About 100,000 deaths a year in Africa are linked to the counterfeit drugs trade, according to the World Health Organisation (WHO). Sometimes counterfeit medicine kills directly, as in 2008 when 84 Nigerian babies given a teething mixture called ‘My Pikin’ were killed (the standard glycerin had been replaced with cheaper – and poisonous – diethylene glycol). More frequently, counterfeits kill by simply being ineffective. Reports tell that every third malaria pill sold in African countries is counterfeit or substandard, and very often contains no active substance at all.
Dysfunctional and corrupt governments lack the capability of combating the illicit trade, which combined with widespread low literacy and a desperate need for medicine makes poor people in African countries an ideal target market for unscrupulous entrepreneurs. In Nigeria, where I recently had the privilege of living as an expat trailing spouse, decades of political instability, widespread corruption and an ever increasing and very poor population facilitate the trade with counterfeit drugs.
Attempts to resolve the problem on an international level have been hampered by a lack of consensus on an internationally recognized definition of counterfeit drugs. Counterfeits are often confused with generic medicines. This has flawed the debate and caused generic drug companies to raise worries that they would fare with accusations of counterfeiting if harsher regulations were instituted. However, commercial patent infringement disputes should not be confused with disputes related to fake versions of branded and approved medicines. Counterfeits are not by definition infringing patents, but they are by their nature at high risk of being ineffective and not meeting recognized quality standards. Counterfeits are therefore a threat to global health, and not primarily a question of infringement of intellectual property rights.
So, what can be done? Maybe technology can put an end to the problem. One promising example is cell phone authentication, which is a recently developed high-tech alternative using scratch-off labels with a unique ID number for verification. The purchaser can text the ID free of charge to a number on the box, and receive an answer saying whether the product is fake or real. By using an encrypted system, counterfeiters will face quite a lot of troubles when trying to put fake verification labels on products.
The government in Nigeria recently launched a campaign for cell phone authentication of malaria medicines. The authentication system was publicized with TV spots and posters, and verification is now required for all malaria medicines. According to the Nigerian National Agency for Food and Drug Administration and Control, this has drastically reduced the counterfeiting of anti-malarial drugs from 40% to 3.6%. The system also turned out useful for tracking stolen goods – when 3,000 doses of the anti-malarial drug Lonart DS were stolen on its way to retail stores in Nigeria, the manufacturer set the ID numbers on those boxes to respond to texts with “stolen: please call in”. Within a few days, the company had enough responses to find the products and identify the wholesaler involved.
International agreements, effective regulation and strong institutions should of course be the ultimate goal in the fight against counterfeiting. However, while waiting for that to happen, high-tech solutions may as we have seen provide an efficient alternative. Technology empowers people to take matters into their own hands when the international community and their governments fail. Better still, it might empower people to put pressure on their leaders and bring about real change in the society.