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This study addresses the significant issue of counterfeit drugs in Kenya, highlighting the urgent need for robust quality control systems in developing countries. Through the examination of Kenya's experiences, the authors analyze the impact of substandard medicines on public health, economic losses, and consumer trust. The findings suggest that improved monitoring, better regulatory practices, and enhanced quality control infrastructure are essential to combat counterfeiting and ensure the safety of medical products in the market.
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COUNTERFEITING OF DRUGS AND THE NECESSITY OF QC SYSTEMS IN DEVELOPING COUNTRIES: THE KENYAN EXPERIENCE By Isaac O. Kibwage
Authors: G.N. Thoithi1, K.O. Abuga1, H.K. Chepkwony2 andI. O. Kibwage* 1Department of Pharmaceutical Chemistry, University of Nairobi, Kenya. 2National Quality Control Laboratory (NQCL), Nairobi, Kenya
Quality of Medicines • Quality of medicines • Impact of quality on consumers • Kenyan mass media reports – drug quality concerns • Poor quality • Expired products • Counterfeits • Lack of adequate policy • Limited market surveillance
Daily Nation, Monday May 2, 1988 PSK Symposium1988: Debate on quality of locally produced medicines stopped by PSK chairman
Africa Health Market Letter, Vol. 6 No. 4, April 1992 VLIR, KUL – UON Project for QC of drugs
Sunday Standard, Nov. 9, 1997 Sale of non-registered loperamide & sulfadoxine/pyrimethamine in the Kenyan market. Chief pharmacist admitted dispensing malpractices and the presence briefcase imports in the country
Sunday Standard, Nov. 9, 1997 Sale of non-registered loperamide & sulfadoxine/pyrimethamine in the Kenyan market. Chief pharmacist admitted dispensing malpractices and the presence briefcase imports in the country
Historical Background DARU: Established in 1977 Work started in1980 VLIR funded KUL-UoN project was a major boost NQCL: Established in 1993 Takeoff slow - inadequate facilities 2004 – Enhanced budgetary allocation + donor funding WHO certification in the process
Sources of Drugs • Central Medical Stores • Government and Private Hospitals • Pharmaceutical industry • Pharmacy and Poisons Board • Community Pharmacies • Doctors, Dentists and patients
Sources of Drugs • Local Manufacturers • Imported • India • China • Israel • Far East • Western/ Eastern Europe
Results for DARUPeriod: 1980 - 2007 Therapeutic categories (% Failure)
Observations • 2001-2007: Quality of drugs has improved • Failure rate slightly higher in locally manufactured drugs • Drugs of greatest concern • 1980 – 1990: skin preps (50% failure) • nutritional preps (25-38%) • antibiotics (about 30%). • 1996-2007: antimalarials, especially S/P (30%)
Possible Reasons for Improved Quality • Improved technology globally • Professional advice given to local industry following failure of their products. • Investment in QC Labs • More pharmacists in the industry • Greater vigilance by the regulatory authority.
Observations • 2001-2007: Quality of drugs has improved • Failure rate slightly higher in imported drugs • Drugs of greatest concern by end 2007 • antibiotics (17.3%) • anthelmintics (10%) • antituberculars. (17.4%) • antimalarials, (13.8%)
PREDINSOLONE TABLETS COUNTERFEIT (NQCL) TWO PACKS WITH THE SAME BATCH TABLETS LOOK DIFFERENT
METAKELFIN TABLETS COUNTERFEIT (NQCL) Counter feit Genuine product
METAKELFIN TABLETS COUNTERFEIT (NQCL) Genuine product Counter feit
DUO-COTECXIN TABLETS COUNTERFEIT (DARU) Counterfeit product Genuine product
DUO-COTECXIN TABLETS COUNTERFEIT (DARU) New product bears the hologram ‘FACT’
DUO-COTECXIN TABLETS COUNTERFEIT (DARU) Counterfeit Genuine product New genuine pack
DOU-COTECXIN TABLETS COUNTERFEIT (DARU) Counterfeit Genuine product New pack
DUO-COTECXIN TABLETS COUNTERFEIT (DARU) Counterfeit Genuine product New pack
Market Surveillance • Market surveillance is weak in Kenya • Concern for quality • Availability of substandard products in the market • Regulatory authority needs to be more stringent
Conclusions • Counterfeits harm health, results in economic loss • Meaningful surveillance • Strong DRA • Well equipped QC facilities • Comprehensive policies on handling and distribution of drugs
ACKNOWLEDGEMENTS VLIR: Equipment Human resource development Technology transfer DARU: Staff NQCL: Staff GoK, PPB Donors: GTZ, DANIDA, WHO
ACKNOWLEDGEMENTS NATIONAL QUALITY CONTROL LABORATORY (NQCL) STAFF