RISK DRIVERS OF FALSIFIED AND SUB-STANDARD MEDICINES IN EAST AFRICA: PERCEPTIONS AND PRACTICES OF PHARMACEUTICAL DRUG FACILITY OWNERS/EMPLOYEES (original) (raw)
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Counterfeit and substandard drugs in Tanzania: A review
2022
In several countries, counterfeit and substandard pharmaceuticals are a severe public health concern. This is a global issue, but it is especially prevalent in African countries, where more than 30 % of the pharmaceuticals supplied are counterfeit or substandard. Many reasons contribute to the emergence of this issue, which differ from country to country. Online business, light sanctions for drug infringers, ignorance, and an absence of meaningful collaboration amongst players are all variables involved. The Tanzania Food and Drugs Authority (TFDA), Tanzania Police Force, Weights and Measures Agency Tanzania Fair Competition Commission (FCC), Tanzania Bureau of Standards (TBS) and Tanzania Revenue Authority (TRA) Customs are all involved in the fight against counterfeit drugs in Tanzania. Despite this, more work needs to be done to control the supply of counterfeit and substandard pharmaceuticals, which have major health and economic effects. Based on the public health and economic consequences of these low-quality pharmaceuticals, strong international cooperation is required to address the issue. This includes tighter state licensing oversight of pharmaceutical suppliers. In order to identify these products at various supply chain stages, advanced technologies should be used. Finally, consumers must be educated on how to recognize counterfeit pharmaceuticals and their effects.
Open Journal of Pharmaceutical Science and Research, 2021
Background: Counterfeit medicines are drugs which are deliberately and fraudulently mislabeled with respect to identity and/or source. According to the WHO 2017 report, about 1% of prescribed medicines in the developed world and about 10-50% in parts of the developing world are estimated to be counterfeits. Objective: The objective of this study was to assess the knowledge and attitude of pharmacy professionals towards counterfeit medicines in Harar town. Method: A cross sectional study was conducted among pharmacy professionals found in Harar town, East Ethiopia. All pharmacy professionals working in community drug retail outlets of Harar town was included in the study. Accordingly, 92 pharmacy professionals were included in the study. The data was collected by using self-administered questionnaire. The questionnaire was prepared in English language. Data was coded, entered and analyzed by using Statistical Package for Social Science version 22. Then chi-square(x 2) test was performed to determine there exists association of so-cio-demographic characters, profession and year of service towards awareness and attitude about counterfeit medicines was investigated using. Result: A total of 92 respondents were included in the study. The majority, 76 (82.6%), of the study participants had information about counterfeit medicine. The 26(28.3%), 42(45.7%) and 24(26%) of the respondents replied that counterfeit medicines have problem of efficacy, safety and cause economic problem on sellers of genuine drugs respectively. Majority of the study of the study participants were not aware of a way of identification of counterfeit medicines, with only 18(19.6%), 47(51.1%) and 27(29.3%), replied that counterfeit medicines can be identified by its effect, inspection and cost respectively. Majority of the respondents, 60(65.2%), responded that pharmacy professional that knowingly dispense counterfeit medicine are business man /women. Most of the respondents , 66(71.7%), replied that pharmacy professionals carry out the business of counterfeit medicines transaction because of big profit obtained from such an activity. gender, profession and year of service in serving as pharmacy professional was found to be significantly associated with awareness towards counterfeit medicines, (p<0.05). Conclusion: Significant proportion of the study participants were not aware of the problems associated with counterfeit medicines as efficacy, safety and economic problems. Majority of the respondents still are unaware about ways of identification of counterfeit medicines as inspection, by efficacy and cost.
