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HEALTH: Uganda Authority Finding Less Counterfeit Drugs

Rosebell Kagumire

KAMPALA, Jul 29 2010 (IPS) - Uganda’s National Drug Authority (NDA) says the failure rate among samples of medicines tested at their laboratories has fallen by 15 percent from the early 2000s. This serves as a possible indication of a drop in the availability of counterfeit medicines in the East African country.

According to the NDA registrar, Apollo Muhairwe, the work of the drug authority at border points has ensured that fewer counterfeit medicines make it into the Ugandan market.

“We have put measures in place during the last 10 years that have worked. Now we have embarked upon raising awareness among Ugandans to only buy their drugs from accredited outlets,” Muhairwe told IPS.

Counterfeit medicines can be both branded and generic medicines and refer to drugs without the necessary ingredients to treat the disease it is fraudulently purported to treat. Such drugs include anti-malarials, antibiotics and sexual stimulants.

But much as the NDA applauds itself on improving controls over counterfeits, the number of Ugandans exposed to counterfeits remains high.

It is estimated that at least 53 percent of the population lives within in a radius of less than five kilometres from a public health facility, with a range of between nine percent in parts near the northern border with Sudan to 100 percent in the capital Kampala.

According to the NDA, the country has over 5,000 “drug shops” (small-scale medicine retail outlets) and about 500 registered pharmacies, most of which operate in urban areas.

Sandra Jaclyn Kiapi, a health rights advocate, told IPS that the NDA’s work at ports of entry does not mean Uganda is close to being free from counterfeit medicines.

“The NDA is mostly Kampala-based. Their capacity is still weak. I think that may be the reason why the NDA was at first overlooked when the Counterfeit Goods Bill was drafted – that is, until civil society intervened,” said Kiapi.

The Counterfeit Goods Bill has caused an outcry in the east African state because of its conflation of legitimate generic medicine with counterfeit medicine.

“Most of the times counterfeit drugs were discovered at the border. What about the people out there in rural Uganda who are consuming pharmaceuticals?” Kiapi asked. “Is the NDA also active from the border with Sudan to the border with Rwanda?”

Swaibu Mukiibi, a pharmacist, told IPS that he still comes across counterfeit drugs at his practice.

“We have to admit that there are still counterfeits. Our borders are porous and many of our people don’t know how to detect such fakes. To a large extent only pharmacists would be able to detect counterfeits from physical appearance; other practitioners may not be able,” explained Mukiibi.

The Counterfeit Goods Bill is partly controversial because it assigns customs officials the duty of deciding whether drugs are counterfeit or not.

Mukiibi said the limited number of pharmacists in the country makes the situation worse. Ugandan pharmacists mostly operate in urban settings. With Uganda importing about 90 percent of the medicines consumed in the country, coupled with poorly trained or untrained drug dispensers, the issue of counterfeits is far from being resolved.

The NDA believes the solution lies in accrediting all pharmacies and drug shops across the country, an initiative that is underway.

“We have already started a project in Kibale district to ensure all drug shops are assessed and authorised,” said Muhairwe. “In other areas where people have to walk miles to get to facilities we are encouraging people to start drug shops.”

A 2002 Pharmaceutical Sector Baseline Survey found that only 47 percent of surveyed public health facilities had more than 75 percent of key medicines available. Though the situation has improved, most Ugandans buy medicines out of pocket.

The NDA also raises awareness through the use of SMS campaigns. In a country where more than five million people have mobile phones, the campaign promises to reduce the number of Ugandans buying counterfeit medicines.

The SMS initiative, launched in October 2009, seeks to convince Ugandans to buy drugs only from pharmacies and drug shops accredited by the NDA.

Spokesperson for the NDA Fredrick Ssekyana told IPS the project has grown in the last three months with the extension of services outside urban areas.

“Ugandans in hard to reach places are more vulnerable to unscrupulous traders in medicines because of fewer drug shops being around,” said Ssekyana. “We are therefore extending the accreditation of pharmacies and drug shops in those areas with the SMS campaign to make known places with safe medicine.”

At the beginning of the year only about 150 Ugandans sent messages to inquire about the places to buy safe medicine but with the move to include rural Ugandans the authority now gets over 1,000 messages per month.

Using a mobile phone, a Ugandan in any part of the country can send a message to the NDA to get the name of the pharmacy or drug shop that stocks a particular medicine or food supplement. The service also has also been extended to condoms.

The only sure way of eliminating counterfeit drugs lies in cutting off the demand from unsuspecting Ugandans.

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