With the Government Analyst Food & Drugs Department (GAFDD) facing ever increasing challenges in its quest to effectively monitor the entry of unauthorised foods and medicines into the country, local consumers could face more risks in the year ahead in its quest to fend off a fake medication industry estimated to be worth in excess of US$30 billion. While there have been no shortage of warnings from the World Health Organization (WHO) regarding the size and potency of the fake drugs industry and the thousands of victims, including children that it claims every year, those warnings have limited effect in countries like Guyana where the end of 2018 finds the GAFDD still under-resourced and the country’s open borders inviting the further proliferation of illegal imports, not least, fake drugs.
Numerous public warnings from the GAFDD over the years and particularly in more recent times have elicited the same response. While the authorities are aware of the country’s vulnerability to fake drugs reaching patients here, a lack of adequate deterrent capacity continues to be its Achilles Heel. And even if there was a more effective deterrent force the GAFDD concedes that apart from the vulnerabilities associated with entry of imports into the country through the state-controlled system, there is no reason to disbelieve that a significant portion of fake drug imports arrives here through back channels. More than that, where there is a high demand for life saving and/or health restoring medicines, consumers preoccupied with the urgency associated with finding remedies are often less mindful of investigating the bona fides of the drugs that reach them.
It is not a Guyana problem alone. Repeated warnings about the size and potency of the fake drugs industry coming from the World Health Organization (WHO) have not done a great deal to slow the global growth of the fake drugs trade, an indication that even highly credible warnings are not having the desired effect.
Setting aside the particular challenge of limited resources with which to check the proliferation of fake drugs in developing countries, evidence has come to the fore in many developing countries that fake drug importation is embedded in official drug acquisition systems. With health care and specifically drug importation accounting for a huge slice of state spending in developing countries, the official sanctioning of fake drug importation by well placed state officials can bring them significant material.
Reliable statistics on the likely extent of fake drugs imports into Guyana are not easy to come by though a 2017 post based allegedly on an investigator assigned by an organization called the International Institute for Research Against Counterfeit Medicines (IRACM) puts the extent of fake drug imports into Guyana at 25% to 35% of overall drug imports, rating the country, along with Haiti, Jamaica and Trinidad and Tobago as experiencing the “highest exposure” to fake drugs penetration in the region.
Earlier this year GAFDD Director Marlan Cole went on record as saying that it was likely that that figure could be in the region of 30%. Worryingly, he also alluded to the likelihood of patient mortality linked to the administering of fake drugs.
As both the health risks and the economic costs associated with public exposure with fake drugs rises, it was disclosed earlier this year that the GAFDD was investigating cases in which medication administered may have “indirectly” resulted in fatalities. Over a much longer period the GAFDD has been periodically issuing public statements seeking to provide assurances that it continues to step up initiatives to guard against the dangers. The problem with these ‘assurances’ is that they continue to be made against the backdrop of what is widely known to be serious physical limitations in its actual monitoring capabilities, whether it be at official ports of entry or at unofficial crossing points.
With the cross-border movement into Guyana from both Brazil and Venezuela occurring on a sustained basis and without the benefit of any serious monitoring there is little doubt that these have become routes for fake drug entry into Guyana. Brazil, which possesses a globally recognized pharmaceuticals industry has been tagged as a significant producer of fake drugs. Back in 2000 a Study undertaken by the Latin American and Caribbean Regional Office of the World Bank had listed penicillin and tetracycline as being among drugs produced in Brazil that contained “only a small amount of the labeled amount of the antibiotic, or none at all.”
Much more than territorial integrity may be compromised by porous borders. Two years ago the Government of Guyana announced that it was undertaking the construction of a modern multi-million dollar complex in 2017, to house the GAFDD. The announced upgrade was estimated to cost $130.7 million. That project has not been executed up to this time, though in April this year there was another high profile announcement made regarding a multimillion dollar investment in the upgrading of the GAFDD. There is no evidence of significant movement on this undertaking up to this time. Meanwhile, the threat being posed by the proliferation of fake drugs appears to be worsening.