Medicines Counterfeiting in Africa: A View from Zimbabwe

Abstract

With the sprouting of unregulated outlets on the streets of Zimbabwe, common questions that are raised include: (i) what is the Medicines Control Authority of Zimbabwe (MCAZ) doing about these street vendors? and (ii) is the law against unregulated markets and proliferation of substandard and falsified (SF) medicines being actively enforced? There is no doubt that this is a new challenge for MCAZ because of the risks involved with SF medicines. Notwithstanding the rather strong regulatory framework for the regulated market that the MCAZ has major control over, and its demonstrable regulatory prowess over the last 20 years as a National Medicines Regulatory Authority (NMRA), MCAZ is increasingly challenged to take a leading role in addressing this rising phenomenon. MCAZ has attempted to address the problem through collaboration with the Zimbabwe Republic Police (ZRP), public education and inspections by port officials at ports of entry. However, the problem still persists. A general lack of concrete qualitative and quantitative data on the commonly encountered SF medicinal products on the Zimbabwe market is another major issue. This is evidently a multi-layered problem and as the Shona adage goes “chara chimwe hachitswanye inda” (loosely translated “one thumb cannot crush all lice”), there is need for engaging local and regional partners in a bid to fulfil the MCAZ's mandate of protecting public health by ensuring medicines and medical devices intended for sale and distribution in Zimbabwe, are safe, effective and of good quality.

Inappropriate Antibiotic Use in Zimbabwe in the COVID-19 Era: A Perfect Recipe for Antimicrobial Resistance

“…Strategies to curb the spread of SARS-CoV-2, such as international travel and trade restrictions at the onset of the COVID-19 pandemic, led to supply chain disruptions and pharmaceutical regulatory governance challenges that created opportunities for the increased influx of falsified, substandard drugs [ 23 , 26 , 27 , 28 ]. While the precise market share of informal street markets in low- and middle-income countries is unknown, a study in Nigeria suggested that more than 40% of rural communities consult and purchase drugs from street vendors for illnesses such as childhood fevers [ 25 , 29 , 30 ]. The use of counterfeit vaccines and antimicrobials leads to the development of new SARS-CoV-2 variants and the emergence of AMR.…”

The ghost in the data: Evidence gaps and the problem of fake drugs in global health research

“…Such exposure presents a major health challenge as the market is likely to be proliferated with SF [substandard & falsified] pharmaceutical products for major diseases such as antiretroviral therapy (ART) anti-tuberculosis (anti-TB), anti-malarial therapy and other essential medicines. (Gwatidzo et al, 2017 , p. 82)…”

“…For example, one paper paints a picture of how fakes – both medicines and non-medical products – were presented to inquisitive passers-by and presumably potential consumers: Such exposure presents a major health challenge as the market is likely to be proliferated with SF [substandard & falsified] pharmaceutical products for major diseases such as antiretroviral therapy (ART) anti-tuberculosis (anti-TB), anti-malarial therapy and other essential medicines. (Gwatidzo et al, 2017 , p. 82) Here, the possibilities of the market extend claims about fakes’ threat to health by using the extent of their reach (Hornberger, 2018 ) as indicative of ‘evidence gaps’. Similar claims were made about the absence of regulation in online markets (Interpol, 2014 ; see also discussion by Clark, 2015 ).…”

Advancing health system strengthening through improving access to medicines: A review of local manufacturing policies in Ghana

“…For example, when medicines are not affordable through the formal regulated health system due to prohibitive costs or lack of national health insurance schemes, patients will be driven to seek these through other routes, where regulatory oversight may be compromised and there is a greater risk that the medicine will be substandard or falsified. 14 This has been highlighted in Morocco where unaffordable medicines were implicated in driving medicine’s trafficking from Algeria and sold at markets, where the quality and validity were unknown. 15 …”