<h2 class="wp-block-heading" id="h-topline">TOPLINE</h2>



Suicides by drug overdose are increasing among Black women, young people and the elderly, according to a new peer reviewed <a href="https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2021.21060604" target="_blank" rel="noreferrer noopener">study</a> published in the American Journal of Psychiatry, despite an overall downward trend as U.S. drug overdose deaths soar to record levels. 



<h2 class="wp-block-heading">KEY FACTS</h2>



Though there was a steep increase in the number of people dying from drug overdoses in 2020—<a href="https://nida.nih.gov/drug-topics/trends-statistics/overdose-death-rates" target="_blank" rel="noreferrer noopener">nearly</a>&nbsp;92,000 people, a record figure and up from around 71,000 in 2019—the overall rate of suicides by overdose fell, according to researchers at the National Institute on Drug Abuse (NIDA), part of the National Institutes of Health.



The researchers, who analyzed data from the Centers for Disease Control and Prevention between 2001 to 2019, found that intentional overdose deaths among women fell from 1.7 to 1.5 per 100,000 people between 2015 and 2019 and from 1.6 to 1.2 per 100,000 people among men between 2012 and 2019.



However, intentional overdoses rose among older women ages 75 to 84 (from 0.8 in 2001 to 1.7 in 2019), older men ages 75 to 84 (from 0.7 in 2001 to 1.6 in 2019), young women ages 15 to 24 (from 0.6 in 2014 to 1.0 in 2019), young men ages 15 to 24 (from 0.6 per 100,000 people in 2015 to 0.8 in 2019) and Black women (from 0.4 in 2013 to 0.7 in 2019).



Suicides by overdose were most likely to occur on Mondays and least likely to occur at the end of the week (Friday, Saturday and Sunday), which the researchers said could be partly down to increased social interaction over the weekend and a reluctance to begin the workweek.



By month, intentional overdose rates were lowest in December and highest in late spring and summer, something the researchers said fits with observed seasonal variations in suicide risk.



<h2 class="wp-block-heading">TANGENT</h2>



Drug overdose deaths&nbsp;<a href="https://edition.cnn.com/2021/07/14/health/drug-overdose-deaths-2020/index.html" target="_blank" rel="noreferrer noopener">jumped</a>&nbsp;by nearly a third in 2020, the largest yearly increase&nbsp;<a href="https://nida.nih.gov/drug-topics/trends-statistics/overdose-death-rates" target="_blank" rel="noreferrer noopener">recorded</a>&nbsp;and a fivefold increase from 1999. Synthetic opioids, mostly fentanyl, are responsible for most of this increase in recent years. Deaths linked to stimulants, primarily methamphetamine, are also increasing.&nbsp;



<h2 class="wp-block-heading">KEY BACKGROUND&nbsp;</h2>



<a href="https://abcnews.go.com/Health/increase-depression-pandemic-suicides-decreased-studies/story?id=77039876" target="_blank" rel="noreferrer noopener">Rates</a>&nbsp;of&nbsp;<a href="https://www.economist.com/graphic-detail/2021/10/11/covid-19-has-led-to-a-sharp-increase-in-depression-and-anxiety" target="_blank" rel="noreferrer noopener">depression</a>&nbsp;and anxiety soared&nbsp;<a href="https://www.nature.com/articles/d41586-021-03454-x" target="_blank" rel="noreferrer noopener">during</a>&nbsp;the Covid-19 pandemic amid widespread economic uncertainty, the collapse of support networks, an inability to access mental health support and a myriad of other stresses. Though experts feared a commensurate rise in suicides, rates actually&nbsp;<a href="https://www.bloomberg.com/news/articles/2021-11-03/u-s-suicides-fall-for-second-year-in-a-row-during-pandemic" target="_blank" rel="noreferrer noopener">fell</a>&nbsp;in the U.S. for two consecutive years in 2019 and 2020, bucking a decades-long trend of almost yearly increases since 1999.&nbsp;



<h2 class="wp-block-heading">WHAT WE DON’T KNOW&nbsp;</h2>



How many suicides by drug overdose there are. It can be difficult to determine whether overdose deaths are intentional or not, the researchers note, pointing to the complex interactions between mental illnesses—which carry their own elevated suicide risk—and substance use disorders. Around 5% to 7% of drug overdose deaths are recorded as intentional, the researchers said. The distinction “has important clinical implications” in preventing accidental and intentional overdose deaths, said NIDA director Dr. Nora Volkow. “We must implement strategies for preventing both,” Volkow added, including screening for suicidality among people using drugs and providing support for mental illnesses and substance use disorders to those who need it.



