Pharmacists Tackle Fake Drug Menace With New Detection Skills

Pharmacists Tackle Fake Drug Menace With New Detection Skills

Pharmacists from the Federal Capital Territory, Niger, and Nasarawa states have intensified efforts to combat the growing menace of counterfeit medicines in Nigeria through a hands-on capacity-building workshop aimed at equipping practitioners with skills to detect and isolate suspected fake drugs before they reach patients. The workshop, titled “Test and Stock for Medicines Against Counterfeiting,” was organised by the West African Postgraduate College of Pharmacists (WAPCP), Abuja Branch, in collaboration with the Bioscientific Research Group of the Department of Clinical Pharmacy and Biopharmacy, University of Uyo.

The initiative comes at a critical time, as the World Health Organization (WHO) estimates that 10.5% of all medicines in low- and middle-income countries are substandard or falsified, with the deaths resulting from the use of these products in malaria and childhood pneumonia alone estimated between 105,000 and 285,000 annually. The problem is particularly acute in Nigeria, where a 2022 report by the National Primary Healthcare Development Agency (NPHDA) suggested that up to 70% of drugs in circulation are substandard or counterfeit. While NAFDAC has contested this figure, stating that between 13% and 15% of medicines are fake, the scale of the problem remains alarming. In a recent operation, NAFDAC seized over 3 billion Naira worth of counterfeit medicines, including 10 million doses of antimalarial drugs that could have endangered over three million lives.

Counterfeit medicines represent a significant threat to public health in Nigeria. Studies have shown that the country faces a severe challenge, with drug counterfeiting accounting for an increasing percentage of the global drug market. According to the Food and Drug Administration (FDA), counterfeit medicines account for more than 10% of the world drug market. Between 2001 and 2005, Nigeria’s drug regulatory agencies reduced the circulation of counterfeit medicines from 40% to 17%, yet the issue continues to remain a major public health and socio-development burden. In 2018, the National Agency for Food and Drug Administration and Control (NAFDAC) destroyed fake foods and drugs worth over $10 million in the country. The market is highly import-dependent, sourcing 70% of its finished products from abroad and relying almost entirely on other countries for active pharmaceutical ingredients for local manufacturing, creating vulnerabilities that counterfeiters exploit.

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Speaking at the event, Prof. Sunday Awofisayo, Professor of Biopharmaceuticals and Clinical Pharmacy at the University of Uyo and principal researcher of the Bioscientific Research Group, said pharmacists must take a more active role in assuring the quality of medicines dispensed to Nigerians. He noted that pharmacists are recognised as drug experts and should be able to assure patients that medicines contain the active ingredients stated on their labels. According to him, counterfeit, falsified, and substandard medicines can lead to treatment failure, prolonged illness, organ damage, and even cancer when harmful substances are substituted for genuine ingredients. “If the quality is not there from the beginning, no matter how good the consultant or specialist is, treatment outcomes will be compromised,” he said. Awofisayo noted that the workshop was designed to refresh knowledge acquired during professional training and provide practical skills in detecting counterfeit medicines through basic laboratory procedures, including colourimetric testing and thin-layer chromatography (TLC) . Research published in the Journal of Pharmaceutical Policy and Practice has shown that visual inspection alone can identify many deficiencies in dosage units and packaging information. All four falsified medicines detected in a recent Nigerian study were readily identifiable, primarily from serious spelling errors in labelling and from manufacturer names that could not be verified using internet resources.

Key visual deficiencies observed in counterfeit medicines include non-uniformity of dosage units, where containers have multiple different types of tablets with different embossings and thickness; discolouration of tablets, such as brown discolouration in chloroquine tablets that correlated with API content of only 81.9% compared to 100.6% in white tablets; poorly manufactured tablets with ridges, erosion, cracks, and powder formation indicating physical instability; and incomplete filling of blisters with empty compartments or half tablets, indicating insufficient quality assurance.

Also speaking, the Zonal Coordinator of WAPCP, FCT Zone, Dr. Tijani Mufutau, described counterfeit medicines as a major threat to public health, saying pharmacists have a responsibility to verify the authenticity of medicines before they are supplied to patients. He noted that fake medicines contribute to therapeutic failure, organ damage, death, and increased healthcare costs due to prolonged hospital stays and additional treatments. Workshop lead and immediate past Zonal Coordinator of WAPCP Abuja Zone, Dr. Abubakar Danraka, said the training formed part of efforts by pharmacists to complement existing strategies aimed at reducing the circulation of counterfeit medicines. He explained that the programme focused on empowering pharmacists with practical skills that can be deployed immediately without reliance on expensive laboratory equipment. Danraka noted that the high cost of sophisticated quality assessment equipment had limited medicine testing in many health institutions, adding that the initiative sought to bridge that gap. According to him, strengthening NAFDAC and other relevant institutions through increased funding and support would help scale up such interventions across the country.

