MORE than 122 000 children from Africa die every year as a result of sub-standard anti-malarial drugs alone, says the World Health Organisation (WHO).
Counterfeit or sub-standard drugs are medicines that may be contaminated or contain the wrong or no active ingredient.
And these fakes can find their way into pharmacies, clinics and street vendors’ stalls as well as be sold online via thousands of unregulated websites.
In fact, it is estimated up to one-third of medicines used in Africa are of poor quality or fake.
In effect, this means many Africans have more than a 30 percent chance of getting medicines that are partially effective, completely ineffective, or downright harmful to their health.
The Lancet Commission on Essential Medicines, in its recent report called for urgent reforms to curb counterfeit drugs from reaching developing countries.
The commission comprising 21 international experts said persistent problems with the quality and safety of medicines in many low and middle-income countries must be addressed with better regulation and with urgency.
Counterfeit and sub-standard medicines are contributing to the rise of drug-resistant strains of deadly diseases such as malaria, tuberculosis and common infections.
When medicines contain too little or no active ingredient, they do not fully kill the disease-causing bacteria or parasite, leaving a resistant strain to multiply within the infected individual – and likely infect others.
The development of drug resistance will ultimately make even high-quality medicines ineffective over time, posing a major threat to global public health.
Sometimes counterfeit drugs contain a number of harmful or poisonous chemicals such as boric acid, floor polish, nickel, leaded highway paint, heavy metal, brick dust and arsenic, to name but a few.
Counterfeit and sub-standard medicines are so pervasive because, unfortunately, they are difficult to detect, particularly in low-resource settings in Africa.
Many governments have quality standards in place but are ultimately unable to enforce them.
Customs procedures are often quite lax, and most regulatory agencies and laboratories simply do not have the equipment or the technical skills required to conduct rigorous quality control tests.
Corruption is also to blame, with some Government Ministers allegedly often appropriating expired subsidised medicines and inspectors accepting bribes to turn a blind eye to fake shipments.
Some people involved in the fight against counterfeit drugs have also complained about the light sentences for those prosecuted.
In Zimbabwe, despite the fact that Government in February this year introduced Statutory Instrument 68 of 2016 that controls the import of drugs, counterfeit and sub-standard drugs still find their way into the country.
Among the restricted medicines were aspirin and caffeine tablets, cotrimoxazole, ibuprofen tablets and capsules, paracetamol tablets, amoxillin tablets and sodium chloride.
But smuggled ibuprofen, cotrimoxazole, anti-retroviral (ARVs) drugs, sedation drugs such as diazepam and cough syrups such as broncleer, histalix have flooded the informal market.
Many of the drugs on sale are sub-standard or fake.
Late last year, the Zimbabwe Republic Police (ZRP) in conjunction with Interpol seized about 424 000 tablets including fake ARVs and cough syrups.
A bogus doctor operating a clinic in Karoi and dispensing unregistered drugs was also arrested during that operation.
Last week, the Medicines Control Authority of Zimbabwe (MCAZ) warned of an increase in counterfeit veterinary drugs.
MCAZ senior regulatory officer, Zivanai Makoni said the smuggling and selling of fake veterinary drugs had resulted, in some instances in cattle dying after the drugs have been administered to them.
Makoni said the smuggling of the fake drugs is rampant in Gokwe, Harare, Karoi and Masvingo, where they are being sold openly to unsuspecting farmers.
It is estimated that around 80 percent of all pharmaceuticals in Africa are imported.
And many of these counterfeits drugs have been traced to India and China.
Some sources say 35 percent of Indian drugs are sub-standard, but this figure has not been ascertained by WHO.
And Zimbabwe, in particular, before the import ban largely relied on imported drugs from India and its drug bill from that country rose from US$14 million in 2008 to more than US$50 million in 2013.
To fight against counterfeit drugs, WHO Africa Region in August this year proposed a strategy aimed at strengthening National Medicine Regulatory Authorities (NMRAs) to ensure that only safe, good quality and effective medical products are available in African countries.
“By 2018, countries are expected to ensure that a regular surveillance of all medical products circulating on the market is carried out,” said WHO regional director for Africa, Dr Matshidiso Moeti.
“During the same time frame, it is recommended that countries have access to certified quality control laboratories and embark on joint reviews of applications for clinical trials.
“By the same period, application for clinical trials or marketing authorisation of medical products should take a maximum of six months.
“Every two years there will be an assessment of how countries are implementing the strategy based on a set of agreed indicators.”
However, this still comes back to the issue of lack of resources for some African countries.