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Counterfeit medicines: a global health risk

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The Pharmaceutical Journal Vol 265 No 7112p337-338
September 2, 2000 Forum

International Pharmaceutical Students Federation

Counterfeit medicines: a global health risk

The annual congress of the International Pharmaceutical Students Federation attracts more than 200 students from about 30 member countries, giving them the opportunity to meet colleagues from around the world, to discuss educational and professional issues and gain a global perspective on their chosen career. This year eight British pharmacy students and young pharmacists travelled to Central America to take part in the 46th annual IPSF congress, held in San Salvador, the capital of El Salvador, from August 3 to 12. Emily Horwell (vice-president, British Pharmaceutical Students Association) reports

New IPSF president is British

During the final business session of the congress, at which elections were held for next year's IPSF executive, Ms Lindsay McClure from Britain was elected as the new IPSF president.

One of the main events of the 10-day IPSF congress was the educational symposium, the topic for which was "Counterfeit medicines: a world menace." In her opening speech, the co-ordinator of the event, Ms DIANE GAL from Canada (IPSF chairperson of information and education) stated that it was every future pharmacists' role to combat this problem as it posed a great potential for global health risk.
Speakers included Dr MARTIJN TEN HAM (senior adviser, Department of Pharmaceutical Affairs, the Netherlands), who was chief of the drug safety unit based at the World Health Organisation from 1991 to 1998. Dr Ten Ham said that, although most of counterfeit drugs were found in Asia, South America and Africa, the problem was on the increase in the western world.
A study in the United Kingdom involving the police and regulatory bodies had found 30 cases of counterfeit medicines entering the UK in one year, from a very small sample of goods inspected. Around 5 to 8 per cent of all pharmaceutical products internationally were thought to be counterfeit and counterfeiting was estimated to cost the industry around US$10bn a year.
The most commonly counterfeited drugs were antibacterial and anthelmintic drugs and vaccines. This trade could pose a major health risk, because the most common type of counterfeit contained little or no active ingredient, leading to antibiotic resistance and ineffective vaccination programmes.
Another important factor to consider was the erosion of public confidence in health care professionals, especially in developing countries, where levels of education about health and access to health care were poor.
Dr EMILIO SEGOVIA (Mexico), a pharmaceutical chemist and consultant for the Pan American Health Organisation, stressed that falsification of medicines was a serious crime and could endanger life. One example given was a case in which over 500 children in Haiti had developed acute renal failure after a batch of paracetamol suspension had been found to have been made with antifreeze instead of glycerol.
Dr Segovia concluded that it was everyone's responsibility to detect and eliminate counterfeit medicines - from the manufacturer and wholesaler to the pharmacist and patient.

Students at a stand promoting the IPSF?s Neema village
Students at a stand promoting the IPSF's Neema village concept project, which has built, and runs, a dispensary in a Tanzanian village (PJ, July 17, 1999, p97)
Students enjoy themselves during the congress international evening
The congress social programme included a "traditional evening", at which participants attempted to salsa and local food was cooked by the families of local students

The IPSF congress and El Salvador

The annual congress of the International Pharmaceutical Students Federation attracts more than 200 students from about 30 member countries, giving them the opportunity to meet colleagues from around the world, to discuss educational and professional issues and gain a global perspective on their chosen career.
This year's congress in San Salvador attracted delegates from South American countries such as Chile, Peru and Argentina for the first time, increasing IPSF's representation in the area. El Salvador is the smallest country in Central America. Because of its civil war, which ended just eight years ago, it is not a well-known tourist spot. San Salvador, the capital, has one of the highest crime rates in Latin America. It has its own "tourist police" department, providing 24-hour armed escorts. Even the local restaurants and shops have their own armed guards - which is disconcerting when one comes come from a country in which firearms are not seen on the street on a regular basis. Congress participants also saw the other side of El Salvador- the friendly people, sunny beaches and palm trees, and plenty of Latin American spirit, including a laid-back approach to time-keeping.
Information on the IPSF annual congress and other IPSF activities is available from the British Pharmaceutical Students Association, c/o Royal Pharmaceutical Society, 1 Lambeth High Street, London SE1 7JN (e-mail

Improving education in developing nations

International co-operation towards the improvement of pharmacy education in developing nations was the subject of an educational forum at this year's congress. The aim of the forum was to share ideas on how to increase access and participation to higher education globally, and learn from the different strengths and weaknesses of each country's educational systems to help students attain academic freedom and quality assessment of their education.
The first speaker, Professor JOHN MURPHY (head of the department of pharmacy practice and science, college of pharmacy, University of Arizona, United States), commented that the western world had as much to learn as it had to offer. In the US, US$76bn dollars was spent annually on health care associated with medication problems - the same amount as was spent on the medication! Although developing nations might be seen to be disadvantaged because of a lack of computer skills and inadequate research and teaching, their education had many strengths, such as the application of rational drug use knowledge, and in-field research and assignments. However, sharing ideas was not enough: it was important to prevent the "brain drain" phenomenon in developing countries. In other words, students needed to "learn and return."

Innovative teaching methods
Professor ZUBIN AUSTIN (co-ordinator of pharmacy practice, faculty of pharmacy, University of Toronto, Canada), speaking on the changes taking place in pharmacy education, said that students currently had an unprecedented opportunity to have an impact on their own education. He mentioned innovative methods of teaching, such as "team" teaching, where a senior academic lecturer was paired with a pharmacy practitioner - or even a senior pharmacy student - who could "translate" the scientific information to give it practical relevance.
In several countries, such as the US, Canada, Singapore, Denmark and Portugal, there was a national award scheme in which classes could vote for their favourite teacher. This promoted good teaching and some healthy competition. The value of international co-operation was under-used in pharmacy and students needed to take the initiative. It might take effort, but the results were worth it.
Speaking on distance education in developing countries, Mr KEVIN MOODY (pharmacist and co-ordinator, Campaign for Access to Essential Medicines, Médecins sans Frontières) said that distance learning could help eliminate time and distance barriers to create a "global village", helping to facilitate international communication.
Technology was a useful tool but might not always be appropriate. For example, it was hard to use the internet effectively in Nigeria because one needed a satellite telephone, and the computer would work at one-hundredth of the speed people in the western world were used to.

Pharmacy education in El Salvador

San Salvador is the home of El Salvador's only school of pharmacy. A visit to its chemistry laboratories, and a discussion with academic staff, produced the information that the school owns analytical equipment not found elsewhere in the country. However, many of the machines do not work properly because air temperatures are too high and the school cannot afford to ventilate the building to the necessary standard.
The laboratory has a corrugated iron roof and is filled with equipment that is at least 30 years old. Despite this, the students carry out some of the same experiments as those performed by British pharmacy students.

Citation: The Pharmaceutical Journal URI: 20002702

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