Liberalizing import of malaria drugs without strict rules is suicidal
A new study by researchers from Fogarty International Center at the National Institutes of Health in the United States of America has revealed that a third of antimalarial drugs in South East Asia and sub-Saharan Africa are counterfeit.
As a result, more than 3.3 billion people risk of malaria in the 106 endemic countries may soon develop resistance to malaria drugs. That means that even the most effective drugs would no longer be able to cure the disease in such people. Therefore, the number of people who die every year from this tropical disease will inevitably shoot up. Yet already, about 1.2 million people die every year from malaria infection.
Closer home, data collected by the researchers from 21 countries in sub-Saharan Africa, after looking at 2,500 drug samples, shows that most of the medicines on the market are either fake or of poor quality and are causing drug resistance and treatment failures.
Just across in neighboring Uganda, authorities say they suspect nearly 30% of the drugs imported into the country to be fake counterfeits. The tragedy is that the National Drug Authority, a Uganda Government agency that regulates manufacture, import and distribution of human drugs in the country, says it has neither the equipment nor the manpower to stop fake drugs from being sold to the people.
This confirms the findings of the American study that affected countries lacked sufficient facilities to monitor the quality of antimalarial drugs.
And the fact that there is no punitive action for counterfeiters to deter them from the elicit trade, importation of such fakes continues to flourish.
Quoting officials of NDA, Uganda’s Daily Monitor reported last week that some of the drugs, manufactured in the country, are sold cheaply to pharmacies and small drug shops from where unsuspecting consumers buy them.
But most counterfeit drugs are presumed to come from the usual suspects—China and India and enter the country either as imports or are smuggled in through the porous borders.
Malaria is big business for pharmaceutical companies world-wide and counterfeiters also know this. In endemic countries such as Uganda where nearly 500 in every 100,000 people suffer from malaria annually, it is indeed big business and the temptation to make free money is quite big for any dubious person.
This therefore calls for strict control over manufacturing and importation of such drugs. In fact, considering the catastrophe that could befall countries when millions of people develop resistance to drugs and eventually die, it is time to classify malaria and its treatment as a security issue.
This means that countries take strategic interest in importation and/or manufacture of antimalarials just like it is done with ammunitions. Not anybody with some little money can import bullets and vend them on the streets because of the security dangers associated with that business.
In the same way, not very one should manufacture, import or sell widely consumed drugs such as antimalarials because use of fakes could actually wipe out populations. Malaria kills more people than all other diseases combined. It can therefore be a lethal weapon that terrorist organizations can use against people by flooding the market with fake drugs.
On the other hand, the same can be used to economically cripple a country. Consider the financial loss to families and the country when suddenly one million or more people cannot be cured of malaria and die. Domestic incomes will be strained in trying to treat chronic infections, family bread winners will die and certainly this will put a big strain on the already strained national health budgets. And as millions of people fall ill, national productivity will shrink alongside the tax the base.
For endemic countries, it is therefore time to impose strict controls on the manufacture and import of malaria drugs. Governments should deal directly with genuine and known drug manufacturers to supply known and efficacious drugs. Any government that cannot deal directly with manufactures, can license a small number of companies that it can regulate to import drugs. Any other drugs that are not imported through the known channels should strictly be banned. Violators should be tried for terrorism-related charges and if found guilty should be sentence to life imprisonment.
Liberalizing trade in such drugs that have security and economic implications is wrong and must be rescinded.