Tracking down counterfeiters
During the Corona pandemic, Fidelis Nyaah noticed something disturbing. The head of a church central pharmacy in Cameroon had found four counterfeits of the malaria drug chloroquine in quick succession. The trigger for this accumulation was the scientifically unproven claim that chloroquine could help with Covid-19. Not only had demand grown enormously worldwide, but the prices for the drug had also risen rapidly, in some cases by a factor of a hundred. This had brought drug counterfeiters onto the scene.
Fidelis Nyaah is a member of the DIFÄM Minilab network. With a simple laboratory no bigger than a suitcase, he can test a hundred of the most important medicines. For example, he found that one preparation contained far too small a quantity of the active ingredient. The other three counterfeits contained no chloroquine at all, but other active ingredients.
Georges Mutombo in Bukavu in the Democratic Republic of Congo, 3,000 kilometres away, also discovered the same thing with tablets that had been sold as chloroquine preparations. The two African pharmacists informed Difäm, whose Department for Pharmaceutical Development Cooperation closely cooperates with the Pharmaceutical Institute of the University of Tübingen.
The counterfeits from Cameroon and Congo were sent to Tübingen. The analysis showed that one of the preparations contained less than a quarter of the alleged amount of active ingredient, which on the one hand is far too little to cure patients of malaria, and on the other hand favours the development of chloroquine-resistant malaria pathogens.
The other four preparations did not contain any chloroquine at all, but other, undisclosed active ingredients, including the painkiller paracetamol and the antibiotic metronidazole. These have their own risks and side effects and - if administered unknowingly - can put patients at risk, which is why this form of counterfeiting is one of the most dangerous in the pharmaceutical sector.
International altert via WHO
The pharmacists from Tübingen and Africa informed the authorities in Cameroon and Congo as well as the World Health Organisation (WHO). The WHO immediately issued an international alert with photos of the counterfeit medicines.
Since 2020, DIFÄM has been one of the few organisations worldwide that are allowed to feed cases of counterfeit medicines directly into the international WHO database. The WHO thus acknowledges the continuous and high-quality work of the minilab network coordinated by DIFÄM, from whose close cooperation not only the partner institutions will benefit, but also the health systems and patients worldwide, especially in Africa.
The network currently comprises 16 partner organisations from twelve African countries and India. Every year, they analyse almost a thousand medicines. In 2019, seven counterfeits and 20 defective preparations were discovered. In these cases, the medicines were malaria preparations. However, everything is being counterfeited, from generics to original preparations, from expensive cancer drugs and antibiotics to cheap paracetamol.
DIFÄM equips the facilities of partner organisations with minilabs and looks after and advises member facilities that have already received a minilab. They are provided with chemicals or tablets of assured quality as standards of comparison. In addition, we accompany the South-South exchange and create awareness for the issue of quality of medicines among health workers and patients.
