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Countering the counterfeiters

In Africa, counterfeit medicines account for around 10 to 30% of products sold, but this figure is only an estimate. Getting the true figure is nearly impossible since the counterfeiters are constantly changing their methods to avoid detection. Combating these potentially dangerous counterfeit medicines on a continent with little healthcare infrastructure required innovative thinking. How could we protect patients who rarely - if ever - saw a doctor?

It became a question of coverage and reach. In Africa the reach of the national media is low, especially in remote villages, so it would be hard to get the message out to enough people through advertising or publicising in print, TV or radio. There needed to be an interactive element as well, so that a patient could verify if the medicine they had bought was genuine. The answer - with nearly 50% coverage across the entire African population - lay in mobile phones.

In February 2011 we began using text messaging as part of a six-month pilot anti-counterfeiting programme in Nigeria with one of our antibiotics. Run in collaboration with Nigeria’s National Agency for Food and Drug Administration Control (NAFDAC), the pilot involved scratch-off codes on the back of the antibiotic packets. 

A person could send the code via a text message to a central NAFDAC toll-free phone number, where the code would be checked against a list of actual codes. The mobile service would then text back with a verification – or other - to the consumer. There was also a toll-free phone number for consumers to call if they had any questions.

The response from consumers was enthusiastic: in all, we received 145,000 texts from 115,000 unique users. This means that about 10% of the packs bought were verified by using this text service. Ninety per cent of texts returned a confirmation that the medicine was genuine, 2.5% received a counterfeit alert.

More than 2,360 calls were made to the helpdesk, some of which helped us identify counterfeit blister packages in the Nigerian market.

Counterfeit medicines are not only illegal, they are also dangerous. Counterfeiters concern themselves only with perfecting the outward appearance of their fake medicine - to mimic the real thing as closely as possible. What goes inside is of little or no concern at all.

What actually goes into these fake pills can cause health problems. Aside from having little or no active ingredients (i.e. the actual medicine), other ingredients that have been found in the fake medicines include metals such as mercury, uranium and arsenic, and poisons such as boric acid and antifreeze.

The problem is global but most acute in the developing world, where regulation and law enforcement capacity is relatively weak. In 2009, 20 million counterfeit and illegal medicines – including pills, bottle and sachets - were seized in a five-month operation by Interpol across south-east Asia.1

Following the success of the pilot, we are rolling out our text-messaging programme to other products and countries in east Africa, including Tanzania. We have also just introduced the system in Kenya.

1 World Health Organisation: http://www.who.int/bulletin/volumes/88/4/10-020410/en/index.html

Updated on 12 December 2012: The anti-counterfeiting programme in Nigeria has won an Institute for Safe Mediciation Practices 2012 Cheers award. The awards honour organisations and companies that have set a standard of excellence in the prevention of medication errors and adverse events.

Key fact

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    In 2009, 20 million counterfeit and illegal medicines we seized in a five-month operation by Interpol