"In the mid-2000s, Myanmar saw between 500,000 and 600,000 cases of malaria every year. So it wasn’t surpr ising when, in February 2005, a 23-year-old man in Myanmar came down with a fever, nausea, chills and a headache so severe he had to be taken to the local hospital. His doctors quickly determined he was, in fact, stricken with malaria. They prescribed him artesunate, an inexpensive anti-malarial regularly used by Myanmar’s health care professionals to treat the infectious disease.
Typically, a patient’s symptoms will subside after a few days on the drug, but this young man grew much worse. He slipped into a coma, his kidneys showed signs of failing, and the concentration of malarial parasites in his blood grew higher. His doctors tried to give him fluids and a more powerful dose of artesunate injected into his bloodstream, but they were too late. The infection spread to his brain and killed him.
Because artesunate is safe, generally well-tolerated and highly effective, hospital investigators decided to probe the case to try to understand what might have gone wrong. They were shocked to discover that the artesunate given to the patient had only 20 percent of the active ingredient required to kill the parasites. The drug, in other words, was a fake.”
— Excerpt taken from a 2015 Newsweek Report
Tragic incidents like the story above are not isolated either. Almost every type of drug is susceptible, from vaccines to Viagra, and they are adversely affecting individuals from all walks of life, all over the world. In 2012, a poor-quality tuberculosis drug triggered severe adverse reactions and killed 100 patients at a Lahore hospital in Pakistan. In 2013, officials in India discovered that at least 8,000 patients died because an antibiotic used in preventing infection after surgery was counterfeit and contained no active ingredient. In May 2015, the World Health Organization (WHO) issued a warning about falsified meningitis vaccines being sold in West Africa. The list of stories similar to this grows daily.
Counterfeit drugs pose a global threat to the health and wellbeing of individuals and the institutions duped into administering these imposter drugs. According to various reports from the WHO, up to 50% of prescription medications in some countries are counterfeit, and cause or contribute to over 100,000 deaths annually in Africa alone. Additionally, these counterfeit drugs represent a large financial resource for unscrupulous entrepreneurs while at the same time exacting high human and economic costs. In 2003, the WHO estimated global sales of counterfeit medications could top $75 billion USD— 10% of all medicines sold worldwide.
Within this ecosystem, the black market for counterfeit drugs has found a disproportionately large foothold through the exploitation of many economically vulnerable and developing nations. While undoubtedly a global issue, the most staggering effects are often felt in areas with high corruption and low existing infrastructure, regulations, and safety practices. Further compounding this problem, recent studies show that the sale of counterfeit drugs via the internet has become an attractive and popular venue for marketing and sales. Globalisation, therefore, continues its upward trajectory with little chance of slowing down. The proliferation of counterfeit drugs highlights this trend and represents a global crisis that is no longer confined to just small and localised developing economies.
Luckily, solutions are on their way. Within this space there are companies innovating rapidly in order to combat the current issues and even prevent further exploitation. Two companies actively combating this problem are RxAll and Veripad. Both participated in the Merck Accelerator Program, the program that supports startups with the potential to reshape entire industries with a focus on digital startups in the fields of healthcare, life sciences and performance materials.
RxAll is an innovative technology company developing an artificial intelligence (AI) deep learning algorithm platform that enables spectrometer devices to authenticate medicines in real time. The AI learns changes to ingredients it samples in the field and is able to inform pharmaceutical manufacturers in real time about counterfeiting of their products.
The AI platform works through spectrometers and a cloud dataset of spectral signatures of medications to carry out non-destructive product authentication. The latest working authentication prototype has a 92% matching effectiveness and uses RxAll’s proprietary machine and deep learning algorithm.
Additionally, RxAllng is Nigeria’s first marketplace platform to enable hospitals and retail pharmacies procure and authenticate high quality stock from verified and licensed pharmaceutical manufacturers, distributors, and wholesalers. They are effectively deploying this digital AI platform in combating and preventing supply chain breaches by counterfeiters.
Veripad is another exciting and innovative company utilising technology to tackle the problem of counterfeit drugs. Their goal is to “stop the spread of falsified and substandard medication,” and they have developed a technology that offers an “affordable, portable, and easy to use solution.”
Veripad uses chemical testing paper and a mobile application to identify falsified medications. They have developed their own testing cards that can perform several chemical tests on a medication in question by simply adding water. From there, they utilise their smartphone application to interpret the results of the chemical test card and indicate whether the medication is suspicious or authentic. Finally, they utilise data analytics technology to aggregate the results of every test in order to better understand the flow of counterfeits within affected regions with the ultimate goal to improve initiatives and policies.
The fight against counterfeiting is an ongoing battle that doesn’t appear to be slowing down anytime soon. Existing organisations such as the WHO and Interpol have made some inroads by identifying illegal sellers and disrupting existing networks. As we move forward, companies such as Veripad and RxAll are using innovation and technology to develop practical solutions to deal with the associated issues. The U.S. Food and Drug Administration (FDA) has come out in support of this model for what they call “track and trace technology.”
In the next five years, we can reasonably hope to have developed widespread adoption of track and trace technologies such as RxAll or Veripad that substantially reduce the sale and consumption of counterfeit medication globally (even 1–2% would be significant). The first step is awareness, followed by cooperation with existing institutions and governments, followed by adoption of combative practices including technology at scale. Together we can all be part of the solution. Take the first step and help spread awareness: Share this article with your network. Every little bit helps as we forge toward a better, safer tomorrow.