MANILA — A coma induced by a fake drug led Adebayo Alonge to an unusual yet productive outcome — a solution to stop the proliferation of falsified and substandard medicines.
“I survived a 21-day coma from a fake drug some 15 years ago in Nigeria,” Alonge, the co-founder of RxAll, told Devex over email.
Surviving the ordeal, he decided to become a pharmacist, then went to Yale to get a business degree where he co-founded the startup which uses artificial intelligence technology to check and monitor drug quality at different points of the supply chain, including at ports, hospitals, and pharmacies.
“The scale of the counterfeit drug problem is difficult to assess because, in many circumstances, people and authorities have no real way of knowing whether a drug is fake or not.”— Peter Bryant, chief operating officer, FarmaTrust
The technology includes a nanoscanner used to help check the quality of a drug before it reaches consumers or patients. The drug’s scanned information is referenced in the company’s cloud database to check for its quality, helping determine whether it is falsified, substandard, or authentic.
Today, the company is working with drug regulators in Nigeria and Ghana, and several hospitals and pharmacies including in Myanmar and Ghana. “Our goal is to protect people through improving the ability of national drug regulators to secure the drug supply chain. We do this by providing our platform as a service tool to drug regulators for their use in real-time drug quality checking, monitoring and reporting,” Alonge said.
But this is not the only digital solution to the problem of fake medicines. FarmaTrust, a London-based company, is also using AI as well as blockchain solutions to address the problem of counterfeit medicines. Using blockchain, the company creates a “digital twin” of the identity of each packet of drugs, which comes with a unique, machine-readable serial code. This helps them track and trace the drug’s journey, from manufacturer to consumer.
Peter Bryant, FarmaTrust’s chief operating officer, said their blockchain solution is currently the only system approved under the Falsified Medicines Directive by the European Parliament.
FarmaTrust CEO Raja Sharif also had a relative who was treated with fake medicines. But the discovery came too late and the patient died, Bryant said.
“The scale of the counterfeit drug problem is difficult to assess because, in many circumstances, people and authorities have no real way of knowing whether a drug is fake or not. Usually, counterfeits are detected after a fatality, sometimes in large scales or through international cooperation,” he said. “However, through various recent studies over the last decade, the significance of the problem has become evident. And it is a global issue affecting everyone in the East and the West.”
One in 10 medical products in low- and middle-income countries is substandard or fake, according to the World Health Organization. But even high-income countries are not free from the problem.
For example, in February, WHO issued a warning about a fake cancer drug for leukemia circulating in Europe and the Americas. The drug was a copy of Iclusig, which costs £5,000 ($6,360) for a 30-dose pack in the United Kingdom. They found the fake drug in circulation contained only paracetamol, commonly used to relieve fever and to provide pain relief.
In a report published in 2017, WHO estimated low- and middle-income countries were spending some $30 billion on substandard and falsified medicines. But it noted more data was needed for a more accurate estimate.
Digital solutions by RxAll and FarmaTrust help address some of the supply chain issues linked to the proliferation of substandard and falsified medicines in the market, and brings the focus to finding solutions to tackle the problem, said Oksana Pyzik, a pharmacist and senior teaching fellow on practice and policy at University College London’s School of Pharmacy.
“Many of the leaders in this industry ... might not be aware of how blockchain and other types of tools can be used in a setting. I think we could get to the stage of problem solving because a lot of the discussion now is about the complexities of [the] problem,” she said.
Pyzik was part of the organizing team behind the “Digital Natives Fight Fake Medicines” side event during the recent 72nd World Health Assembly. The event explored how tech startups like RxAll and FarmaTrust as well as young people are at the forefront of developing innovative technologies to address the issue of fake medicines, which she emphasized could happen “anywhere in the world.”
“There's a great photograph of a pharmacy in Macau, which has the traditional green cross and which advertises that it's a pharmacy. And on the bottom it says, ‘No fakes.’ So already ... that really begs the question around, shouldn't that be [a] given?” she told Devex. “A regular pharmacy advertising that they have no fake medicines … I think that's a real barometer towards what the scale of the problem is across different regions of the world.”
Issues such as access to medicines and universal health coverage took center stage at WHA72, but Pyzik would like to see governments, civil society, and the private sector focus some attention on the issue of substandard and falsified medicines.
“Because really, you don't have quality of care without ensuring you have access to good medicines,” she said.