BMC Health Services Research, 2011
Background: Recent investigations by the Ministry of Health of Cambodia suggest that counterfeit medicines have been introduced into the pharmaceutical market in tampered packaging. To further explore this possibility, an interview survey was conducted at the wholesaler level to investigate the medicinal supply chain in Cambodia. Methods: Managing executives of 62 (83.8%) registered wholesalers of modern medicines in Cambodia were interviewed in 2009 on their knowledge of, perception on, and practices related to counterfeiting issues through a semi-structured questionnaire. Results: According to our findings, 12.9% of the wholesalers had encountered counterfeit medicine. However, they demonstrated a variety of perceptions regarding this issue. A majority (59.7%) defined counterfeit medicines as medicines without registration, while other definitions included medicines that were fraudulently manufactured, medicines without a batch/lot number, those containing harmful ingredients or a reduced amount of active ingredients, and expired medicines. Additionally, 8.1% responded that they did not know what counterfeit medicines were. During procurement, 66.1% of the wholesalers consider whether the product is registered in Cambodia, while 64.5% consider the credibility and quality of the products and 61.3% consider the reputation of the manufacturers. When receiving a consignment, 80.6% of wholesalers check the intactness of medicines, 72.6% check the specification and amount of medicines, 71% check Cambodian registration, 56.5% check that the packaging is intact, 54.8% check batch and lot numbers, 48.4% check the dates of manufacture and expiration, and 9.7% check analytical certificates. Out of 62 wholesalers, 14.5% had received medicines that arrived without packages or were separated from their packaging and had to be repacked before distribution. Significant statistical association was found between wholesalers who received medicines separately from their packs/containers and who consider their belief on reliability of pharmaceutical products of certain manufacturing country during procurement (Chi-square: 12.951, P = 0.002). When wholesalers divide medicines from larger packs into smaller ones, 54.8% use packaging purchased from local markets. Conclusion: A number of wholesalers think counterfeit medicines are medicines without registration, and/or do not have any uniform ideas on the issue and what to do, when they find or suspect counterfeits. Furthermore, their strict adherence to anti-counterfeiting measures is urgently needed.
Background: The proliferation of counterfeit drugs is of public health concern and worthy of discourse. Aim: The aim of the study is to assess the perceived factors affecting the distribution of counterfeit drugs in community pharmacies in Calabar municipality. Methodology: This study is a cross sectional descriptive study that employed the use of closed ended pretested questionnaire for the collection of data. Data was analyzed using the SPSS 20.0. Results: Findings show that 23(74.2%) of the respondents were males while 8(25.8%) were females. Majority of the respondents 28(90.8%) were community pharmacist, 2(6.5%) nurses and 1(3.2%) pharmacy technician. Findings show that about 58% of purchase of drugs is been determined by the medical/pharmacist representative while 42% of drugs purchased is been determine by the distributor. Majority of the respondents 19(61.3%) buy their drugs from medical /pharmacist representative. Respondents were able to detect counterfeit drugs through: customers report (19%), close scrutiny (32%), regulatory officials (13%) and news/company alerts (36%). Poverty 10(32%), greed 6(19%), heavy taxes/VAT on drugs 5(16%), government policies towards health care delivery 5(16%), and poor implementation of relevant laws by government agencies 5(16%) were factors identified as responsible for proliferation of counterfeit drugs. Conclusion: Poverty is a significant factor responsible for the proliferation of counterfeit drugs. The most common means used by community pharmacists to identify counterfeit drugs are scrutiny and news/alerts. There is need to create more awareness, and seek collaboration with community stakeholders in the fight against counterfeit drugs.
REGULATION OF MEDICINES IN SOUTH -WEST NIGERIA: COUNTERFEIT ERADICATION STRATEGIES AND CHALLENGES
The African Journal of Qualitative and Mixed-Methods Research (AJQuM-MR, 2021
Despite the regulation of medicine by NAFDAC, the magnitude of circulation of counterfeit and substandard medicines is still of great concern due to its serious effects on the health and general wellbeing of Nigerians. This study examined the regulation of medicines before and after the establishment of NAFDAC, the challenges faced in curbing counterfeit and substandard medicines and how NAFDAC handles the challenges. The study adopted the mixed-method approach using explanatory concurrent mixed-method design. Multistage sampling procedure was employed to select pharmacists, patent medicines, vendors and NAFDAC staff in the SouthWest , Nigeria. Data were collected using Counterfeit Medicine Eradication Activities Questionnaire (CMEAQ; r=0.87), Key Informant Interview Guide (KIIG) and Documents. The credibility of the KIIG was obtained using the expert judgment. Findings reveal that imported medicines were regulated through the medicine labels while the standard of locally made medicines was monitored by the Pharmaceutical Board of Nigeria. Also, there have been proliferations of counterfeit medicines before establishing NAFDAC. Unfortunately, the phenomenon appears to persist with more sophistication despite NAFDAC efforts at curbing the hazardous trend. Drastic steps are being taken by the organisation in order to safeguard the health of Nigerians.
medRxiv, 2020
Background: Counterfeit medicines (CFMs) are a global problem with significant and well-documented consequences for global health and patient safety. Pharmacists, as healthcare professionals, have a vital role in combating CFMs via ensuring the effectiveness and safety of any imported and dispensed medicines. Objectives: The aim of the present study was to assess the extent, awareness and attitude of pharmacists in Sudan towards CFMs. Methods: A cross-sectional study was conducted applying pretested and structured questionnaire and the awareness and attitude were assessed statistically. Results: A total of 229 participants have enrolled in the study. The majority of the respondents (76%) were found to be aware about the term CFMs during practice. 59% reported their ability to distinguish CFMs from the packaging feature and cost. Unavailability of medicine and inadequate regulatory bodies control were mentioned as the main leading factors for the spread of CFMs. 86% of the respondent...
