Patients’ access to safe and quality drug products is currently very limited in Africa, leading people to buy and make use of dangerous, substandard or falsified medicines. Such medicines are widely sold by vendors on the streets, which can have fatal consequences.
Political leaders of seven African countries signed the Lomé Initiative, a declaration to establish strict legislation that would criminalize trafficking of fake drugs and enable the states to coordinate to fight this market, which, according to the World Health Organization (WHO), is estimated to be worth $200bn (€180bn).
The Initiative was developed and coordinated by the Brazzaville Foundation, a UK-based, non-profit charity organization. During the signing ceremony event that took place the past weekend in Togo, West Africa, in-PharmaTechnologist spoke with David Richmond, the CEO of the foundation, regarding the effort to improve African patients’ access to quality medicine.
“Apart from a sufficient regulatory framework to tackle fake drugs, countries also need to be able to ensure supply of good quality products, and that can be achieved through the development of local or sub-regional production,” Richmond told us.
According to the executive, African countries currently import nearly all of the drug products needed, giving a ‘major opportunity’ for smugglers to disrupt the supply chain and introduce their fake drugs.
“If there was more production within the region, it would be easier to control and put surveillance on the shorter supply chain, and the cost of the medicines would be significantly decreased” Richmond explained, adding that this is where the pharmaceutical industry could play an important role in helping Africa.
Richmond clarified that the production could be focused on generic drugs, which are suitable to cover most of the healthcare demands in the continent.
Substandard or falsified medicine can also be found to be provided in healthcare settings such as hospitals and pharmacies, according to Richmond, a fact that also proves the vulnerability of the supply chain on the continent and the poor-quality control processes.
Asked about whether the Brazzaville Foundation has been in touch with representatives of the pharmaceutical industry regarding increasing the local manufacturing operations, the organization’s CEO replied that such discussions have not been initiated, due to the strengthening of legislation being a priority and a precondition to these talks.
Support from the WHO
In his speech during the ceremony for the signing of Lomé Initiative, Tedros Adhanom Ghebreyesus, the director-general of the WHO, stated that traffickers see Africa as a ‘dumping ground’ for fake drugs, and this is also due to the lack of affordability of genuine medicine.
“Strengthening the legal response [by criminalizing trafficking of falsified medicines] is important, but we must also do more. As we work to cut the supply of these medicines, we must address the demand by ensuring people have access to medicines they can trust,” he stated.
“Substandard and falsified medical products only exist because access to quality, affordable medicines does not. Our biggest challenge is to ensure that people have access to high quality affordable medicines,” he continued.
In-PharmaTechnologist discussed with Adhanom, after the signing of the Initiative, the establishment of a productive drug manufacturing industry in Africa, which would help to reduce the importation rates, along with the risks of disruption within the supply chain.
“Local production is actually one of the strategies that we are preparing to improve affordability and access to safe and quality medicine,” Adhanom told us.
He added that the WHO puts effort to help African countries move in that direction, as well as to support the operations of the African Medicines Agency (AMA), once this is established.
A treaty for the establishment of the AMA, which would be the African equivalent of the European Medicines Agency, in charge of the evaluation and supervision of medicinal products, was adopted by the African Union Heads of State and Government during their 32nd Ordinary Session of the Assembly, in February 2019.
However, for the regulatory body to be established and operational, the treaty needs to be ratified by fifteen African Union Member States, which, to date, has not been achieved.
Asked about whether the WHO is also in talks with the pharmaceutical industry to encourage investments that would lead to increasing manufacturing activity in Africa, Adhanom told us that “we encourage the countries to work on that.”
“The duty of attracting investment is the states’ responsibility, therefore we leave it up to them. However, we provide them with the technical support required in order to make that happen,” he added.
Adhanom told us that many African states are interested in the topic and willing to build on their own manufacturing capabilities. Additionally, there are ongoing efforts from the countries to invest in their local production of medicines and attract foreign investment for that purpose.