<h2 class="wp-block-heading">BIG NUMBER</h2>



47,511. That’s how many people died by suicide in the U.S. in 2019, according to&nbsp;<a href="https://www.nimh.nih.gov/health/statistics/suicide" target="_blank" rel="noreferrer noopener">data</a>&nbsp;from the CDC. Suicide was the tenth leading cause of death overall—second among those ages 10 to 34 and fourth for ages 35 to 44—and killed nearly two and a half times the number of people as homicides. Firearms were the most common method used in suicide in the U.S., accounting for just over half of deaths in 2019.&nbsp;&nbsp;



If you or someone you know is in crisis and needs immediate help, call the&nbsp;<a href="https://suicidepreventionlifeline.org/" target="_blank" rel="noreferrer noopener">National Suicide Prevention Lifeline</a>&nbsp;at 1-800-273-TALK (8255).&nbsp;<a href="https://www.nimh.nih.gov/health/topics/suicide-prevention/" target="_blank" rel="noreferrer noopener">Learn more about suicide prevention</a>&nbsp;and ways you can help someone who might be at risk for self-harm.&nbsp;



<h2 class="wp-block-heading">FURTHER READING</h2>



<a href="https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2021.21060604" target="_blank" rel="noreferrer noopener">Intentional drug overdose deaths in the United States</a>&nbsp;(The American Journal of Psychiatry)



<a href="https://www.buzzfeednews.com/article/theresatamkins/suicide-rates-dropped-pandemic" target="_blank" rel="noreferrer noopener">Here’s Why Experts Think Suicides Dropped During The Pandemic</a>&nbsp;(Buzzfeed News)



<a href="https://www.nature.com/articles/d41586-021-03454-x" target="_blank" rel="noreferrer noopener">Millions of helpline calls reveal how COVID affected mental health</a>&nbsp;(Nature)



<a href="https://www.bbc.co.uk/news/world-us-canada-59253091" target="_blank" rel="noreferrer noopener">US annual drug overdose deaths hit record levels</a>&nbsp;(BBC)

Many kinds of drugs.

Drug Overdose Suicides Increasing Among Black Women, Young People And The Elderly

Blockchain technology is also revolutionizing supply chains in the pharmaceutical industry, in the process, helping track fake medicines. 



From genomics to robotics, technology is truly revolutionizing
the healthcare sector. And while it’s easy to become consumed by exciting,
futuristic trends like artificial intelligence (AI) diagnosis, digitized
patient records and 3D-printed medical tools, technology is also transforming
the pharmaceutical industry. How medication is prescribed, dispensed and
administered is big business with McKinsey predicting the value of Africa’s
pharmaceutical industry to be $65 billion in 2020.



But fake drugs are an ongoing and complex issue – they can
cause death, have unknown side-effects, fail to treat illnesses, and sometimes
even add to the spread of disease. According to World Health Organization (WHO)
statistics, 42% of detected cases of falsified (or substandard) pharmaceuticals
occur in Africa – reports estimate that between 72,000 and 169,000 children die
each year from pneumonia because of counterfeit antibiotics while fake malaria
drugs cause an additional 64,000 –158,000 deaths every year in sub-Saharan
Africa. Both antimalarials and antibiotics sit among the most commonly-reported
counterfeited drugs.



“Fake medicine distribution is rampant because business
processes are siloed between the various industry stakeholders, which puts the
industry at risk of fraud,” explains Heidi Patmore, a marketing consultant
specializing in technology that’s changing consumer behavior. 



“One solution to this would be cross-company process
automation which could easily be enabled by a blockchain data interchange. This
creates an open information system that all players can use to verify the
authenticity of medication because it can track and trace it from when it’s
manufactured to when it is dispensed to the patient.”



