Local Drug Outlets – A Control for Counterfeit Drugs?

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Where are these drugs coming from?

The challenge posed by the epidemic of counterfeit drugs and the health risks they represent in Nigeria makes distribution of drugs a sensitive component of its health care sector. In Nigeria, 17 percent of the drugs in circulation are still fake despite recent focused efforts undertaken by the National Agency for Food, Drug Administration, and Control (NAFDAC).  Several forces drive the demand for counterfeit and substandard drugs; financial inaccessibility of basic medicines and limited physical access being the obvious ones. Also, the large role of informal channels (where quality is by nature harder to control) make the situation more challenging; for example, according to the former Director General of NAFDAC Dr. Akunyili, 60% of the secondary distribution in Nigeria takes place in informal markets, which also supply a large proportion of formal retailers. Even pharmacists patronize these open markets, often prefer to pick up goods from the marketplace at a discount rather than having them delivered through formal distribution channels.

An initiative already launched in Tanzania known as Accredited Drug Dispensing Outlets (ADDO) addresses this fragmented drug supply channel by using the existing consumer behavior of local retail patronage in conjunction with the training and accreditation of these retailers to dispense over the counter and some prescription drugs. If this is introduced in Nigeria, it will help to control the influx of drugs in the market as local retailers will be trained, registered and supervised to help monitor medications dispensed. The major stakeholders in this will be the consumers, healthcare professionals especially pharmacists as well as regulatory agencies. Many non governmental organizations will also be interested to see how this affects drug prices and availability.

An ADDO in Tanzania

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3 Responses to “Local Drug Outlets – A Control for Counterfeit Drugs?”

  1. mjberley Says:

    Counterfeit drugs are a huge issue in developing countries and one that must be address. Like many public health problems, sell of counterfeit drugs is so widespread and accepted that controlling it can seem to be quite a daunting task. This ADDO initiative is very intriguing, but it leaves me wondering what will hapen when these trained retailers discover they can obtain counterfeit drugs easier and for a fraction of the cost, will they stick with selling the correct drugs? This will certainly be a program to watch and if successful should absolutely be spread elsewhere.

  2. riwunze Says:

    In 2010, I was in Nigeria and saw a TV news story on NAFDAC and its crack down on sellers and a supplier of counterfeit drugs, and I saw how peoples concern about counterfeit drugs contributed to the distrust of the health care system and increased utilization of “natural” remedies, herbs and traditional healers. This problem is a failure of multiple systems, greed, lack of enforcement of laws/regulations and lack of regulation. There is a major shortage of health care providers with any uneven distribution of the providers, a majority fee for service system of health care, “pharmacies” run and staffed by people with no training, and anyone can sell medicines. A systems like the ADDO is a good start, but when these “informal channels” are the norm and the most accessible health care system, and the average citizen does not appreciate the qualifications and purpose of a pharmacist or such training it will have a limited effect.

  3. suedocdo1 Says:

    I feel as though this is a problem that has been ongoing for quite some time, and is as important now as it ever has been. I remember reading a book about the counterfeit drug market in Western Africa about 10 years ago while I was finishing my medical training. It is disappointing to see that so little has been done to fix the problem within this period of time. I revisited a few studies that I recall reading from the late 1990s and early 2000s that estimated the spread rate of counterfeit medications to be between 36 and 48%. The Nigerian equivalent of our FDA apparently puts the rate currently at 16%, which is obviously better, although the accuracy of even the current data is questionable. I’d like to see more widespread application of a program like ADDO across multiple countries on a larger scale in order to address what my colleague above stated, which is futility due to lack of community and individual buy-in and lack of trained providers ensuring accuracy of the goods. I would suggest that this is larger than what each individual country is able to enforce, and that a larger entity such as WHO or other should step in and take over on a broader scale. Accurate and effective medications are essential in the care and treatment of every patient throughout the world.

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