Editor’s Note: This week’s Op-Ed comes from Howard Catton, CEO of The International Council of Nurses (ICN). Ahead of World Health Day 2019, which is on Sunday, April 7th, he writes about the importance of the fight against counterfeit drugs through training and the use of technology and how this is critical if Nigeria and Sub-Saharan Africa are to make significant progress towards Universal Health Coverage by 2030.
Last year, 5 young Nigerian students won a gold scholarship in the prestigious finals of the Technovation Challenge in Silicon Valley. Promise Nnalue, Jessica Osita, Nwabuaku Ossai, Adaeze Onuigbo and Vivian Okoye, all girls, won the top prize in Technovation’s junior division for inventing a novel app that detects fake drugs, called the “FD Detector”. The app uses a drug’s barcode to verify its authenticity and expiration date.
For 15-year old Jessica Osita, there was a deeply personal motivation behind creating the app; her brother died after taking a fake drug. The tragic incident inspired her and fellow members of Team Save a Soul to create an app which would help relieve the scourge of counterfeit drugs in Nigeria. She now aspires to become a pharmacist to continue the fight against fake drugs.
Another Nigerian, who has experienced the devastating effects of fake drugs is Adebayo Alonge. As a teenager, Adebayo suffered a severe asthma attack and was rushed to the hospital. There, he was given Ventolin, a drug which should have helped him breathe but instead it put him in a coma for three weeks. During this time, the catastrophic expenditure his family was subjected to, as well as the emotional trauma they faced, made it a very trying period.
Thankfully, he survived, but the ordeal opened his eyes to the scourge of counterfeit drugs in Nigeria. “I remember asking, ‘how can medicine be fake?’ I had no idea why anyone would make or sell a fake drug. As I learned more, I got really angry that someone actually thought my life was worth a few cents”, he said. The experience inspired him to work on fighting counterfeit medicine. He studied business with a focus on pharmacy at Yale and created a start-up, RxAll, which uses Artificial Intelligence (AI) to verify the legitimacy of medicines on the market via a handheld authenticator.
Young solutions for an age-old problem
The World Health Organization (WHO) estimates that in sub-Saharan Africa alone between 64,000 and 158,000 people die every year from taking fake anti-malaria medications. Counterfeit medicine has no frontiers and the WHO estimates that the global market is worth around $200 billion, making it the most lucrative and dangerous trade in illegally copied goods. In Nigeria, the government destroyed N29 billion worth of fake drugs between 2015 and 2017 and set up the Anti-Counterfeiting Collaboration of Nigeria (ACC) to take on the hydra-headed problem of counterfeiting. Young healthcare innovators such as Team Save a Soul and Adebayo Alonge with their cutting-edge digital solutions are versatile enough to penetrate regions where government efforts may be insufficient in the fight against counterfeit drugs. These tech solutions are vital to saving the lives of thousands of patients dying from fake drugs each year.
The link between Counterfeit Drugs and Universal Health Coverage Counterfeit medicines not only pose significant threats to health, increase disease prevalence and antimicrobial resistance, but also cause loss of public confidence in healthcare professionals and health systems. They impede access to healthcare and ultimately the goal of Universal Health Coverage (UHC).
Having quality healthcare includes access to quality medicines and it is among the best investments a society can make to achieve a thriving and productive people. Investing in UHC protects people from out-of-pocket medical expenses and reduces the risk of being pushed into poverty and financial ruin due to unexpected illness, destroying their futures and often those of their children too.
The significance of UHC globally is captured in the theme for this year’s World Health Day, which is annually celebrated on the 7th of April. Reiterating the main themes of UHC, World Health Day 2019 is demanding Universal Health Coverage for everyone, everywhere.
To achieve UHC, we need to focus on quality; of health commodities, healthcare and health systems. As Dr Tedros, WHO Director General has said: “It is not just the provision of services that matter. The quality of those services provided are also vital and important. There is no UHC without quality”.
With the world requiring 18 million health workers to deliver and sustain UHC by 2030, we need to educate and train the next generation of healthcare workers, including nurses. Nurses make up more than half of the shortfall and are intrinsically linked to the ability of countries to address health priorities and achieve the SDGs. Further, nurses prescribe, administer and monitor patient treatment and experienced nurses with vast nursing expertise are especially well positioned to detect falsified medicines and early side effects of it. The next generation of trained nurses, together with innovative digital solutions, created by young entrepreneurs like Team Save a Soul and Adebayo Alonge, will spearhead the way to UHC by 2030.
To further accelerate the fight against falsified medicines and reach UHC by 2030, the International Council of Nurses is proud to partner with Fight the Fakes, an international umbrella organisation with 37 partners that raises awareness about the dangers of fake medicines and aims to build a global movement to highlight the harmful effects on falsified medicines.
Last, we need to remember that fake drugs are a symptom of the much larger problem of lack of access to quality, affordable healthcare. Much of the harm from counterfeit medical products could be avoided if quality medical products were available and affordable. This is why fighting counterfeit drugs is fighting for UHC.
Howard Catton is the CEO of The International Council of Nurses (ICN), a federation of more than 130 national nurses associations, representing the more than 20 million nurses worldwide. He has been a registered nurse since 1988 and has held a range of nursing posts in the UK and United States prior to joining ICN in 2016.