that 200,000 – 300,000 people die each year in China due to fake medicines, while the European Commission’s 2006 report estimated that 20 percent of fake drug imports come from China according to an IPN report. This necessitates a diplomatic wakeup call on these countries by the international community to strengthen their regulatory systems on fake drugs or put the entire global community at risk
The Ghanaian Situation
Ghana has had her fair share of counterfeit drugs mainly from imports and the local market. Though the reportage of import or sale of counterfeit drugs in the country is becoming common and worrisome, the distribution and consumption of locally manufactured substances in the name of drugs rather presents a more precarious perspective to the menace in Ghana.
The situation in Ghana has taken twists and turns with human health and future toyed and threatened with an eminent jeopardy. Though most of the occurrences of fake drug dealings go unrecorded it may be contributing tremendously to untimely and avoidable deaths especially of the uneducated.
The marriage of superstition with modern orthodox medicine which was hitherto a preserve of traditional herbal or non-orthodox medicine is a case for worry. It is very common to find this orthodox medicine with no or unclear labelings being prescribed and administered by illiterates or semi literates with no qualifications or license. This is normally done in moving vehicles (sometimes in public/government owned buses) beginning with a prayer and sometimes a preaching after which such drugs are brought to consumers which supposedly cures virtually all sicknesses and diseases as long as a client is suffering from such sickness.
A classical experience was where a drug dealer prescribed one drug for headache, stomachache, foot rot, toothache among others evidently seeking to reach as many customers as possible with the same drug. What rather presents a stunning picture is the alacrity and desperation with which passengers on board the vehicle buy such drugs sometimes for kids and relatives at home. It is disheartening to know that innocent kids at home are being treated with these medicines, the outcome can be devastating! The dangers caused at home might be enormous though undocumented.
The faith-based approach normally taken is what seems to drive the whole deal but what also presents a more dangerous block to curbing the menace.
Market centers are however not also spared of the canker. All major market centers in the country are normally opened with loud sirens communicating the potency of medicines that can best be described as orthodox medicine sold in herbal fashion. Moving vehicles mostly mini buses solely dedicated to the sale of drugs also carry drugs from one vicinity to another without license and under questionable conditions.
Indeed, there are now some drugs in the Ghanaian market that can neither be described as herbal nor orthodox. What is worth noting is that these perpetrators only capitalize on the ignorance and illiteracy of the uneducated to make money and not to cure them of their diseases.
The most precarious aspect of the menace is that most of these drug dealers in communities, moving public vehicles and major market centers are without any license or qualification. This signifies state failure, institutional malfunction or breakdown in regulatory and legal frameworks. Most of these dealers have either low or no education and the drugs sold have the potency of worsening the conditions of victims.
It is necessary to indicate that this article has not explored other dimensions of the problem as it is very extensive, diverse and complex. Experience has however shown that the problem is erupting and possibly perpetrated mainly by institutional failure and legal and regulatory loopholes with very little state commitment to curbing it. This is because drug dealers without license or qualifications who are taking advantage of the ignorance of others go about the business freely and atrocities caused without any reprimand, reproof, resentment or even queries showing state endorsement or at best nonchalance.
The menace indeed presents a dangerous front to the future of the country and needs policy attention, political consideration and administrative concern. The level of patronization is simply overwhelming with clients having no idea of the possible consequences. All victims or clients look out for, is a mention of a sickness one is battling with and they are ready to obtain a dosage or prescription. Government is noted and reminded of its regulatory and coordinating role in the economy and anything short of this strikes of ineptitude and non-commitment. The administrative frameworks at work in this sector need strengthening and regulations need intensification.
The Ghana Health Service in collaboration with the Ministry of Health needs to embark on rigorous citizen education and sensitization, especially of the uneducated with regards to the menace. The Traditional Medicine Practice Council of the Ministry of Health needs not to be left out in this effort to salvage our society from damnation.
The TMPC must give license to whom license is due and help in flushing out all the unlicensed dealers who are proliferating the market with all kinds of substance in the name of medicine.
The Ghana food and drugs Authority and affiliated institutions need to take action now or the country’s future is bleak. For they say a healthy nation is a wealthy nation.
Enough of the perpetration of this evil under the sun!
International Policy Network (2009) Health Issues, Keeping it Real: Combating the spread of fake drugs in poor countries
By Anzagra Solomon ([email protected]) and Amanze Chinenye Nneoma ([email protected])