Companies such as IBM and SAP are working on blockchain
solutions to weed out Africa’s counterfeit medication network. When medicine is
returned to pharmaceutical manufacturers, for example, it is often re-sold
instead of being destroyed. How can a small local pharmacy ensure what is
returned is authentic? SAP are working with their existing client base – Merck,
GSK, Ingelheim, McKesson and others – on a blockchain project to verify that
any returned drugs are original. 



IBM Research’s solution for Africa (currently in development
in Haifa, Israel) includes a mobile interface and permissioned blockchain
backend that enables each certified and authorized party in the network to
initiate action, finish their transaction, and track its progress. 



“It also includes the monitoring of temperature to ensure
compliance with the proper conditions for transportation and asset transfer,”
adds Inna Skarbovsky, a blockchain architect from IBM Research – Haifa.
“Blockchain ensures full provenance for each medicine package, uniquely
identified with a barcode or a serial number. This makes it possible for all
authorized parties to track the drugs through the entire supply chain and the
drugs’ life-cycle.”



This also allows significant cost reductions by eliminating each participant’s need to manage a separate system for traceability of its components. “It also improves procedural efficiency for change-of-hands, make it much harder for counterfeit drugs to be introduced into the supply chain and to be distributed to end-users,” says Skarbovsky.



<figure class="wp-block-image size-large"><img loading="lazy" decoding="async" width="768" height="1024" src="https://www.forbesafrica.com/wp-content/uploads/2020/01/IMG_20190927_124217-1-768x1024.jpg" alt="" class="wp-image-42537"/><figcaption> Towett Ngetich, CEO of Uthabiti Health, a Kenya-based pharmaceutical company </figcaption></figure>



Towett Ngetich is the CEO of Uthabiti Health, a Kenya-based pharmaceutical company that has implemented blockchain to bring transparency and accountability back to a country where statistics show that 30% of medicines sold are counterfeit. Uthabiti, which means ‘verify’ in Swahili, was started after Ngetich’s first-hand experience with the effects of fake health products: “Back in university, a significant number of students fell victim to unplanned pregnancies and unsafe abortions. With deep research, it was uncovered that there had been a supply of fake contraceptives and backstreet abortion pills into the student market,” explains Ngetich. More findings showed the presence of fake antibiotics, antiretrovirals (ARVs) and non-communicable diseases (NCD) medicines in the Kenyan pharmaceutical supply chain. 



“Pharmaceutical science is the center of healthcare – one
mistake in any drug composition or formulation has the risk of endangering a
significant number of people. The need to access safe, affordable and quality
health products in its simplest form means life and death in diagnosed health complications.
Blockchain gives patients the ability to track and trace products using
attached IDs – it also gives Uthabiti Health the ability to know where all our
health products sit within each supply chain,” he says. Uthabiti Health
procures medicines from different pharmaceutical manufacturers. Once received,
they go to an internal laboratory for quality testing and are then labeled with
the product’s safety lab report – attached in their codes is a unique
blockchain ID. The medicines are then passed on to their partnering retail
points, ensuring that the medicines dispensed to patients can be verified with
something as simple as a text message. 



“This brings in consumers in safe-proofing the supply chain
of pharmaceuticals,” adds Ngetich. 



The proliferation of fake drugs throughout Africa is complex
– on average, medicine changes 30 hands before reaching the destined pharmacy –
but blockchain technology has great potential to help stop counterfeit medicine
distribution because it brings traceability and trackability to the entire
pharmaceutical supply chain, ensuring the immutability of information.&nbsp; 



<h4 class="wp-block-heading">Blockchain ethics?</h4>



<figure class="wp-block-image size-large"><img loading="lazy" decoding="async" width="709" height="1024" src="https://www.forbesafrica.com/wp-content/uploads/2020/01/CandicedC-709x1024.jpg" alt="" class="wp-image-42533" srcset="https://cms.forbesafrica.com/wp-content/uploads/2020/01/CandicedC-709x1024.jpg 709w, https://cms.forbesafrica.com/wp-content/uploads/2020/01/CandicedC-300x433.jpg 300w, https://cms.forbesafrica.com/wp-content/uploads/2020/01/CandicedC-600x867.jpg 600w, https://cms.forbesafrica.com/wp-content/uploads/2020/01/CandicedC-208x300.jpg 208w, https://cms.forbesafrica.com/wp-content/uploads/2020/01/CandicedC-768x1110.jpg 768w, https://cms.forbesafrica.com/wp-content/uploads/2020/01/CandicedC-1063x1536.jpg 1063w, https://cms.forbesafrica.com/wp-content/uploads/2020/01/CandicedC.jpg 1329w" sizes="auto, (max-width: 709px) 100vw, 709px" /><figcaption>Candice De Carvalho</figcaption></figure>



