Getting a grip on counterfeit medicine in Kenya

How the #ChokersKE project helps people identify whether medicines are real or fake.

Have you ever bought fake medicine? Would you be able to tell the difference?

The trade in fake medicine is rife across the world, and it’s been estimated by the Alliance for Safe Online Pharmacies that 97% of prescription drug vendors who operate via the internet do not comply with local regulations. In Kenya, the issues aren’t just around online sales: unlicensed chemists and even established pharmacies may knowingly or unknowingly be selling fake drugs.

My awareness of how endemic the issue is was raised in August 2016, when I broke a story of a whistle blower who opened the lid on fake drug imports by top officers at PPB. It was an international scandal involving many types of critical medicines including Antiretroviral (ARVs) drugs for treating HIV.

The list of counterfeit drugs that have been imported and distributed includes oncology drugs (for cancers), anti-diabetics, fertility pills, anti-thyroids, anti-allergies and antibiotics.

Illicit drugs carry huge risks for patients: at the very least, they may or may not contain the ingredients claimed, which in turn may or may not be in sufficient quantities. They may also contain other substances which aren’t listed on the packaging.

Either way, the health risks of taking faked drugs are severe — the WHO reckons that fake medicines kill about one million people around the world every year, with about 100,000 of those deaths in Africa. And that’s before the legal aspect that the sale of illicit medicines lines criminals pockets and takes valuable tax revenue out of the system. The business in counterfeit medicine is close to being a $100bn (US) a year industry worldwide.

Inspired by my research into the subject for my story, I approached the impactAFRICA fund to help start the Chokers project, (#ChokersKE), which tracks and tests medicines to try and stop the spread of counterfeits.

Since publishing my first article on counterfeits on how potentially lethal drugs enter Kenya, the Pharmacy and Poisons Board (PPB) — the industry regulator — acted by shutting down more than 670 illegal pharmaceutical outlets across Kenya deemed to have fallen short of the required standards. of this number, at least 612 suspects operating the pharmacies have since been arraigned in court.

I’ve also seen a backlash. Since starting #ChokersKE several sources have stopped speaking to me — and they are a priceless resource in the world of investigative journalism. “This is a sector with vested interests, I don’t want to be quoted,” they said.

Counterfeiting of drugs: Tony explains the danger of fake medicines to Max and why they endanger our lives. The main topics explain what counterfeit medicines are, the scope of the phenomenon, the Internet problem, and of course the solutions. A fun and complete way to be informed about a threat to global public health. Let yourself be guided by Tony. Video courtesy: IRACM.

The main aspect of the #ChokersKE project to date has been to subject random samples of pharmaceutical to lab analysis, in order to gather hard evidence.

This proved surprisingly challenging: most labs weren’t interested in the work. Besides the high costs associated with drug analysis, the private facilities declined my approaches since they “could land in trouble with the PPB” if the outcome was not in their favour.

Eventually I did find one which agreed to conduct the tests.

The experience has been rewarding.

What have I learned?

During my previous life (which is roughly five years ago before I went mainstream) I knew that I wanted to be a good journalist — but I did not know what that entailed. That in a country such as Kenya, public interest was not public interest but interest of certain individuals.

None of the university teachings and trainings taught me how to handle some sources and some stories where your interest and mine came first — the learnings plainly told me — public interest comes first.

But while undertaking this project, I have come to learn that the public interest is not always the first priority for those who are appointed to positions in which they are entrusted to take care of it.

Many in those positions are there for their own selfish interests. Departments and organisations must be seen as they are working yet they are not. The sector or industry must be perceived to be doing well when it is not. They must be seen when they are making achievements in some areas of their jurisdiction, but not be heard from when the loopholes in laws are revealed.

They are not safeguarding the healthcare of the people as is clearly stipulated in the Kenyan constitution — every citizen is entitled to the highest possible standards of health service.

A $100bn-a-year business.

Some six months down the line, my team and I have been waiting to exhale.

We can now look back and be proud of what we have achieved so far in creating a narrative around counterfeit and fake drugs.

As we were waiting for the lab analysis results, we hoped the key industry players would use the report to make a difference. What we have found so far has been disappointing — and not, we believe, a true reflection of what is in the market. Our next step will be to look at other ways of verifying the provenance of medications, such as comparing batch numbers with genuine lists.

Our achievements

Our project, #ChokersKe, which aims to ascertain the prevalence of counterfeit medicines in Kenya, was one of the 13 finalists selected for the impactAFRICA grant.

The project has attracted interests from the Business Advocacy Fund, mPedigree, Jhpiego, DCW, among other players willing to scale it up further.

Key insights that we have learned

Investigating issues such as influx of fake medicines in a market, especially one like Kenya, can create awareness, but a lack of resources hinders a lot of truths from becoming public knowledge.

Image courtesy of BBC

For any other change agents operating in the same space, and willing to continue with the narrative we can offer insights that we have garnered from our experience so far and help create tailor-made solutions.

  1. For the initial few months, you would need to deep dive into the projects yourself.
  2. Patience is key in such a project and do not always imagine the worst… you might be surprised.
  3. While starting out, the community and industry players may not be equipped with the necessary knowledge around fake medicine but with awareness they can be in full support. Involving the community is key.
  4. We have also learnt not to over-expect an outcome. Just chill, get results, and work it further. Be consistent in your efforts and you will surely be rewarded.
  5. We have also incorporated mentorship in our activities and during story lab academy sessions in Nairobi. By this we have learnt to build up a robust and solid mentorship program, through the Code for Africa Kenyan chapter — Code for Kenya — which has aided tracking the various technical and soft skills needed to improve the project.

We are all excited about the future and the challenges it would bring in taking the narrative of counterfeit drugs forward for positive change. We are not done yet. We are just getting started!

The author, Stellar Murumba, is #ChokersKE project lead — an impactAFRICA/Code for Africa project in Kenya — and is also a reporter for the Business Daily under the largest media house in East and Central Africa, Nation Media Group.

Code for Africa is the continent’s largest federation of civic technology and open data laboratories, with affiliate members in 10 African countries including Kenya and funded projects in a further 12 countries. CfAfrica manages the $1m/year innovateAFRICA.fund and $500,000/year impactAFRICA.fund, as well as key digital democracy resources such as Taxclock Kenya and Pesa Check.