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Combating counterfeit drugs in Africa

Each year, Lloydspharmacy funds two pharmacists to visit a drug testing project in Africa. Francesca Rivers talks to project participator Sam Gresham

by Francesca Rivers

Each year, Lloydspharmacy funds two pharmacists to visit a drug testing project in Africa. Francesca Rivers talks to project participator Sam Gresham

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Counterfeit and substandard medicines are a significant problem in many developing countries where resources are already scarce and general healthcare poor.

Earlier this year (2008), Lloydspharmacy pharmacists Sam Gresham and Amanda Pritchard travelled to Nairobi in Kenya, to take part in a scheme designed to tackle the problem by introducing on-site phamaceutical testing laboratories.

The scheme makes use of the Global Pharma Health Fund (GPHF) Minilab, a mobile miniature laboratory containing a three-tier system for testing the quality of pharmaceuticals.

The project began with two days of training at the GPHF in Frankfurt, Germany, explained Miss Gresham, where she and Miss Pritchard learnt how to use the Minilab.

They were trained to carry out a visual inspection of medicines and their packaging in order to reject crude counterfeits, and then perform a preliminary tablet and capsule disintegration test to assess drug solubility, followed by simple colour reactions for the identification of component compounds. Semi-quantitative thin layer chromatography analysis to check the quantities of drug present completed the test series.

Following training, the women spent two weeks working in a small healthcare centre located in the Mathare Valley in Nairobi where they put their training to use, performing quality control checks on medicines as well as training local healthcare professionals — including nurses and pharmacists — to perform the tests themselves.

Sam Gresham: tested drugs in stages

Miss Gresham said: “Most of the drugs [used at the health centre] are locally manufactured, with some imported from India. … We tested drugs in stages — the disintegration test was used first, to eliminate tablets that don’t break down in the body so that we didn’t waste reagents of the more complex tests on these drugs. Then we used colour reactions and thin layer chromatography, against a standard to identify fake or substandard drugs”.

She went on to explain: “HIV drugs are expensive and some manufacturers substitute them for paracetamol to make a profit.”

While working at the health centre, the women also advised local pharmacists about maintaining good prescription records and recording stock levels.

Miss Gresham recalled: “We set up a system for recording stock — just a simple Excel sheet, but before that they had no system in place. We also taught them to keep a duplicate prescription, so the centre had records of drugs dispensed. Before that, only the patients had a record of their medication — and often it would get lost or ruined.”

They also gave advice about communicating with patients, and the impact that they can have on patients’ understanding about their medicines. Miss Gresham explained: “Pharmacy over there is just a college course. Systems and approaches that seem obvious to us they just haven’t heard of, but they make such a difference.”

The project is organised in association with the Germany based charity Ärzte für die Dritte Welt (Doctors for Developing Countries) and funded by Lloydspharmacy and parent company Celesio.

Citation: The Pharmaceutical Journal URI: 10043791

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