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Tackling the scourge of counterfeit drugs in Africa

Former Nigerian minister of health and founder and chairman of Juli PLC, Prince Julius Adewale Adelusi-Adeluyi will be discussing leadership and governance priorities for the pharmaceuticals industry in Africa at the Inspirational Development Group South Africa (IDG-SA) quarterly executive dialogue forum for the pharmaceuticals industry in Sandton on the 14 February 2019.
Prince Julius Adewale Adelusi-Adeluyi
Prince Julius Adewale Adelusi-Adeluyi

He took some time out to chat to Joanne Walsh, IDG-SA managing director, in anticipation of the event.

JW Looking from outside-in; what sound regulatory frameworks will create economic growth in the pharmaceutical industry?
PJ Every country needs a well thought out level of regulation for this sector particularly. It should govern the entire drug lifecycle from research to production, promotion, distribution and ultimately, consumption. Regulation needs to be far-sighted. It needs to be such that encourages scientists to zealously search for new and better drug remedies. It needs to be such that encourages drug companies and investors generally, to invest in drug research. It also, very importantly, needs to protect the consumer. The regulator, needs to bite and not just bark. Regulation should be fair and focus on encouraging research, ensuring the delivery of quality drugs, as well as protecting the industry in general by facilitating ease of doing business. So a good regulatory framework will embody all of these. And good implementation would require sound collaboration between the regulatory body, political body and industry with fairness as a core value.

JW An issue facing the industry in South Africa is the influx of counterfeit products. What is your opinion on this issue?
PJ Counterfeiting is on the rise, especially in emerging economies and needs to be aggressively curtailed early on. The issue with counterfeit drugs is the danger. Developing nations are reaching a level of up to 60% of fake products in their inventory. Thankfully, technology has proven to be a good ally to governments and regulators in the battle against this scourge of fake and counterfeit products. This is a good time to discuss what we can do across the continent to get this under control. As we embark on a way forward, we should ask – Why we are where we are? There are some fundamental issues to keep in mind.

We need leaders who understand and appreciate the danger of counterfeit drugs, with a strong political will, sound governance and supporting institutions.

  • We need leaders to formulate and implement good policies. Typically, leaders are good at formulating policy, but weak on implementation.
  • We need to get even more creative in deploying technology to manage this problem. The use of mobile authentication systems (MAS) has been fairly successful in some countries like Nigeria for instance. How can we improve in the deployment of such technologies? Is there a place for artificial intelligence, for instance, in this battle? We need to get increasingly creative.
  • Most importantly we need to harness the power of collaboration.

JW What policies and actions do you recommend to protect industry and consumers from the menace of rogue operators?
PJ In Nigeria we established The National Agency for Food & Drug Administration and Control (NAFDAC). This came into existence in 1993 during my term as mMinister of health. They were empowered to make an impact in many spheres impacting the industry including import, export, advertising, manufacturing, distribution, sales and use of drugs. This is a difficult job, and every nation needs a strong regulatory body. To ensure their strength they need back-up to build capacity. However, it is not enough to have a regulator, such a regulatory body also needs to be properly funded such that it has the right equipment and adequate and well-trained manpower to deliver real value to society. Regulatory bodies also need to have the right leadership.

Technology is also key. I talked about mobile authentication service, earlier which has recorded good successes with detecting fake and counterfeit medicines. With well over 100 million active cell phone users in Nigeria, NAFDAC saw an opportunity in the deployment of MAS which essentially works via mobile phones. So, anyone wishing to buy an antibiotic or antimalarial, two of the most counterfeited products in our market, is able to confirm the authenticity of these medicines within seconds while in the pharmacy. True, there are occasional false negatives with sometimes bad consequences including reputation-loss especially for the pharmacies, but on the whole, MAS system is a welcome development. I understand that NAFDAC has also successfully used Truscan, which employs a similar technology to resounding success at country borders and elsewhere across Nigeria to detect counterfeit and fake medicines on the spot. So technology is clearly very critical in this battle and we must seek creative ways by which to more aggressively deploy it. Instructively, the beauty of deploying technology especially in the manner in which MAS has been deployed, is that it empowers consumers to become involved in the authentication of drugs and other products. So it supports advocacy and encourages consumer safety and involvement.

Thirdly, I would add that social advocacy is very important. There is plenty of room for education and enlightenment. People need to be taught some of the tell-tale signs of fake products and schooled on why it is important to avoid these products and how.

JW What does the state of healthcare look like on the African continent?
PJ Africa is making efforts to make healthcare better. Rwanda is a country that does particularly well, with Ghana, Kenya and South Africa achieving progress. South Africa is good, but we all need to strive ceaselessly to make the current goodness better.

While on the one hand, I am tempted to commend some of the improvements that have been recorded, the indices are not very encouraging and sometimes make one question if indeed we are making progress in the right quantum. Recently the WHO raised an alarm about the resurgence of the neglected tropical diseases in many parts of the continent. These are diseases like Guinea worm, lymphatic filariasis, schistosomiasis, nochocerciasis, and many others. A good number of these diseases can actually, be totally eradicated by mass drug administration and other interventions like the provision of clean water and proper waste disposal facilities. So clearly, there is still so much that needs to be done in Africa with regard to healthcare. Providing such important basics as clean water, ensuring good sanitation and proper waste disposal would go a long way at helping to redress these challenges.

JW What is your final advice to improve healthcare delivery and eradicate illicit pharmaceutical product trade, on the continent?
PJ My advice is to encourage government to reduce poverty. This encompasses fiscal, environmental and mental poverty. This will therefore also include investing a lot more in education. Mental poverty leads to ignorance which in-turn can be harmful to consumers. Better education always has a salutary impact on all other aspects of life including susceptibility to certain diseases and even deception by drug fakers and counterfeiters. Policy stability, advocacy and stakeholder collaboration across nations is paramount. The continent also needs to look more ambitiously at eradicating diseases that are prevalent in the continent especially the communicable ones. We need to do a better job of funding research as well as domesticating drug manufacture. We need to evolve from the donor-mentality where we consistently look up to developed nations to help solve our most basic health challenges, to a can-do mentality where we decide to rally our resources to solve our problems ourselves. All this has been said before, yet I need to reiterate the need to go from a knowledge world to a humane world. The highest ethical standards will result in products that are more humane, and stability will create prosperity.

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