The World Health Organisation (WHO) banned the anti-malaria drug though in some parts of Africa it is still being produced, prescribed and acquired over the counter. Prior to its ban, chloroquine has been one of the most widely prescribed anti-malaria drugs in Africa.
A rise in counterfeit drugs has been recorded around the globe with Africa on the top list. In Cameroon, a network of counterfeit chloroquine manufacturers was nabbed in March this year following a tip off.
Despite the joint operations against illegal drugs in Africa, the traffic is on a dramatic increase with Mali, Niger and Côte d’Ivoire being countries with the most recently recorded cases. According to WHO, Africa accounts for 42 percent of all reports of counterfeit pharmaceuticals with middle and low income African states on the lead.
Delese Mimi Darko, Chief Executive of Ghana’s Food and Drug Authority (FDA) fears an influx of substandard medical supplies across Africa’s porous borders due to the much attention given to COVID-19.
“The current focus on curbing COVID-19 spread means there is less focus on routine market surveillance” lamented Delese Mimi Darko
While attention is given to Corona virus which has ravaged communities and claimed over half a million lives as of the 6th of August 2020 across the globe, estimates of the World Health Organization (WHO) points out that one in ten medical products in low- and middle-income countries are substandard or counterfeit.
The World Health Organisation issued a warning in April about counterfeit chloroquine products found in some African states including the Democratic Republic of Congo. Speculation that this active ingredient could be used to treat cases of COVID-19 led to a sharp increase in demand and prices for the drug. While chloroquine is no longer widely used against malaria in Ghana, there have been increasing reports of substandard tablets made from similarly bitter substances.
“If we find any chloroquine on the market now, there is likely to be issues with it,” says Kwasi Boateng, director of the non-profit organization United States Pharmacopeia-Ghana.
According to the research conducted by a group led by Professor Lutz Heide of the Pharmaceutical Institute at the University of Tübingen; in cooperation with African pharmacists and the German Institute for Medical Mission, counterfeit chloroquine found in Cameroon and Congo contained far too little or the wrong active ingredients. The counterfeits for example only contain an ineffective dose of chloroquine; or instead of chloroquine, the painkiller paracetamol or the antibiotic metronidazole.
“This very bitter substance was probably used to imitate the bitter taste of chloroquine”, said Gesa Gnegel, a member of the research group.
Due to the low dosage, it is believed the counterfeits might promote the development of resistant pathogens.
“Any potential medicine or vaccine reported to be effective against COVID-19 can trigger a desperate demand world-wide,” explains Heide. This however will cause a rise in counterfeits being pushed onto the unsuspecting market.
The problem will not be limited to drugs against COVID-19 as the supply chains of pharmaceutical products have been disrupted by the pandemic. Developing countries in particular might face supply shortages due to the high cost of legitimate drugs which may be beyond the reach of many, also legal controls which are often weak coupled with corruption and porous borders creates a large-scale sale of counterfeit drugs.
“The counterfeit drugs are not only found at illegal vendors but also over the counter.” analysts
