The Executive Director at Self-Medication Manufacturers Association of South Africa (SMASA), Nicola Brink, explains the dangers of counterfeit medication and what consumers can do to identify them.

According to UNICEF, 438,000 people died from malaria in 2015; 80% of whom were under five years old. That’s more than 800 children a day. According to a BBC news article, however, one-third of anti-malaria drugs in sub-Saharan Africa are counterfeit, unnecessarily causing more than 120,000 annual deaths.

Fake malaria drugs are just a fraction of the counterfeit medication problem. Other popular counterfeit drugs include chronic medicines for illnesses like diabetes and hypertension, antibiotics, corticosteroids, drugs for erectile dysfunction, cancer medicines, and even anti-retroviral medications for HIV/AIDS.

Defining counterfeit medication

The US Food and Drug Administration (USFDA) says that counterfeit medicines are drugs sold as product names without authorisation, and they often look just like the originals; the fake Gucci of the medicine world.

This is a problem because, despite looking similar, counterfeit medicines often contain the wrong amount of the active ingredient; the wrong active ingredient altogether; no active ingredients at all; potentially unsafe ingredients that aren’t on the label; and expired ingredients that have been relabelled.

Nobody knows the exact extent of the counterfeit medication problem, as it’s difficult to detect, investigate and quantify. What we do know, however, is that that it’s more prevalent in developing countries, where law enforcement and regulations are lax.

The USFDA suggests that the recent growth in counterfeit medications is likely to have been triggered by an increasing volume of high cost drugs, the development of technologies that make it easier to counterfeit drugs, and the ability to sell drugs directly to consumers without face-to-face contact, through purchases over the internet.

The risks of taking fake medication

The medicines of today are potent and targeted, and their active ingredients are specific and measured. When you change their composition, even slightly, the effects can be significant.

The USFDA warns that people who take counterfeit medication can suffer a range of negative consequences, including unexpected side effects, allergic reactions, and the worsening of their condition. Other common side effects include gastrointestinal disturbances like nausea, vomiting, and diarrhoea, and even symptoms of poisoning: changes in heart function and blood glucose, breathing difficulty, or organ failure.

The effects of fake medicines are more enduring than just individual cases. Sub-standard antibiotics are a key contributor to antibiotic resistance – a phenomenon that has and will continue to have a massive impact on infectious diseases.

Identifying counterfeit medication

It’s difficult to distinguish authentic medicines from inauthentic ones – especially if you buy them online. However, the WHO says that some fake medicines can be identified by:

  • The packaging – this should be clean, in good condition, and free of spelling mistakes or grammar errors.
  • The expiry date – the manufacturing and expiry dates should be valid and the details on the outer packaging should match that on the inner packaging.
  • Patient information leafletsthe information leaflet should be in the language it was advertised.
  • Medicine condition – the medicine should look correct (a description will be available in the info leaflet), it shouldn’t be discoloured or degraded (e.g. chipped or cracked tablets), and it shouldn’t have an unusual taste or smell.
  • The dosage – this shouldn’t be different to another unit of the same brand, or from your doctor’s prescription.
  • Security seals – these should be intact, with no signs of tampering.

If you’ve taken a medication that you suspect isn’t working properly or you’ve suffered an adverse reaction, discuss your situation with your pharmacist or doctor as soon as possible.

Protecting you and your family

In South Africa, the safest way to avoid fake drugs is to buy medicine from legitimate pharmacies, concrete or online. Look for websites associated with reputable pharmacies you know and trust because, with no way to track authenticity, street vendors and unknown stores are risky options.

It’s important to remember that any medicine that can usually only be purchased in a pharmacy (Schedule 1 and above) cannot legally be bought online. If it is available online there’s a problem, so avoid this purchase at all costs.

The WHO also recommends being cautious of websites that don’t provide their physical address or landline telephone number; spam email that advertises medicines; websites with no verification logos or certificates; websites offering prescription medicines without a prescription; unusually low-priced products; customs declarations or postal labels that don’t declare the contents as medicine; and any unusual activity on your credit card after the purchase.

Stay vigilant, informed, and don’t take chances. The risks associated with taking, or giving someone in your family, counterfeit medications are just too high.

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