While blockchain is still a relatively niche technology, it is slowly changing how organizations operate. Blockchain promises better security and transparency, but not necessarily for the customer, in the case of drug allocation: “Where blockchain technology could likely increase efficiency and simultaneously decrease the abuse of medicines, customers benefit. The pharmaceutical and related industries are unique however, in that the ‘consumer’ is also a patient – a vulnerable group with special needs and rights,” explains Candice De Carvalho, the founder of Easy Ethics CPD.



Although overall transparency in the supply chain increases
through the use of blockchain, and this confers patient benefits, these must be
weighed against patient privacy and confidentiality.&nbsp; 



“With emerging technologies more freely available, we’ve
observed an interesting shift in patient behavior, where data privacy is
regarded less as an absolute by patients, in favor of a kind of sliding scale,
where privacy itself is a currency that purchases medical benefits along the
way,” adds De Carvalho. “Patients, for the right benefits, are perhaps more willing
to part with some privacy privileges.”



De Carvalho questions the genuine knowledge that patients
have of any exposure they experience through their use of novel medical device
or systems innovations. The key drivers for the business are not necessarily
unified with the total needs of the patient. However, the more the technology
owners protect and balance the patient’s need for confidentiality and consent,
the more they will ultimately see business benefit.&nbsp; 



“In the context of a doctor-patient relationship, the doctor has a positive duty to enhance patient understanding so that the patient enjoys a truly informed consent. Does this then mean that technology providers are now responsible in the same way that medical health workers are?” she ends.



-Tiana Cline

GettyImages-1056482262

Cure For Counterfeit Drugs?

