The plague of counterfeit medicines
Finding the right models
‘The ‘feasibility’ of monitoring medicines by near-infrared spectroscopy has been demonstrated on low dosage paracetamol syrups, in other words on a product which is very widespread but which, due to counterfeits, has already caused deaths in Africa. A similar ‘feasibility’ study has been applied to capillary electrophoresis, using anti-AIDS products,’ points out Eric Ziemons. ‘The reliability of the system has also been demonstrated: our equipment is effective. It succeeds in testing and analysing in a trustworthy manner anti-inflammatory and anti-infection drugs, including antimalaria medicines.’
As a priority the team developed methods enabling the equipment to check medicines capable of fighting the diseases responsible for the most deaths in the targeted regions, as well as standard very common medicines, such as painkillers. ‘Eventually, we might add methods allowing us to screen substances used in cardiac pathology treatments,’ anticipates Philippe Hubert. ‘But, in the meantime – and this is the important thing – we already know that we have available two techniques which have been validated in terms of feasibility and are perfectly adequate and adapted to the targeted goals’ (3).
Whilst the personnel continued to be trained in the regions concerned or in Belgium, the Belgian team moved on to the last stage of its projects: installing two laboratories in the Congo (Rwanda already has two laboratories available, there again thanks to assistance from another project involving Liège university academics, in particular Professor L. Angenot and M. Frederich). A site still needs to be found to house the general laboratory. The University of Kinshasa will host the second laboratory, and it will also enable counter-evaluations to be carried out. ‘The coming year will be used to renovate the premises and to contact suppliers who will, for example, provide the air conditioning. During this period the technical training of these laboratories’ future personnel will carry on, as will the development of new models allowing the two systems to increase the number of products they are capable of checking,’ points out Roland Marini. In effect it is a question of continuing to enrich the model, to ‘feed’ it information, in order to make it more ‘canny’ and better able to check a yet higher number of products.
The researchers estimate that it will doubtless require three to four more years before the Congolese laboratories can function autonomously. ‘The objective is to enable local producers and monitoring agencies to make use of these laboratories, and at moderate prices as the equipment’s running costs are low. Thus a monitoring system aiming at the improved quality of medicines could become widespread,’ forecasts Philippe Hubert.
The reality principle
In Belgium at the beginning of October 2010, an international operation against the online selling of counterfeit and illegal medicines allowed the seizure, at Zaventem airport, of 76 parcels sent to Belgian buyers. Inside were found, in the following proportions, 26% counterfeit erection stimulants, 25% illegal slimming products, 6% antihypertensive products, 5% diuretics, 13% hormone substances and 8% sports stimulant supplements. At Bierset, 18 other parcels were blocked by customs officers, in which were products which mainly came from China, including counterfeit antibiotics. In a great number of ‘poor’ countries, a lot more threatened than we are by the traffic in counterfeit medicines, such suppression measures are still a long way off. ‘At the present time, medicine inspection in the Congo involves 69 inspectors (for 70 million inhabitants), of which 40 are in Kinshasa. In Nigeria a female inspector was subject to attempted murder and now only moves around with bodyguards,’ underlines Roland Marini. At their own level, the Liège pharmacists’ projects contribute to responding to this traffic and to supplying the population with quality medicines. One figure, a single one, to measure what is at stake: according to the WHO every year 200,000 people die because of counterfeit products.