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GHANA: Struggle to Prevent Import of Counterfeit Drugs

Francis Kokutse

ACCRA, Aug 25 2011 (IPS) - Counterfeit medicines have flooded the market in Ghana and have even made their way into government hospitals as the country’s drug regulator struggles to control the importation of drugs.

The president of the Pharmaceutical Society of Ghana, Alex Dodoo, said the country’s Food and Drugs Board (FDB) is not a stringent regulator when it comes to the care and management of medicines in Ghana.

Dodoo said fake medicines have found their way into public hospitals as there have been instances where patients on effective antibiotics did not get well until there was a change in the brand of drug administered. This clearly showed that the first line of treatment used had been counterfeit drugs.

He says this has happened because the gangs smuggling the counterfeit drugs into the country have even been able to infiltrate the hospital supply chain.

However, Dodoo says he has no statistics of the number of times this has occurred.

“Unfortunately, these things are not being documented to find out what went wrong so that a clear picture could be seen of the extent of the damage that fake medicines have on patients in the health care delivery system,” he added.

“Importation of medicines is only allowed through the Kotoka International Airport in Accra and the Tema Harbour near Accra, to ensure that only quality medicines enter the country,” the Ministry of Health’s Director of Pharmaceutical Services Martha Gyansa-Lutterodt said of the country’s drug import laws.

“But we have realised that a lot of fake medicines, especially from Nigeria, have found their way into the country because of the porous nature of our land borders,” Gyansa-Lutterodt admitted.

The situation is becoming serious as the FDB, has been forced, over the past two years, to intensify raids on pharmacies to eliminate the sale of counterfeit medicine.

The country’s Pharmacy Board also ensures that only approved pharmacies sell medication. However, there have been cases where both approved and unapproved pharmacies have been found selling fake medicine.

Last year, when Issac Akologo had malaria, he was prescribed Fansidar (a first line treatment against the disease). He bought it at a pharmacy in Bolgatanga in the Upper East Region of Ghana, but after taking the full course, Akologo still did not feel well. He returned to his health centre and was described a different course of treatment.

“It was not until I read in the newspapers that the FDB had arrested the pharmacy owner … that I realised the Fansidar I bought might have been fake,” Akologo told IPS. The FDB has confirmed that the pharmacy in question sold counterfeit Fansidar tablets.

The trade in fake medicines is known to be widespread in pharmacies throughout the country and some have even found their way onto local market stalls.

But it is difficult for consumers to tell the difference between a fake and the real thing.

One hospital pharmacist told IPS that the packaging of the counterfeit medicines was expertly copied and it was difficult to identify a fake.

However, Gyansa-Lutterodt said the ministry of health has no data on the extent of sale and use in the country of counterfeit medicines. It is using a World Health Organisation study estimate that 30 percent of medicines on the market in Ghana are fake.

She said the ministry was aware of the problem and that procedures were in place to ensure that “fake medicines do not enter the public system, because we want public access to medicine to be without any taint.”

The system, Gyansa-Lutterodt said, was buying from approved sources only, strictly following the procedures, which she said were not new. But she did not clarify why this procurement process was not followed in the past.

Charles Allotey of the Health Access Network, a non-governmental organisation that aims to ensure that the public gets healthcare and proper medicines at an affordable cost, says that the ministry has had a difficult job detecting counterfeit medicines.

“It is a technical problem that is difficult to detect and it would be harsh to say the ministry had not done any work on this issue. Suspicion arises only when a particular medicine is used and produces no result and this must be proved by analysis.”

Gyansa-Lutterodt was concerned that the use of counterfeit medicines will have serious implications on people’s health, as many believe they are taking the legitimate drugs to treat their illnesses.

Thomas Amedzro, head of the FDB’s drug post market surveillance, agrees with Gyansa-Lutterodt that the sale and use of fake medicines has a serious impact on the health of Ghanaians.

“We have found out that some fake antibiotics have found their way into the country, and any patient that is given them could die because of the poor efficacy of the drug – this shows that we are battling a real problem.

“It is a serious threat … we have come across some aphrodisiacs being sold in the country that contain 10 times (the approved level of) active ingredients and impurities.”

Amedzro said as a regulator, the FDB’s duty is to ensure that products are safe for use by the public.

“We do this by ensuring that manufacturers register their products as well as packaging. In the case of importers, we send our officers to the countries of origin to ensure that the manufacturing site really exits,” he said. He explained this usually happens when suppliers of generic drugs apply to sell medicine in Ghana.

“The FDB does not have the personnel to patrol our vast land borders and it is this problem that we now encounter,” he added, referring to the way counterfeit medication was entering the country.

Amedzro said: “There is also the need to educate the people first so that they understand what fake medicines mean to their health.

“We also need to encourage the public to stop buying just from any place of sale. In addition, there is the need for the public to report those who sell medicine without registration,” he added.  

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