Brian Muhumuza, a recovering alcoholic who has been sober for more than three years, is a refugee living in Johannesburg, because there are no rehabilitation centers in his home country of Uganda.
“When I wanted to stop drinking at around 25, the only option I had for help was the church. I thought then that if my only option was religion, I would rather just drink through my problem.”
Fortunately, Muhumuza’s mother worked at a medical facility and was able to provide medication while he attempted to stop drinking.
Muhumuza is fortunate. He is one of the few who managed to get treatment. For most, treating an addiction is either inaccessible or unaffordable.
<div id="attachment_33391" style="width: 235px" class="wp-caption alignleft"><img loading="lazy" decoding="async" aria-describedby="caption-attachment-33391" class="size-medium wp-image-33391" src="https://www.forbesafrica.com/wp-content/uploads/2017/09/Brian-Muhumuza-225x300.jpg" alt="" width="225" height="300" />Brian Muhumuza Photo supplied)</div>
Around 5% of the world’s adults, or nearly 250 million people between the ages of 15 and 64, used at least one drug in 2014, according to the latest World Drug Report released last year by the United Nations Office on Drugs and Crime (UNODC).
It reported that the number of people classified as suffering from drug use disorders has increased disproportionally for the first time in six years. There are now over 29 million people within this category (compared to the previous figure of 27 million). Additionally, around 12 million people inject drugs, with 14% of these living with HIV, according to the report which was released in June 2016.
<a href="http://www.forbesafrica.com/focus/2017/08/22/waste-doctors-waiting-tables-answering-phones/" target="_blank" rel="noopener">The Waste Of Doctors Waiting on Tables And Answering Phones</a>
The report highlights a strong link between poverty and drug problems. Indeed, the brunt of the drug use problem is borne by people who are poor in relation to the societies in which they live, as can be seen in stark terms in wealthier countries.
“The strong association between social and economic disadvantage and drug use disorders can be seen when analysing different aspects of marginalization and social exclusion, such as unemployment and low levels of education.”
The overall impact of drug use, in terms of health, continues to be devastating. We are constantly told that substance abuse is a major problem in society, and statistics are often rolled out to prove the point. But trying to track these down is extremely difficult.
South Africa is one of the few African countries to have a national drug policy and this is also reflected in the number of treatment centers in the country. The South African Community Epidemiology Network on Drug Use (SACENDU) tracks admission numbers at government and private rehabilitation centers in South Africa. The SACENDU Project is an alcohol and other drug (AOD) sentinel surveillance system in South Africa.
The system, operational since 1996, monitors trends in AOD use and associated consequences on a six-month basis from specialist AOD treatment programs. The first half of 2016 saw 10,540 patients across 82 centers/programs – up from 9,679 in the second half of 2015. At an average of 21,000 recorded patients a year, at a rough estimate of $1,800 per patient, the annual income earned by these centers is around $39,000. However, Johannesburg alone probably has about 50 treatment centers of various categories and these are always at capacity with around 20 to 40 clients per three-week treatment period. Additionally, patients are often admitted to hospitals and do not go on to enter rehabs, so estimates are largely irrelevant.
<a href="http://www.forbesafrica.com/woman/2017/04/01/death-comes-life/" target="_blank" rel="noopener">From Death Comes Life</a>
The latest research from the Medical Research Council (MRC), which has been published in the SA Medical Journal, indicated South Africa lost about $23 billion in 2009 as a result of alcohol abuse.
It said that about $3 billion of that was used to deal with the socials ills associated with alcohol. These include death, illness, disability, unintentional injury, including road traffic accidents, as well as crime. Healthcare services received the second biggest bill ($930 million), followed by social welfare, at $30 million, according to the MRC study.
South Africa has taken a strong stand on the issue. Nelson Mandela highlighted the problem during his inauguration speech as far back as 1994. South Africa at least continually revisits the issue through its Drug Master Plan. The last one covered the period 2012-2017, meaning that it is currently over five years out of date.
Unfortunately, no such reports or policy have been found from the African Union, meaning that one has to rely on international stats when reviewing the issues in Africa. Even in South Africa, the widely published figures have been challenged by Africa Check, the NGO that reviews widely quoted statistics or reports. It found that many of the figures used by government or research organizations could not be proven.
The organization referred to a June 2016 newsletter, that goes out to over 700,000 principal medical aid members of Tiger Brands, CompCare Wellness and the Government Employees Medical Scheme (GEMS), which alerted them to “shocking South African drug statistics”.
In the Heartbeat newsletter, South African medical insurance schemes administrator, Universal Healthcare, suggests that rampant crime and 15% of South Africans having a drug problem are related. It also stated that the country is home to “one of the world’s drug capitals” and that drug abuse costs the country R20 billion ($1.5 billion) a year. Universal Healthcare was asked for its sources but did not respond at the time of publication.
Africa Check says that the claim of 15% cannot be proven. It reports that South Africa has no regular representative surveys on substance abuse. There has only been one nationally representative epidemiological study of alcohol, drug and psychiatric disorders, carried out between 2002 and 2004, mainly to diagnose mental disorders in adults.
The study provided figures of lifetime prevalence for any substance use disorders, including alcohol. It showed that 13.3% of adult South Africans met the criteria for a substance use disorder, including alcohol, at some time in their life.
“Without alcohol, that figure dropped to around 4.5%,” Shaun Shelley, a research expert in the addiction division of the department of mental health and psychiatry at the University of Cape Town, told Africa Check. “Over a 12-month period, the figure was 5.8% (including alcohol disorders) and about 1.5% for drugs alone.”
<a href="http://www.forbesafrica.com/woman/2017/02/01/mercy-or-monster/" target="_blank" rel="noopener">Mercy Or Monster?</a>
Relying on anecdotal evidence of the issue also threw scant light on the problem. Drug treatment centers in South Africa, particularly Johannesburg, report a steady intake of addicts and alcoholics from across Africa, for those who can afford it as residential treatment facilities charge anywhere from $1,500 upwards for a 21-day stay. But no statistics are available.
Patients from Zimbabwe, Uganda and Mozambique, all explained that the only treatment facilities in their home countries were generally small, with a maximum of 10 to 80 beds, attached to the largest state psychiatric hospitals. Space is at a premium and facilities are harsh, although many report to have met caring and professional medical staff willing to provide help and support.
A Zimbabwean in treatment in South Africa said that, for the first time, a private rehab facility had opened in Harare in March this year. Zimbabweans, Angolans and Mozambicans most often seek treatment in South Africa but one person who has extensive knowledge of rehab facilities said that out of 40 to 80 patients – or clients as they are now known – only about one to three would come from elsewhere in Africa. It is also true that many foreigners travel to South Africa for treatment, given the favorable exchange rate, familiar languages and family connections. They are able to tell employers and friends that they are on holiday in Africa while receiving first-world treatment. Some luxury rehabs, mostly in popular tourist areas like Cape Town, charge up to $8,000 for a three-week stay.
Stepping Stones lists itself as a “luxury rehab” and quotes a figure of $5,500 per month on its website. White River Manor is quoted as charging $4,900 to $12,000 per month.
For most addicts, these prices, and recovery, are difficult to reach. &#8211; Written by Les Tilley

