International Policy Digest

Johnny Vaet Nordskog
Health /15 Jan 2020

The Lomé Initiative and Addressing the False Medicines Epidemic Sweeping Across Africa

Tell our readers about the Lomé Initiative and the motivations behind it?

The Lomé Initiative is to be a landmark agreement that will be signed by the presidents of the Republics of Congo, Ghana, Gambia, Niger, Senegal, Togo, and Uganda respectively at a summit to be held in Lomé, Togo on January 17th, 2020.

These leaders from across the continent of Africa will come together to commit their respective governments to introduce legislation specifically targeted at criminalizing the trafficking and distribution of falsified medicines and to impose stringent penalties on what has been, up until now, considered largely to be a civil or misdemeanor offence. This is far from the case, as I shall explain.

Furthermore, the framework agreed in Lomé will establish African intergovernmental mechanisms for improving coordination in the fight against the trafficking of false medicines for years to come.

This initiative was developed and spearheaded by the Brazzaville Foundation, an independent, non-profit organisation which aims to help Africans take the lead in addressing some of the key economic and environmental concerns facing the continent; not theorizing about those challenges but putting in place practical initiatives which can bring about real change.

Make no mistake – the trafficking of fake medicines has been a blind spot in many criminal justice systems in Africa despite harming millions of people and costing hundreds of thousands of lives every year. It also funding a growing black-market industry with international ramifications. It is estimated that just $1,000 invested into the trafficking of substandard and/or falsified medicines can yield as much as $500,000 in profit. In the process of safeguarding the lives of African families, this initiative will address this major source of financing for organized crime and even terrorist activity.

The agreement to be signed in Togo, which we hope many other African heads of state will join, is not only aimed at disrupting the trafficking networks of falsified medicines but should be seen as the first step towards a much larger goal of making sure all African citizens have access to safe and effective medicines that they and their families can rely on.

Our Foundation will help with the implementation of this initiative, starting with the conduct of an audit to establish where the gaps in existing legislation exist and will be offering ongoing advice and support.

We believe it is in our hands to create lasting change, and we look forward to a productive summit.

You talk about the need for building a coalition that goes beyond the five countries represented in Lomé. Are you suggesting that the trafficking of false medicines has developed into a pan-African epidemic?

It is estimated that each year the trafficking of fake medicines kills 122,000 children under five in sub-Saharan Africa. There is no question the trafficking of substandard to false medicines has reached epidemic levels.

Pictured: Jean-Yves Ollivier.

At present, the estimated illegal market for substandard and falsified medicines has been valued at $200 billion, comprising nearly 15% of the global pharmaceutical market. The World Health Organization (WHO) estimates that substandard and falsified medicines make up an average of roughly 10% of the supply of medicines and medical products in low- and middle-income countries throughout the world, but the position is most acute in Africa where that figure can reach 60% in some countries.

The lack of the right criminal legislation and problems over enforcement, including but not limited to intra-African collaboration at major borders, have enabled the trafficking of falsified medicines to spread across the continent, with the traffickers using the same routes and the same techniques as the smugglers of arms, drugs, and people.

All governments have a responsibility to tackle this threat. The UN Sustainable Development Goal 3 recognizes the need to ensure “…access to safe, effective, quality and affordable essential medicines and vaccines for all,” a goal which remains to be achieved in Africa. We hope to set a precedent replicable across the continent in the aftermath of Lomé 2020, capitalizing on the goodwill and socioeconomic momentum achieved through such similar intra-African collaborations in 2019, such as the African Continental Free Trade Agreement (AfCFTA), ushering in structural transformations across its member states.

Meanwhile, needless deaths are spreading like a wave from the greed and ingenuity of faceless cartels. That this illicit industry thrives and is continuing to grow is not just a cause for concern, but a call for immediate action. The agreement being signed in Lomé represents a direct, practical and tangible response.

What are a few of the ramifications to purchasing fake medicines?

We must consider the vicious cycle that is fueling the black-market industry of substandard or falsified medicines.

First and foremost, they give false hope. A mother hoping to save her sick child buys medicines on the street because she does not have access to or cannot afford a proper hospital or pharmacist. She ends up buying substandard or falsified medicines. At best her child continues to suffer untreated. But in too many cases the child will die from the untreated disease or in the worst cases as a result of a fake medicine which is actively harmful. Even hospitals and pharmacies are not immune from this scourge as genuine medicines are stolen and replaced by falsified ones, undermining trust in the health care system. In the case of substandard medicines, there is a further damaging consequence because they encourage the growth of antimicrobial resistance meaning genuine medicines cease to be effective.

In addition to the human cost, untreated diseases impose a hefty economic burden on poorer countries in terms of loss of productivity and increased costs of healthcare. Finally, this traffic funds organized crime, corruption and increasingly in some parts of Africa, terrorism. As such it threatens the continent’s future stability and prosperity.

What will be the ‘calls to action,’ the takeaways from the Lomé Summit?

First of all, I would draw attention to the fact that this Agreement is being signed by the heads of state themselves. It is a signal of their personal commitment to combating the trafficking of fake medicines. Second, this is an African initiative, showing that African leaders are able and willing to step up when it comes to meeting the challenges that they face. Third, this is an opportunity to speak out about a problem which has not always been given the attention and priority it deserves. We must place more emphasis on resolving this crisis through public education and acknowledgment of its very existence.

A recent study of five African nations indicated that 97% of the public were not properly informed about the prevalence and subsequent dangers of substandard, or falsified medicines in their communities. This dangerously high figure is simply unacceptable. We must work collaboratively to not only pull the political levers at our disposal but to also make sure that we are informing the public that they are the target, the candidates to fall victim to this heinous criminal activity.

We must ensure Africans young and old pressure their leaders to work across international jurisdictions to intercept and destroy trafficking routes and to create a system of intelligence sharing and prosecution when it comes to apprehending and sentencing perpetrators.

Each and every member of society needs to be aware of the problem and act as the first line of defense. If we can educate African communities, then we will be attacking this problem from the ground up, creating a solid foundation for our long-term goal of making sure that all Africans have access to safe and reliable medicines.