By Kundai Marunya

THE growing volumes of counterfeit medicines that are being sold on the streets now pose a serious risk to public health, according to health officials. The medicines being smuggled from neighbouring countries, including Zambia and South Africa, could result in serious health implications such as kidney failure, liver disease and cancer, among other complications. According to research, the medication being imported from aforementioned neighbouring countries originates from as far as India and other Asian countries. So easy is medicine counterfeiting that even locals have reportedly taken up the trade, thus packaging different substances to look like legitimate drugs and parcelling them out to unsuspecting public who buy from the streets and other unlicensed traders.

The revelation comes at a time the Medicines Control Authority of Zimbabwe (MCAZ) is celebrating having achieved Maturity Level Three (ML 3) in the WHO’s classification of regulatory authorities for regulation of medicines and vaccines (non-producing). ML3 signifies a stable, well-functioning and integrated regulatory system, an achievement that means MCAZ has developed a stable, well-functioning and integrated regulatory system, ensuring the quality, safety and efficacy of medicines and vaccines registered by the authority.

Zimbabwe now joins the ranks of only six African nations to have reached this significant milestone Tanzania in 2018, Ghana in 2020, Nigeria, South Africa and Egypt in 2022. “The attainment of GBT ML 3 has been a strategic objective for us as a regulator, reflecting our dedication to safeguarding public health,” said MCAZ director-general Richard Rukwata. “This milestone demonstrates our capability to effectively regulate and monitor the safety, quality and efficacy of medicines, vaccines and medical devices in Zimbabwe. “It assures the public and our partners that Zimbabwe’s regulatory framework meets international standards. I commend the MCAZ board and all our staff for their relentless efforts and commitment to achieving this goal.”

Despite MCAZ working with the Government and other stakeholders to ensure members of the public consume quality and reliable medical products, counterfeit medicines remain a major threat to progress made thus far. “The journey to ML 3 involved extensive reviews and enhancements of regulatory policies, procedures and practices,” said Rukwata. “Key focus areas included strengthening pharmacovigilance, ensuring robust market surveillance and enhancing regulatory inspections and enforcement mechanisms. “The authority would like to assure the Zimbabwean public that as long as they buy medicines through the licit channels, they would get as much protection from the MCAZ as the authority can master by collaborating with the police, port health authorities, ZIMRA and many other agencies that help us in the pursuit of the mandate of the authority.” Registration and certification of medicines is a long process that can take up to three years as the authority does a thorough scientific assessment of the product to ensure quality.

The robust testing which, in Zimbabwe, is done by MCAZ acts as a safety net insuring public health. Rukwata fingered members of the public for complicity in the booming multi-billion-dollar trade in illicit and counterfeit drugs whose depth has pervaded the whole country, and the world at large. “One of our biggest challenges is the complicity of members of our public to the sale of counterfeit medicines,” he said. “You find that vendors will board buses selling medicines like Ibuprofen tablets and members of the public will actually buy and this creates a market for illicit substances. “They believe that if it looks like medicine then it is medicine. The reason we exist as an authority is precisely because the opposite is true. Just because something looks like medicine does not mean it is a medicine. “There is a lot of money being made. In fact, the industry of substandard and counterfeit medicine is believed to fall in the multi-billion-dollar category. “Anyone can get the right equipment, set up in his/her garage, make tablets, coat them nicely and they will look real enough.

There is no way of telling whether a medicine is real or not unless it’s scientifically tested in the lab.” Traders in counterfeit medicines have made them easily accessible and readily available, even in areas that do not have registered pharmacies. In farming areas near Goromonzi, where the nearest pharmacy is about 15km away, traders in counterfeit medicine have taken to using the door-to-door approach in selling their products. Their range, which includes painkillers, such as Ibuprofen, and antibiotics, including Cotrimoxazole and Amoxicillin, are widely popular with locals who believe the medicines to be real and effective. Traders believe they are providing a public health service.

“I buy my medicines from a supplier who brings them into the country from Zambia at a cheaper price and sell them to my community,” said a trader who preferred anonymity. “My prices are similar to those in pharmacies so the benefit for my customers is that they do not have to travel to buy medical supplies. They just call me and I deliver to their doorstep.” Some members of the public have, however, accused pharmacies of inflating prices leading them to buy from unlicensed traders. “I have, on several occasions, been ripped off by pharmacies that inflate their prices,” said a Harare resident who preferred anonymity. “When you complain over the high cost of medication, sometimes the pharmacy staff slash the prices. It’s high time we had blanket prices for medication because if I can’t afford what’s in the pharmacy because someone saw it fit to profiteer from the sick, then the next best option is to buy from the streets where it’s sometimes 50 percent cheaper.” Small pharmacies are also accused of selling counterfeit medicines, thus creating distrust in the health services system.

The absence of a prescription on regulated medicines is another attraction for consumers of counterfeit medicines. MCAZ has been working with the police to remove counterfeit medicines from the market “We have a MoU with ZRP, thus we work together to stop counterfeit medicines. We train them to go onto the field to identifying areas of concern, educating the public on illicit medicines and their effects,” said MCAZ head (Licensing and Enforcement Division) Caroline Gertrude Dandira-Samatanga. “Our engagement which was carried out nationwide has seen an increase in awareness, leading to raids on illicit traders.” Recent raids in Caledonia led to the discovery of six unlicensed shops where unregistered medicines and expired drugs were being sold by unlicensed individuals.

The effectiveness of the raids, however, depends on members of the public tipping off the regulatory authorities. To effectively rid the market of counterfeit drugs, there is also a dire need for awareness on the possible side-effects of their consumption. “There will always be a market for counterfeit medicines smuggled into the country. But it’s impossible for us to be everywhere where the medicines are sold, thus we urge our people to buy from regulated suppliers,” said Rukwata.