The High Price Of Addiction

It’s a familiar scene on a hot day in Accra, the capital of Ghana. The alleys are packed with women, carrying children on their backs, selling vegetables and fake Louis Vuitton bags while men sell anything they can get their hands on. Here, you could be sold a drug that could kill you.
The danger is counterfeit drugs that masquerade as healers but threaten to do the opposite.
Victoria Amponsah claims fake drugs almost robbed her of her unborn child like a thief in the night. The day she was diagnosed with malaria she also learned she was two months pregnant. She went to the nearest pharmacy, in Accra, and bought prescribed anti-malarial drugs she thought would save her and her child.
“That evening, I took the medicine. After about two to three hours, I started shaking and vomiting. I felt weak. I called a cotenant and showed her the drug and she said ‘I know this drug, its ok’. But when she [took out the pills from the box] she said ‘this is not the drug that is supposed to be in this box,’” Amponsah told the NGO, United States Pharmacopeia (USP).
&nbsp;
<div id="attachment_5209" style="width: 310px" class="wp-caption alignleft"><img loading="lazy" decoding="async" aria-describedby="caption-attachment-5209" class="size-medium wp-image-5209" src="/wp-content/uploads/2017/05/Bright_Pharmacy_Lonart_Phone_2015_hi-res-300x200.jpg" alt="" width="300" height="200" />Bright B. Simons is the brain behind mPedigree, a technology that&#8217;s used to counter counterfeiting of pharmaceutical products, wax prints and other products that are prone to piracy. Accra, Ghana.</div>
She was rushed to the hospital where a doctor confirmed the drug she took was fake. She managed to complete her pregnancy, but this was not the end of her struggle.
Near the end of her pregnancy, she almost died from a fake version of oxytocin, disguised in convincing packaging. Within 30 minutes of administration, Amponsah was sweating, shaking, vomiting and bleeding.
“I was bleeding so bad. [The doctors] were scared and didn’t want me to move,” she says.
She nearly lost her baby and was hospitalized for two days. For months later, she had to return to the hospital often, for checks.
“Sometimes I hear stories of a person who was fine, gave birth and the next minute the person has died and you find that they gave the person an injection and they died from it. I didn’t know it was that bad,” says Amponsah.
It is the poor, like Amponsah, that suffer. According to the Dutch Malaria Foundation, malaria is responsible for the death of one child dies every 45 seconds, but a third of malaria drugs sold in Africa are fake.
“My son was my biggest present; the center of my life. He is all I have… I am hoping that globally people understand that our lives are more important than the little money they will make out of bringing a fake drug out. [I hope] people will understand that it’s not all about money. It’s about life… the smallest thing, like just a tiny drug which is bad can cause so much damage in one’s life,” she says.
Amponsah and her son Denzel are among the few lucky ones. Over 30% of antimalarials in Africa contribute to nearly 450,000 preventable deaths each year, according to a report in the medical journal The Lancet. Fake tuberculosis and malaria drugs kill an estimated 700,000 people a year, according to the International Policy Network.
The manufacturers of this fake medicine make it look like the real thing. Mario Ottiglio, the Director of Public Affairs, Communications and Global Health Policy of the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA), says fake medicine thrives in countries with weak regulation.
“In areas of infectious disease, like malaria and tuberculosis, fake products with incorrect dosage of ingredients can result in antimicrobial resistance to genuine treatments. At a global level, analysis of reports over a five-year period, from 2005 to 2010, indicates that incidents of fake medicine increased by 122 percent, while diversion and theft increased by 66 percent,” says Ottiglio.
In 2009, 84 Nigerian children were killed by toxic chemicals that were laced with teething medications for babies. In 2012, Angolan custom agents busted counterfeiters importing what turned out to be one of the largest fake medicine imports in history, when containers shipped from China to Luanda, the capital of Angola, were filled with over 1.4 million packets of a fake version of the antimalarial drug, Coartem.
