Sun, Jun 09, 2019 - Page 7 News List

Fight the fakes: How to beat the US$200bn medicine counterfeiters

Armed with blockchain and AI, health workers and campaigners are battling the bogus business that kills thousands

By Helen Lock  /  The Guardian

Illustration: June Hsu

By the time the teenage boy was standing in front of Bernice Bornmai, feverish and delirious, it was too late.

It was not just the malaria that was killing the 17-year-old, it was the time that he had wasted taking fake medicine. The anti-malarials did nothing to stop the disease marching through the young Ghanaian’s body: His organs were already shutting down.

“He died waiting to be taken to a larger teaching hospital for dialysis,” said Bornmai, senior medical officer of a small hospital in Accra. “It was one of my saddest cases, but I have lost other patients who would have survived, too, because of fake medicines.”

It is not just ineffective malaria medication that can prove fatal.

Bornmai’s patients have sometimes taken counterfeit antibiotics that not only do not fight the illness, but also increase bacterial resistance to effective medicines.

“Sometimes I just throw up my hands when I see the results showing which antibiotics have a chance of working — often they are not readily available or too expensive,” the doctor said. “It makes my work frustrating and it means patients have to stay here longer while I investigate.”

When it comes to trying to stop fake medicines getting into the hands of sick patients, experts describe a difficult task where they are constantly trying to stay one step ahead of counterfeiters.

Law enforcement and legislation are needed, strong pharmaceutical regulation has to be in place and well-trained healthcare professionals are essential, said Cynthia Genolet, an Africa policy expert at the International Federation of Pharmaceutical Manufacturers. “You can’t focus on one specific dimension to be successful in this fight — it has to be a holistic effort.”

Genolet is a member of Fight the Fakes, a campaign group launched in 2010 to raise awareness of the problem among pharmacists and industry.

One tool that campaigners hope would have an effect is the harnessing of emerging technologies such as blockchain and artificial intelligence (AI), which have the potential to help in dealing with the complexity of the task at hand.

A handful of new start-ups are focusing on tracing medications on blockchain-type technologies, as well as arming consumers with instant information about what they have bought.

For example, the Nigerian start-up RxAll has created a handheld scanner that can assess the compound of a drug in real time. The device connects to a cloud-based database of information of what the drugs should contain, which then feeds back that information.

“The information collected is a spectral signature of the drug, and once checked, the database sends back information to an app on your phone,” cofounder Adebayo Alonge said.

The vast information database is updated using an AI algorithm.

“The app also shows you the other parts of your city that the drug has been tested in, meaning that you can see where bad patches and bad suppliers are,” Alonge said.

Alonge and his colleagues in October last year launched Rxall and have launched it in countries such as Ghana, Cambodia and Kenya. It has been in use commercially in Myanmar and has been sold to a large Nigerian teaching hospital and to the Nigerian National Agency for Food and Drug Administration and Control, whose officials have begun training to use it.

It is a personal cause for Alonge, who nearly died at the age of 15 after taking what turned out to be fake Ventolin for his asthma. The toxic tablets put him in a coma for 21 days, and it took six months for him to completely recover. That experience motivated him to train as a pharmacist himself before starting RxAll.

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