The presence of counterfeit or substandard drugs in Africa is a threat that cannot be under estimated as it has been widely reported worldwide. Indeed, sub-standard formulations of antimalarials and antibiotics have been reported in the East African region.^{1, 2, 3} These drugs are majorly procured from manufacturers in Asian countries. Manufacturing of drugs in African countries by local entrepreneurs is also on the increase. There is therefore need to develop local capacity to counter this problem as it has a direct bearing on morbidity, mortality and the overall confidence in the health services at all levels.

Most African countries lack the financial and human resources to setup well equipped state of the art laboratories country wide across the various regions and provinces.⁴ The development of field tests is a prerequisite to enhance drug quality monitoring as these field tests should be robust, inexpensive, simple to conduct, rapid and reliable quality control methods.

The support of drug regulatory authorities by way of building and developing specialized human resources and physical infrastructure should be enhanced. Human resource includes chemists, pharmacists and laboratory technicians among others. The physical infrastructure should be decentralized to the regions/provinces so that these services are as close as possible to where the drugs are being utilized.

Availability of inexpensive essential medicines that treat the common ailments at all times in an efficient public health service at all levels would reduce the temptation of unscrupulous drug companies and pharmacies to fill the void by providing substandard or counterfeit drugs. The failure to access genuine medicines in public facilities is probably the main factor why patients will seek medicines from the private sector where the propensity to supply counterfeit or substandard drugs is high due to poor law enforcement.⁵

Public health campaigns in the society on how to make decisions on where to obtain good quality drugs and hence make the right choices when seeking medical care are essential. This could be by way of posters, mass media i.e. radio and newspapers and health educators in the community.⁶ The information provided could include information on appropriate packaging, proper storage conditions, shelve-life and the reliable brands and manufacturers. The public awareness ought to be coupled with vigorous enforcement of laws and regulations governing the procurement and supply of medicines must be strengthened.

By Guest Blogger David Musoke-Muweke, Postdoc at Gulu University, Uganda.

References

1. Anon. Fake malaria drugs in Tanzania. Marketletter Feb 20, 2001
2. Kayumba PC, Risha PG, Shewiyo D, et al. The quality of essential antimicrobial and antimalarial drugs marketed in Rwanda and Tanzania: influence of tropical conditions on in vitro dissolution. J Clin Pharm Ther 2004; 29: 331-38.
3. Amin AA, Snow RW, Kokwaro GO. The quality of sulphadoxine-pyrimethamine and amodiaquine products in the Kenyan retail sector. J Clin Pharm Ther 2005; 30: 559-65
4. WHO. What encourages counterfeiting of drugs? http://www.who.int/medicines/services/counterfeits/faqs/16/en/index.html
5. Pecoul B, Chirac P, Trouiller P, Pinel J. Access to essential drugs in poor countries. A lost battle? JAMA 1999; 281: 361-67.
6. Rozendaal J. Fake antimalarials circulating in Cambodia. Mekong Malaria Forum 2000; 7: 62-69.