“In 2013, the World Health Organization (WHO) launched a global surveillance and monitoring system… Thus far, 48 percent of cases reported [to the system] have been in the African Region,” says Ottiglio.
A study published in the International Journal of Tuberculosis and Lung Disease found one in every six pills in Africa to be fake. Furthermore, a survey conducted by the National Institute of Health, which examined over 2,600 malaria drug samples across 21 sub-Saharan African countries, found 20% of these drugs were fake and a third were of poor quality.
Ottiglio says the first line of defence is to always buy medicine from licensed and certified sellers. People can check the packaging of the product for spelling mistakes or grammatical errors. Check for expiry dates and that the details on the outer package match up with the inner packaging. Those who are familiar with the medicine can check that the pill looks correct, is not discolored, degraded or doesn’t have an unusual smell.
Even with checks, there is still a problem. Some fake products are almost visually identical to the genuine ones. Often it’s difficult to tell the fake from the real thing.
Patrick Lukulay, Vice President of Global Health Impact Programs at United States Pharmacopeia, says during the outbreak of Ebola in Liberia, there were fake drugs on the market purporting to cure Ebola and people were attracted to them.
“The drugs most counterfeited though are lifestyle drugs such as Viagra and Cialis&#8230; Antibiotics and antimalarials are heavily counterfeited also because of demand for these drugs and the tendency for people to self-medicate. ARVs (antiretrovirals) are also counterfeited because of demand and the fact that people might seek to buy them in private settings for confidentiality purposes instead of getting them free from public facilities,” says Lukulay.
These drugs, according to Lukulay, are made in countries that have developed capacity for pharmaceutical manufacturing and packaging, such as India, China, Vietnam and Malaysia.
He says the ingredients used for fake drugs are usually cheaper versions of legitimate ingredients. An example is diethylene glycol, which is toxic but 10 times cheaper than the legitimate pharmaceutical grade ingredient, glycerine.
“They may also include impure cheap raw materials, such as over-sulphated chondroitin sulphate, the one found in blood thinner, heparin, a few years ago that killed people in the US,” says Lukulay.
<img loading="lazy" decoding="async" class="alignleft size-medium wp-image-5208" src="/wp-content/uploads/2017/05/20160801_091625-300x169.jpg" alt="" width="300" height="169" />
Unfortunately, the problem grows at an alarming rate. Lukulay estimates the counterfeit drug market is worth over $75 billion per year.
Like many problems in Africa, it is seen as an opportunity by private money.
In Ghana, entrepreneur, Bright Simons, says he has developed a program that is helping to curb the counterfeit drugs.
In 2007, he launched mPedigree, a company that has created software manufacturers can use to label their product packaging with a random code hidden beneath a scratch-off covering. If a consumer wants to know if their product is fake or not, they can just scratch off the covering and SMS the code to a toll-free number. They will then be notified whether the product is authentic.
Simons claims his services are used by around 100 million people per year in 12 countries, from India to Uganda.
“Our biggest frontier now is predictive analytics, in particular the use of our EarlySensor technology to predict hotspots and flashpoints of emerging counterfeit activity by looking at large data sets across time and space. If we can predict retail points that are likely to be targeted by counterfeiters by disrupting upstream distribution networks, we can actually stop counterfeiting from even getting to the level of the consumer,” he says.
This will help prevent the suffering that Amponsah experienced. She at least lived to tell her story; many more were not so lucky.

Tag: Drugs

FORBES AFRICA SOCIAL MEDIA

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Cure For Counterfeit Drugs?

The High Price Of Addiction

A Deadly $75-Billion Business