Health

Counterfeit drug threat

BY DRS CAMEIL WILSON-CLARKE
& JACQUELINE
CAMPBELL

Sunday, June 10, 2018

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RECENT news reports have stated that Counter-Terrorism and Organised Crime detectives have made a remarkable discovery which shows that thousands of Jamaicans are at risk as the counterfeit drug market trade has been aggressively targeting the island as a place of business.

Counterfeit drugs threaten the health of millions of people living in developing countries like Jamaica.

According to the World Health Organization (WHO), “A counterfeit drug is one which is deliberately and fraudulently mislabelled with respect to identity and/or source and may include products with the correct ingredients but fake packaging, with the wrong ingredients, without active ingredients or with insufficient active ingredients.”

Contrary to popular opinion, the practice of counterfeiting is applicable not only to brand name drugs, but also to generic drugs, over-the-counter preparations and traditional remedies.

The counterfeit products usually have no active pharmaceutical ingredient (API), incorrect amount of API, inferior quality of API, and incorrect API or contaminants. The products may be incorrectly formulated and produced under substandard conditions. They may be composed of repackaged, expired products or be sold in fake packaging. Some constituents found in counterfeit products include bacteria-laced water, floor wax, powdered cement, boric acid, and antifreeze.

Individuals who receive a counterfeit drug are exposed to a multiplicity of risks. These risks include unwanted adverse effects; loss of confidence in health care professionals, including their physician and pharmacist, modern medicine or the pharmaceutical industry; lack of trust in the government and other agencies.

The falsification of medical products dates to 1500 BC, when Queen Hatshepsut of Egypt hired a team to go hunting for genuine medicinal plants because the market was flooded with worthless fakes. Stories of substandard and fabricated/falsified medicines have frequently graced our history books and our culture.

During the 2014 chikungunya outbreak in Jamaica, there were reports of individuals selling grated avocado (pear) seeds deliberately mislabelled as Bissy (Cola acuminata, a medicinal herb known and widely used for its effectiveness against poisons). Avocado seeds contain a small amount of a toxin, persin.

Recent efforts by the World Health Organization and other organisations to support countries in tracking and reporting substandard and falsified medical products indicate the production, distribution and utilisation of counterfeit drugs is on the rise.

The Counter-Terrorism and Organised Crime Investigation Branch recently held a workshop to highlight the issues affecting Jamaica. For smaller and poorer economies, globalisation and e-commerce have increased the complexity of the supply chain for medicines, providing numerous entry points for unethically and illegally produced medical products.

The challenge for developing countries like Jamaica is that they do not possess the infrastructure and human capacity to effectively manage all ports of entry to prevent or minimise the threat to individuals and society.

The production, distribution and utilisation of counterfeit drugs has implications for public health and trade relations. Pharmaceutical companies are not only concerned about loss of revenue, but also about the damage to patients' and physicians' confidence in legitimate products if ineffective or dangerous copies are in circulation. These pharmaceutical companies may decide not to sell in our region as the negative effects of these counterfeits may destroy their image and distort the information sent to WHO relating to adverse effect reporting and pharmacovigilance.

The Ministry of Health and its support networks across the region and globally need to continually strengthen anti-counterfeiting measures at a policy level.

It is essential that a multifaceted approach be used to control the problem of counterfeit drugs.

Within Caricom, Caribbean Public Health Agency can support governments by providing laboratory infrastructure that continually monitors the quality, purity and potency of manufactured medicinal products using recognised international reference standards.

If we fail to act, it will result in serious implications for public health safety.

Dr Cameil Wilson- Clarke is a clinical pharmacist and university lecturer. She is a member of the Pharmaceutical Society of Jamaica. Dr Jacqueline E Campbell is a family physician, university lecturer and pharmacologist. She is the author of the book “A patient's guide to the treatment of diabetes mellitus.”

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