Counterfeit drugs and medical devices in developing countries
Research and Reports in Tropical Medicine, 2014
The World Health Organization has reported that counterfeit medicines potentially make up more than 50% of the global drug market, with a significant proportion of these fake products being encountered in developing countries. This occurrence is attributed to a lack of effective regulation and a weak enforcement capacity existing in these countries, with an increase in this trade resulting from the growing size and sophistication of drug counterfeiters. In addition, due to both cost and lack of availability of medicines, consumers in developing countries are more likely to seek out these inexpensive options. The World Health Organization is mindful of the impact of counterfeit drugs on consumer confidence in health care systems, health professionals, the supply chain, and genuine suppliers of medicines and medical devices. Antibiotics, antituberculosis drugs, and antimalarial and antiretroviral drugs are frequently targeted, with reports of 60% of the anti-infective drugs in Asia and Africa containing active pharmaceutical ingredients outside their pharmacopoeial limits. This has obvious public health implications of increasing drug resistance and negating all the efforts that have already gone into the provision of medicines to treat these life threatening conditions in the developing world. This review, while focusing on counterfeit medicines and medical devices in developing countries, will present information on their impact and how these issues can be addressed by regulation and control of the supply chain using technology appropriate to the developing world. The complexity of the problem will also be highlighted in terms of the definition of counterfeit and substandard medicines, including gray pharmaceuticals. Although this issue presents as a global public health problem, outcomes in developing countries where counterfeit drugs to treat malaria, tuberculosis, and human immunodeficiency virus/acquired immunodeficiency syndrome not only result in drug resistance, but a number of deaths from the untreated disease, is in stark contrast with the developed world, where lifestyle drugs such as sildenafil (Viagra ®) are most commonly counterfeited.
Journal of Public Health Policy, 2013
Falsified and substandard medicines present serious concerns for public health. We describe an event that occurred in late 2011 involving falsified antiretroviral medicines found in the supplies of Médecins Sans Frontières (MSF) projects in Kenya. We discuss factors contributing to these falsified medicines entering the supply chain as well as the response by MSF and others. We make recommendations to help defend against future episodes of entry of falsified medicines into the supply chain as well as comments on appropriate responses in cases of falsified medicines.
Counterfeit medication: Perception of doctors and medical wholesale distributors in western India
Journal of International Society of Preventive and Community Dentistry, 2015
Background: Fake drugs and active pharmaceutical ingredients most often originate in emerging industrial economies before entering the global market. Health care workers play a crucial role in detecting and preventing the distribution of counterfeit medicines. Aim: The present study was conducted to assess the knowledge, attitude, and practice of doctors and medicine wholesale distributors regarding counterfeit medication in western India. Materials and Methods: A cross-sectional questionnaire survey was conducted among 300 participants consisting of 100 medical practitioners, 100 dental practitioners, and 100 medical storekeepers. Results: It was observed that medical practitioners had more knowledge, followed by medical storekeepers and dental practitioners (mean 2.82, 2.52, and 2.37, respectively). Dental practitioners had the best attitude, followed by medical practitioners and wholesale distributors (mean 1.77, 1.76, and 1.55, respectively). Best practice behaviors were observed in medical storekeepers followed by medical practitioners and dental practitioners (mean 1.46, 1.29, and 1.12, respectively). Conclusion: The study points out the need for designing and implementing continuing educational programs and enforcement of vigilant laws.
International Journal of Scientific Research in Education, 2020
Medicine counterfeiting is a global public health problem, because the effects can be felt by both the country of manufacturer to the recipient countries. This study investigated pharmacist and patent medicine vendors' perception of NAFDAC activities to combat the sales of counterfeit and substandard medicines. Purposive sampling technique was used to select Oyo, Lagos and Ogun States in the southwest geopolitical zone. The psychometric properties of the instrument were established through face validity and expert judgement. The result shows that NAFDAC carry out routine visit to most of the pharmacies at least once in a year except few pharmacies they rarely visited. The study reveals that majority of the patent medicine sellers were rarely visited. Moreover, the study affirms that pharmacists' and patent medicine vendors supported the view that NAFDAC has been very effective in their work and their work has reduced the proliferation of counterfeit and substandard medicines.