Haifa, built on the slopes of Mount Carmel, is Israel’s third largest city. It is here where IBM research laboratory is creating a blockchain based platform to try and reduce the unceasing tide of fake medicines coming into Africa. These drugs often contain no active pharmaceutical ingredients and sometimes contain toxic substances.
Users of the solution have a basic mobile interface and permissioned blockchain backend that gives them permission in the network to initiate action, track, verify and finish their transaction.
The pharmaceutical supply chain, from raw ingredients to patients in Africa confronts many hurdles in both regulated and illegal, unregulated settings. With some studies showing that upto 30 different companies can touch a product before it ends up on the pharmacy shelf, the supply chain is as tangled and confusing as the streets in a large urban market.
As the demand for affordable healthcare for Africa’s growing population increases, more and more people are falling victim of fake medicines. Thus fighting this criminal trade, in a land where real medicines is desperately needed, is crucial.
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The Kenya Association of Pharmaceutical Industry has warned that fake medicines threaten delivery of President’s Big Four agenda on access to universal healthcare by all.
The risks to patients and their families posed by these drugs are immense, often leading to painful injury which in turn spirals into economic hardship and ultimately death. Fake drugs are also a boon to drug resistance.
A statistical model developed by the London School of Hygiene and Tropical Medicine estimates that up to 158,000 deaths from malaria could be caused every year by fake antimalarial drugs in Africa, South of the Sahara. This is equivalent to one fully packed Jambo Jet crashing everyday.
We are faced with a multi-billion dollar industry operated by transnational criminal networks who are motivated by phenomenal profits. With global sales estimated by WHO at over 75 billion Euros each year, it is several times a more lucrative business than cocaine or heroin trafficking.
The current solutions have been struggling to keep pace. They range from legacy technologies like bar cording and serialisation to new innovations trying to enhance pharmacovigilance and post marketing surveillance of drugs. Yet they seem ill-equipped to tackle the challenge on their own.
But what if we could track and trace drug sources and verify that only authentic drugs are handed over to an authourised party at each transfer point? And ensure compliance with asset transfer through a joint verified ledger of all transactions that is broadcast to all?
Many experts think that patient safety, enhanced drug surveillance, and the integrity of drug supply chain will be secured by employing the next generation of technology that could enable integration and interoperability of all data points in the supply chain, record history of specific assets, and authenticate drugs at each stage of their journey like blockchain. While others believe the supply chains do not need blockchain to solve the perils of fake medicines as existing technologies could be leveraged.
Well, take the Nakuru-based clinician Teresia. She needs anti-malarial drug, Duo-Cotecxin which was previously recalled from Kenyan markets for failing to comply with specifications for essay of dihydroartemisinin tablets, meaning fake. She arranges the deliveries from the pharma using blockchain so as to trace the origins of the drugs should an anomaly arise.
At Kilimani pharma company in Nairobi, Otieno receives an order from Dr Teresia for Duo-Cotecxin drugs. The order is registered in a blockchain.
Otieno prepares the delivery for Dr Teresia and scans QR codes and serial numbers for the drugs for the blockchain. Currently, packages and capsules are easily imitated perfectly by criminal counterfeiters.
The order is ready to go to a delivery carrier. From the list of possible carriers available in the blockchain system, Otieno selects Solomon who is available and has a good reputation score. In Kenya, inefficiencies are mostly witnessed in getting drugs to local clinics.
He heads to Kilimani pharma where he meets Otieno. When he arrives,Solomon authenticates to the blockchain system and Otieno initializes the delivery transfer. Solomon then checks the serial numbers of the drugs and accepts the delivery. The transaction is appended to the blockchain ledger.
Solomon heads out to Teresa’s clinic in Nakuru. They both examine the delivery and together authenticate using the blockchain. Dr Teresia verifies the tracking code number of the delivery then scans and verifies the drugs using a QR scanner.
Dr Teresia accepts the delivery while Solomon accepts the delivery transfer. All participants have matching records and examine all of the day’s blockchain transactions.
Back at Haifa site, new African partnerships are afoot from pharma keen to have a technology with an immutable audit trail able to detect drug supply chain irregularities, enhance optimization, and better effectuate a drug recall process. The question is; can any promising technology overcome weak legal, regulatory, policy, institutional frameworks experienced in our health systems?
Mr Onyango is a Global Health Programme for Germany Fellow at European Journalism Centre and a youth development [email protected]