Shock of fake toxic drugs on sale

By Standard Team

Kenya’s healthcare is in a deep crisis. From fake drugs, professional negligence by medics to lack of facilities, the poor are the most affected as the cost of healthcare continues to skyrocket.

In the three-part series, The Standard exposes the rot in the country’s healthcare system.

Kenya Medical Practitioners and Dentists Board CEO Daniel Yumbya (right) inspects a herbal ‘clinic’ during a crackdown on illegal medical facilities in Nairobi recently. [PHOTO: jonah onyango/STANDARD]

Even as consumer watchdog organisations brag about upping their skill, thousands of Kenyans are routinely risking their lives by taking unwholesome drugs with researchers warning that nearly half the drugs in Kenya are either fake or sub-standard.

To compound the problem further, about 40 per cent of the population — accounting for about 15 million people — purchase medication over the counter without any form of medical advice.

And the tragedy is that many of the counterfeit drugs and generics often contain cement, chalk, sawdust, paint and an array of other toxic or inert substances that cause more harm rather than restore the health of the sick.

These are some of the findings in a new report by the International Policy Network released recently.

Although most of the drugs are imported from Kenya’s key source markets for generic drugs in India and China, Africa bears the brunt as 700,000 deaths are reported on the continent resulting from ineffective treatment in malaria, tuberculosis and HIV and Aids.

The situation has increasingly led to the emergence of drug resistant strains of the highly infectious diseases ranging from HIV/Aids, malaria to tuberculosis and a wide range of other respiratory infections.

Liberalisation blamed

In Kenya, the report says, over 40 per cent of sampled drugs have been found to be outside recommended pharmaceutical standards.

"Fake medicines seem to be prevalent across all classes of drugs, yet most cases of counterfeit drugs probably are not known to the Government since there is no systematic mechanism for discovering and disclosing them," the report says.

The liberalisation of the drug market has not helped since regulation is still a great challenge.

Head of operations at Mission for Essential Drugs and Supplies (Meds), Dr Jane Masiga, a clinical pharmacist, told editors in a forum in Nairobi last week that the crisis of sub-standard drugs and fakes has hit the country in a big way.

Masiga blamed the lack of a strong regulation regime for drug importation and quality checks, which she said leaves loopholes that rogue importers are using to flood the country with fakes.

On the role of Meds, Dr Masiga said her organisation’s officials were shocked during a recent visit to China to find backstreet companies exhibiting fake drugs branded as those from well-known international pharmaceuticals.

"We asked them if they knew the contacts of the original pharmaceuticals but they had no idea. The samples we took and tested were all sub-standard," she said.

Pre-qualified by the World Health Organisation (WHO), the Meds laboratory is a registered trust of the ecumenical partnership of the Kenya Episcopal Conference (KEC) and the Christian Health Association of Kenya (CHAK).

Medical Services Permanent Secretary Prof James Ole Kiyiapi played down the crisis facing the drugs sector.

Fake drugs crisis

Speaking from Geneva where he and Public Health Minister Beth Mugo have been meeting with the Global Fund managers, Kiyiapi dismissed as exaggerated claims that there was a fake drugs crisis in the country.

He said it is true counterfeit drugs were entering the market but said the problem was not confined to Kenya only.

Kiyiapi noted the issue of counterfeits was slotted for discussion in the World Health Assembly this year but it has been pushed forward to next year.

He said the Government was working to appoint a new Kenya Medical Supplies Agency (Kemsa) board in order to bring efficiency in drug procurement.

The previous board was disbanded by the Medical Services Minister Prof Anyang’ Nyong’o over gross mismanagement.

Currently, the acting chief executive officer Dr John Munyu has been steering the Agency that is mandated with the drug procurement and distribution of drugs to all Government hospitals and dispensaries.

Kiyiapi said the Government had upgraded the National Quality and Control Laboratory to ensure all drugs are tested for safety.

There were plans to computerise the drugs system in order to monitor the supplies from the procurement level to the point of consumption.

He explained that, Kenya through the Pharmacy and Poisons Board is mapping out strategies to root out this problem.

According to the chairman of Kenya Association of Pharmaceutical Industries (KAPI), Dr Moses Mwangi, between 30 to 40 per cent of the drugs are dispensed over the counter.

Shrinking resources

On the other hand the Kenya Pharmaceutical Distributors Association chairman Dr Kamamia Murichu pegs self-prescription at as high as 60 per cent.

But the Government plays down the figure with an estimate of about 3 million Kenyans who self-medicate.

The Director of Public Health and Sanitation Dr Shahnaaz Sharif said about eight per cent of Kenyans buy drugs without seeking professional advice.

"Some do not see the need of seeking medical care especially when having something like a flu," said Sharif.

Still, the burden of diseases is weighing heavily on Kenyans amidst shrinking financial resources.

What is worse is the fact that the poor are likely to shoulder a larger load of the disease burden than the rich, according to the Kenya Household Health Expenditure and Utilisation Survey report published in March this year.

The study shows the number of annual rate of hospital admission has increased from 15 per 1,000 people in 2003 to 27 per 1,000 in 2007, and is projected to be increase this year.

— Additional reporting by David Ohito