The ‘two price’ phenomenon for the same item or brand is a common and seemingly normal scenario on the Ugandan market. Everyone knows that one will find a cheap GUCCI and an expensive one, a cheap Samsung and an expensive Samsung, a cheap Philips electrical equipment and an expensive Philips and so on. ‘Cheap’ is taken to be for duplicate and ‘expensive’ for original.
The same is unfortunately happening on the medical market as well, exposing the lives of every innocent citizen to glaring risk of death due to use of fake medicines, development of drug resistance by diseases resulting into complex scenarios and others.
Apart from the price difference, there is always little or no difference left to the unsuspecting common Ugandan to differentiate between the original and the duplicate. Therefore, sometimes the duplicate is sold expensively in the guise of being the original!
When I visited my cousin recently who is struggling with Leukemia (cancer of the blood) at Uganda Cancer Institute- Mulago, the mother revealed that all medicine prescribed is sold at different prices in different pharmacies around the same business locality- Wandegeya.
One of the prescriptions for example was at Ugx.190, 000 in one pharmacy but the same could be obtained at Ugx.110, 000 at the next door pharmacy, a price difference of Ugx. 80,000!! Yet everything starting from the packaging material, name of medicine, manufacturers, size of pills, font size and type on packaging, colours all looked similar.
This scenario reminded me of our family doctor who used to run two dispensing areas at his clinic in Mukono. He would prescribe for a patient a drug like Coartem and suggests a price. In case the patient hesitated to pay that amount, he could reduce the price and direct his nurse to dispense the same drug but at a different room in his clinic. Psychologically, patients thought that when you are treated from the doctor’s room, you get better faster than when you are treated outside by the nurse! The price difference was therefore tagged on how fast one wanted to get better and not on the quality of the medicine used!
World Health Organization (WHO) defines a counterfeit drug as a drug made by someone other than the genuine manufacturer, by copying or imitating an original product without authority or right, with a view to deceive or defraud and then marketing the copied or forged drug as the original. Counterfeit products encompass drugs that may have wrong active ingredients, fraudulent packaging, insufficient active ingredients and/or absence of active ingredients.
In many parts of Africa, Asia and Latin America, between 30%- 60 % of the medicine on market can be fake! WHO revealed in a report published in 2012.
According to David Nahamya, chief drug inspector at the Ugandan National Drug Authority, if someone wants to counterfeit a drug, they just take the package to China and they can make it in thousands. ‘In China, they can copy anything!’ he exclaims.
The effects of this dubious business borders to nothing but death and no one including the corrupt officials of regulatory authorities at boarder points who allow in these fake products is safe, because they will never be in position to detect these medicines when they go to the drug shops to buy for themselves, family or friends.
The high taxes imposed on genuine medicines coupled with expensive distribution networks and dispensing costs make their prices almost outrageous to the common poor users. The populace is therefore left with no option other than consuming the cheap fake that usually ends up being tragically expensive claiming lives of close 100,000 people per year according to WHO.
Does the UNBS and NDA have capacity and the will to protect the lives of Ugandans?