Uganda battles problem of counterfeit drugs

Jane Nafula | 13 Sep 2008
Monitor (Kampala)
As the Ministry of Health struggles to combat various epidemics that are claiming millions of lives like HIV/Aids, TB and Malaria, unscrupulous people are also doing what it takes to make billions of shillings out of the misfortune.

Officials at the National Drug Authority, the body charged with ensuring that all drugs coming into the country are of good quality, have now admitted that individuals dealing in counterfeit drugs are maneuvering through the country's porous borders and selling fake drugs on the local market.

According to the Chairman of the National Drug Authority (NDA) Board, Dr Frank Mwesigye, the drugs that are on high demand are the most counterfeited.

"Most counterfeits are drugs that are widely used such as, TB drugs, anti-malarials and antibiotics," he says.

Dr Mwesigye says an estimated 50 per cent of the drugs manufactured in developing countries and 10 per cent world over are counterfeits. The percentage of counterfeit drugs in Uganda is not known.

He explained that all drugs imports that go through NDA and those manufactured in Uganda are genuine. About 15 per cent of the drugs used in Uganda are manufactured locally.

"We have not yet come across any manufacturers dealing in counterfeits because our inspectors monitor the factories frequently. Similar inspections are being done in factories abroad that supply different types of medicines to Uganda," he says.

"We only pass drugs of good quality and fail those which don't meet our requirements. When we fail the factory, we don't allow it to export the drugs to Uganda," he adds.

The Executive Secretary of NDA, Mr Paul Muheirwe said the authority has on several occasions impounded and destroyed substandard drugs at the port of entry where they always test drugs coming to Uganda.

Mr Muheirwe, however, noted that such cases are now rare because dealers in fake drugs fear to invest in counterfeits and lose them to NDA in case they are impounded.

He says the public should not panic because NDA is doing what it takes to ensure that all medical supplies in Uganda are not harmful for human consumption .

He says a national study is currently being done by the World Health Organisation in collaboration with Pharmacopoeia to establish the magnitude of the fake drugs problem in Uganda.

Mr Muheirwe said the authority has so far tested 237 different types of drugs and that they were all genuine. The samples are being collected right from referral hospitals up to the smallest drug shops and pharmacies.

This study was triggered off by the findings of another research published in the online journal Public Library of Science Researchers recently which indicated that 35 per cent of the anti-malarial drugs sold in Kampala were either counterfeit or lacked the correct levels of active ingredient.

The drugs tested included amodiaqine (camaquin), sulfadoxine-pyromethamine (fansidar), and coartem.

A similar study was done in Uganda's neighbours (Kenya, Tanzania, and Rwanda) as well as Ghana and Nigeria.

According to the study, Kenya had the highest percentage of inefficient drugs (38 per cent), followed by Uganda and Ghana (35 per cent), Rwanda (33 per cent ) Tanzania and Nigeria (32 per cent).

An estimated 48 per cent of the sub-standard drugs were made in Africa, while 32 per cent were made in Asia and 24 per cent were from Europe.

NDA staff who talked to Saturday Monitor on condition of anonymity for fear of being sacked, however, called for more resources given the additional duties assigned to them. They said they are now required to inspect food stuffs and cosmetics that are imported into and exported out of the country.

"We should be allocated more resources and manpower to enable us fulfil our new mandate of ensuring that only high quality, effective and cost effective medicine (both human and veterinary) are availed to the population in Uganda," one of the NDA staff said.

NDA has only eight drug inspectors countrywide, regulating the over 400 pharmacies. Three of the inspectors work in Kampala and five are in charge of the up country districts.

State Minister for Health in charge of general duties, Dr Richard Nduhuura said counterfeits are a big problem in Uganda and world over.

"The problem doesn't affect Uganda alone and that is why inspectors who go to inspect factories abroad should be careful so that we don't bring in counterfeit products in the country," he says "People are after making money and we have to be on the watch out. If the drug inspectors are not compromised by the manufacturers, we shall have the right drugs coming to Uganda," Dr Nduhuura adds.

He says Uganda has a high disease burden and that the drugs used to treat these diseases should be safe, effective and of good quality.

"It is the government's objective to ensure that all people in Uganda live a healthy life and have access to quality health care," Dr Nduhuura says.

According to Dr Nduhuura, the Ministry of Health is in the process of reviewing laws in the pharmaceutical sector to facilitate effective regulation of the sector.

He said that fake drugs can not be effective in treating disease but they simply make the disease to develop resistance because they lack the right ingredients.

"It may be given in the right dose but fail to combat the disease because it lacks the necessary ingredients. fake products tend to be cheaper and poor people could be rushing for these fake products," he says.

There is already an emergence of drug resistant TB mycobacterium that is difficult to treat and whose treatment cost is very expensive estimated at Shs50 million per year per patient. These drugs are not yet available in Uganda.

The mosquito parasites have also become resistant to malaria chloroquine while the HIV, the virus that causes Aids is also increasing becoming resistant to the first line ARVs. Malaria alone kills 320 Ugandans every day.

People living with HIV/Aid can not live longer if they are dispensed fake ARVs. An estimated 312,000 are eligible for ARVs although only 13,000 have access to the drugs.

Despite these challenges, Uganda remains a dumping ground for various drugs and other products.