BlessWorld Foundation International

The increase in Substandard and falsified medical products is a growing public health concern that is not always in the public’s mind. It is always assumed that all health products affect health positively but that is not always true. Just as there are fake gold necklaces and adulterated fruits, there are also substandard and fake medical products. Drugs are by far the most common medical products implicate as well as vaccines and in-vitro diagnostics. Drugs come in either brand or generic forms; the brand forms are made and sold exclusively by the producer while the generic forms can be produced and sold by any manufacturer. Unlike other products that their generic forms are poor, generic drugs actually do very well when compared with their brand counterparts as they contain the same active substances and ingredients. However, brand drugs are far more expensive due to their strict monopoly and exclusivity. It is due to this price difference that insurance companies continue to advocate for the use of generic drugs to help improve drug coverage not only in low and middle income countries but also in developed countries. Furthermore, this price difference also accounts for the safety of brand drugs and is why the vision of improved drug coverage have been sabotaged by substandard and fake drugs.

Substandard drugs are drugs that fail to meet quality standard or specifications due to poor production practices or storage procedures. There are common thoughts that brand drugs are never substandard and that generic drugs are all substandard but that is actually not true. Some brand drugs, no matter how expensive they are sold, can be substandard. The problem with generic drugs is that the manufacturers (particularly those in China and India) tend to send their higher quality generics to developed nations like Canada and the United States while they sell poor quality drugs to developing nations like Nigeria. The ideal is that generics should be as effective as brand drugs. Sometimes, substandard dugs are released by mistake and then subsequently taken out or recalled voluntarily by the pharmaceutical company unlike fake drugs. Fake drugs are not even drugs in the true sense and its production is a pharmaceutical crime. They are drugs and pharmaceutical products that are deliberately and fraudulently falsified products which do not represent their identity, composition or source and are produced for monetary gains. Whether substandard or fake, these drugs pose significant limitations to the realisation of the SDG 3 which aims to achieve universal health coverage, including access to essential medicines and vaccines. This problem is not only faced by developing, low and middle income countries because of their poor drug regulation and poor access to care, but every country and every one is a potential target due to online marketing.

The impacts of accidentally using substandard or fake drugs are glaring. Some of the resulting problems include treatment difficulties, non-responsiveness to health care, adverse reactions, dissatisfaction with drugs and death. In countries where these drugs are very common, many patients have died of treatable infections due to poor activity of these drugs since antibiotics are mostly involved. This can be really frustrating for doctors who sometimes question their diagnosis or drug recommendation and may even increase doses to over 10 times what is considered normal with no perceived effect. In addition, the poor activity of these drugs ends up worsening the problem of antimicrobial resistance since not all organisms are wiped out. More so, some of these products can contain substances that can harm an individual; there have many cases of drugs contamination with toxic substances.

The availability and sale of substandard and fake drugs is a life-threatening problem and must be tackled as a priority. This must be taken seriously by all governments and followed with proper legislative actions including clear and hefty punishments on offenders. There should increase in drug surveillance and these bad drugs should not just be seized but traced back to the source and disciplinary action carried out by responsible regulatory agencies. Currently, there are already very efficient means of detecting these drugs such as scanning of codes or product labels but they are mostly in developed countries. Improved and effective communication between clinics, local and national regulatory agencies and pharmaceutical companies would also help increase surveillance. Finally, we must learn to be careful ourselves and know that these medicines are capable of causing severe harm… always remember to:

• Check if the production and expiry dates of the inside and outside packaging match
• Examine the packaging for spelling mistakes and errors
• Make sure the medicine is not disclosed and doesn’t smell unusual
• Report adverse reaction to your doctor
• Report suspicious products to regulatory agency

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