The recently released report by the United Nations Office on Drugs and Crime (UNODC), titled “Trafficking in Medical Products in the Sahel,” has unveiled distressing figures.
It estimates that approximately 500,000 individuals have lost their lives in Sub-Saharan Africa due to the consumption of counterfeit and substandard medications. Among these fatalities, 267,000 deaths were attributed to falsified antimalarial medicines, while 167,271 deaths were linked to falsified antibiotics used for treating severe pneumonia in children.
Furthermore, the report reveals that 40% of the substandard and falsified medical products detected in Sahel countries between 2013 and 2021 were discovered within the regulated supply chain.
The UNODC has issued a warning, stating that although accurate confirmation is challenging, they estimate that 50% of medications in West Africa are either substandard or counterfeit.
This alarming situation not only leads to antimicrobial resistance and toxic contaminations but also erodes trust in healthcare systems.
According to the report, an astonishing amount of up to US$44.7 million is spent annually on treating individuals who have used counterfeit or substandard malaria treatments.
The Sahel countries mentioned in the report—Burkina Faso, Chad, Mali, Mauritania, and Niger—rely heavily on imported medical products since their own pharmaceutical industries are still in the early stages of development.
International operations conducted between January 2017 and December 2021 resulted in the seizure of at least 605 tons of illicit medical products in West Africa. These operations include Operation Heera I and Heera II by the International Criminal Police Organization (INTERPOL), Operation CRIPHARM III by the World Customs Organization (WCO), and Operation Pangea XIV by INTERPOL.
The operations also include UNODC-coordinated programs such as the UNODC-WCO-INTERPOL airport communication project (AIRCOP) and the UNODC-WCO Container Control Programme (CCP).
The major entry points for falsified medical products destined for the Sahel countries have been identified as seaports in the Gulf of Guinea, namely Conakry (Guinea), Tema (Ghana), Lomé (Togo), Cotonou (Benin), and Apapa (Nigeria).
In contrast, air trafficking involves smaller quantities of medical products transported through postal shipments or by commercial air passengers.
Once in West Africa, these trafficked medical products reach the Sahel countries via buses, trucks, and private cars.
Between 2017 and 2021, the Sahel countries imported pharmaceutical products worth approximately US$103-194 million from China and India.
The UNODC report exposes the involvement of various opportunistic actors in the trafficking of medical products within the Sahel countries.
Perpetrators range from employees of pharmaceutical companies, public officials, law enforcement officers, and health agency workers to street vendors—all driven by the lure of financial gain. Some operate individually, such as pharmacists selling illegally acquired medicines in the informal market, while others collaborate at different levels of the supply chain.
Counterfeit drugs encompass those sold without proper approval, clearance, or licensing. They may have expired or lack the necessary active ingredients.
Francois Patuel, the head of the UNODC’s Research and Awareness Unit, emphasizes that once a legitimate product is diverted from the supply chain, there is minimal oversight regarding its usage.
The report also highlights that this issue is part of a larger cyclical problem in healthcare delivery within the region, resulting from multiple contributing factors.
These include a shortage of public sector healthcare facilities, insufficient skilled staff and resources, poor healthcare system quality, corruption, mismanagement, and inadequate education quality.
Additionally, healthcare delivery is hindered by the absence of adequate social security and a lack of meaningful commitment to the welfare of the most affected population. Increased competition between drug peddlers and private clinics further exacerbates the situation.
The fight against counterfeit medicines
The World Health Organization (WHO) has launched the Global Surveillance and Monitoring System in collaboration with member states. This system aims to monitor products and issue alerts to its 194 members regarding falsified medical products.
The UN Interregional Crime and Justice Research Institute (UNICRI) conducts studies on counterfeit products and their impact on consumer health and safety. As part of the UNODC Strategic Vision for Africa 2030, there is a focus on enhancing protection against falsified medical products.
Additionally, the Good Legislative Practices on Combating Falsified Medical Product-Related Crime provides support to countries in enacting legislation and safeguarding public health.
In an effort to assist authorities in intelligence sharing and enhance supply chain security, the World Customs Organization (WCO) and UNODC have jointly launched a program in 70 nations.
SOURCE: Healthcare Middle East & Africa