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The Global Pharma Health Fund (GPHF)-Minilab is the most widely used screening device for medicine quality surveillance in low-resource settings. The analysis consists of visual inspection of packaging and dosage units, simplified disintegration testing for solid oral dosage forms, and qualitative and semi-quantitative analysis of active pharmaceutical ingredients using thin-layer chromatography (TLC) . Additional training of local personnel significantly improved the results of both TLC analysis and image evaluation. Photographs of visual deficiencies and TLC analysis results have been compiled as teaching materials for future training courses of pharmacy staff and healthcare workers. A recently developed open-source smartphone application named “TLCyzer” enables photography and image analysis of TLC plates for improved quantitative evaluation of medicine quality screening. However, the application increased sensitivity to 62.5% but led to an unacceptably low specificity of 75.2%, highlighting the need for further development.

A study involving 390 pharmacists across Nigeria, published by the National Institute for Pharmaceutical Research and Development (NIPRD), identified primary challenges in combating fake medicines in the country, including inadequate inspection (90.93% of pharmacists affirmed this as a major challenge), poor cross-border enforcement (90.43%), poor collaboration among regulatory agencies (89.94%), inadequate legislation (88.83%), and online drug commerce (72.68%). While pharmacists demonstrated good knowledge of medicine counterfeiting, gaps were observed in their practices. About one-third (30.7%) indicated their current knowledge and skills were inadequate to detect counterfeit medicines. Age, years of practice, and area of practice significantly influenced detection abilities.

Former National Chairman of the Association of Community Pharmacists of Nigeria, Dr. Albert Alkali, described falsified medicines as one of the biggest challenges facing the country’s healthcare system. He said patients could suffer severe health complications, including kidney, liver, and heart damage, from consuming counterfeit medicines. Alkali urged Nigerians to obtain medicines only from registered pharmacies and seek professional guidance from pharmacists when purchasing drugs.

Participants at the workshop also called for stronger regulation, stricter enforcement of existing laws, and increased local pharmaceutical manufacturing to reduce dependence on imported medicines and improve quality control. This call aligns with recent efforts by NAFDAC to introduce regulatory tools including the NAFDAC Green Book, an online database allowing confirmation of registered medical products, and the Pharmaceutical Products (Traceability) Regulation 2024, mandating unique identifiers for every drug in circulation. Nigeria is the first country in Africa and the second in the world to deploy this level of pharmaceutical traceability.

Also speaking, Pharm. Rahma Issa, Deputy Head of Jummai Babangida Aliyu Maternity and Neonatal Hospital, Minna, said widespread circulation of counterfeit medicines was undermining treatment outcomes and negatively affecting both household and national economies. She advocated increased support for local drug manufacturing and stronger enforcement measures against offenders. Similarly, the Head of Pharmacy at the National Hospital Abuja, Pharmacist Clara Adesola, said pharmacists attending the workshop would transfer the knowledge acquired to colleagues in their respective institutions to widen the impact of the training. She noted that drug source verification, visual inspection, and the use of NAFDAC registration checks remained important measures for reducing the risk of counterfeit medicines entering health facilities.

The fight against counterfeit medicines has received international attention, with the International Pharmaceutical Federation (FIP) publishing a new curriculum guide in partnership with the WHO to support educators in ensuring that pharmacists are better able to prevent substandard or falsified medicines from reaching patients. These materials were developed with the support of the European Commission and in collaboration with five universities in sub-Saharan Africa, a region particularly vulnerable to counterfeit medicines. Additionally, the National Institute for Pharmaceutical Research and Development (NIPRD) has launched a nationwide training aimed at equipping early-career scientists with the skills and knowledge to ensure medicine security, strengthen healthcare systems, and combat the proliferation of fake and substandard drugs in the country. The training, part of the World Bank–funded IMPACT Project, targets approximately 50 young scientists from across Nigerian universities.

Participants agreed that strengthening pharmacists’ capacity to identify suspicious medicines before stocking them would significantly reduce the circulation of counterfeit products and improve patient safety across the country. As training programmes expand and detection technologies improve, pharmacists remain at the forefront of protecting Nigeria’s pharmaceutical supply chain and ensuring that patients receive safe, effective, and genuine medicines.