Going beyond digitech in fighting fake drugs

Nigeria has a long, sad history of counterfeit drugs. Though the fake drug issue affects virtuallly every country, few, including Nigeria, have been worse hit. A number of incidents over the past few decades demonstrate the country’s battle with with counterfeit drugs.

In 1989, three children died at the University of Nigeria Teaching Hospital, Enugu State,after taking sub-standard chloroquine syrup, an anti-malarial treatment. The following year, 109 more died when they were treated with Paracetamol syrup, a common Over-The-Counter pain and fever elixir, that had been made with toxic ethylene glycol solvent, instead of propylene glycol.

Still on the same sad trajectory, in 2003, three children died during open-heart surgery at UNTH, in part, because counterfeit adrenaline was used during the procedure, as widely reported by the media at the time the gory incident occurred.

The foregoing are just three of the reported incidents where people have been harmed by counterfeit drugs in Nigeria. Not only can fake medicine harm if it is prepared with toxic substances, but those that are prepared with benign materials can give patients false relief, as they equally may believe they have dealt with their malady and not seek further treatment.

Besides, there were instances of patients getting into more trouble, as they developed more complicated ailments after taking the tainted drugs. 


There was an amazon

The story of the fight against drug counterfeiting in Nigeria will not be complete without the mention of an amazon, Prof Dora Akunyili (1954-2014), the Director-General of National Agency for Food and Drug Administration and Control (NAFDAC) from 2001 to 2008.

Akunyili had a special motivation for attacking the country’s counterfeit drug problem because, in 1988, she had watched her sister, aged 21, die after taking injections of fake insulin as part of her regular diabetes treatment. Akunyili put together a team of mostly female pharmacists and inspectors and started a war against counterfeit drugs that saw many medicine markets across the country closed down, including one in Kano State after her officers confiscated £140,000 worth of fake drugs.

The agency, under her leadership, broadcast jingles on radio and television to make the public aware of the dangers of substandard drugs and to encourage people to report suspicious drugs, while also publishing counterfeit products regularly in the newspapers.


Enter lawmakers 

Ostensibly in the bid to ameliorate the recurring challenge in Nigeria’s health sector, and particularly worried by the devastating impact of drug counterfeiting, the House of Representatives had, in July 2008, directed NAFDAC, Consumer Protection Council, now Federal Competition and Consumer Protection Commission, and the Standards Organisation of Nigeria to ensure that Mobile Authentication Service is reactivated and applied to all drugs purchased in the country.

The lawmakers further urged NAFDAC to, as a matter of urgency, commence a coast-to-coast awareness campaign, and directed its committee on health services to ensure compliance.

The resolution of the green chamber resulted from a motion sponsored by Jimi Benson from Lagos on the need to carry out the directive to save lives, even as he had expressed concern that drug faking remained a major cause of deaths of many citizens.

While leading the debate, Benson said fake drugs undermine every aspect of medical treatment and healthcare delivery and constitute the major cause of suffering and death of many Nigerians. The lawmaker had argued that counterfeiting of drugs contributed negatively to the wellbeing of Nigerians. 


How MAS works

For the sake of clarity, it is essential to note that MAS allows globally unique codes for each product unit made by genuine drug manufacturers or distributors. The codes can be delivered as labels based on the manufacturer’s preference or drug package. 

To verify the authenticity of the product, the consumer, at the point of sale, scratches or peels off the tamper-evident layer to reveal the unique code. They send the code to Sproxil, the solution’s service provider, using one of several options including SMS, Sproxil Consumer App, toll-free call centre or the website of the service provider.

A verification response is immediately sent to the consumer informing them of the authenticity or otherwise of the product.


Service providers for NAFDAC

NAFDAC, being the agency charged to implement the project through its Pharmacovigilance and Post-Marketing Surveillance department, is subscribed to five service providers, namely, PharmaSecure with Shortcode 38351, Sproxil with Shortcode 38353, Savanté with Shortcode 38120, UBQ-t/Kezzler with Shortcode 20966 and M-Pedigree with 1393. 


Challenges faced by MAS

Despite the introduction of MAS as a technological means of tackling counterfeiting of drugs, which has remained a major challenge facing the global pharmaceutical industry, Senior Lecturer in the department of Mass Communication at Babcock University, Ogun State,Helen Adekoya, and her colleague, Charles Ekeh, an associate lecturer in the same department, in a study, to determine the extent of awareness and adoption of MAS among Nigerians, found out that not a few consumers in the healthcare sector of the economy are unaware of MAS as a technological means of tackling counterfeiting of drugs, despite that they have phones compatible with the apps. 


Yet another app  

Another digital technology, named Med Safety App, was recently introduced to consumers by NAFDAC. It is a tool to improve reporting of Adverse Drug Reactions, Adverse Events Following Immunisation and side effect of medical products used for the prevention and management of the Coronavirus Disease.

The Med Safety App can be used to report a suspected side effect of a medicine, including vaccines, herbal products and homeopathic remedies, and keep up-to-date with all the latest safety information published by NAFDAC using the newsfeed. It is also innovated to create watchlists for alerts to new safety information about medicines of interest.

The app can view reports received by the World Health Organisation Collaborating Centre for International Drug Monitoring, the Uppsala Monitoring Centre  on specific medicines and vaccines as well as view previous reports as a registered user.

In its appreciation, the agency recently stated on its Facebook page, “NAFDAC is appreciative of WHO for supporting the procurement of the app, the UMC for providing administrative and technical support, and the UK Medicines and Healthcare Products Regulatory Agency for technical support and coordinating the WEB-RADR project, which led to the development of this app.”


Knocks for NAFDAC

According to Bob Efamgbe, a businessman, “Even as many consumers are ignorant of MAS, NAFDAC has come with another digital app. It is not about integrating technology into its operation’s architecture, but about adequately enlightening the people about the purposes the applications are meant to serve, so that the people will not be ignorant. 

“For instance, majority of consumers in the healthcare sub-sector do not know about MAS, let alone how it works. But they buy drugs every day without bothering to check the authenticity. Some of them do not even bother to check the expiry date.

“In my view, a consumer education that focuses on the message of how consumers in the healthcare sector should be using the apps or devices should be embarked upon. Now they have introduced another app, which is highly commendable.”

To Banjo Ogunmuyiwa, a communication expert, NAFDAC should adopt a media campaign machinery that should regularly be operated in collaboration with information managers like journalists.

“It can as well be operated through town hall meetings. The machinery can be operated majorly in rural areas, which is the grassroots. The campaign machinery, to me, should be ongoing; if possible, a unit that can be devoted to its operation can be created in the Public Affairs department of NAFDAC to ensure that Nigerians are rightly and regularly guided in the healthcare consumer market,” he added. 


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