When tackling the proliferation of fake or inferior drugs, local innovations and local solutions are key, writes Muhammad Hamid Zaman
AS WE learn more about the threat from substandard and counterfeit medicines, it is becoming clear it is a far greater problem than previously thought. It is also a scourge that is most acutely felt in developing countries, where fake and low-quality pharmaceuticals kill more than 500,000 people a year and affect millions more by contributing to the emergence of diseases that are resistant to existing treatments.
Compounding the problem is the approach taken by policymakers in the developing world, who are far more likely to look for solutions abroad than at home. This shortsightedness is a grave mistake that impedes innovation and progress. When it comes to tackling high-impact health challenges like the proliferation of fake or inferior drugs, local solutions and local innovations are not only likely to be central to any successful effort, they have the potential to provide benefits that go far beyond the scope of the original problem.
Throughout the developing world, but most evidently in Africa, two groups are interested in finding tools to combat the menace of bad drugs. One group, comprising students, entrepreneurs, and researchers, seeks solutions that are local, original, and tailored to the needs of their societies. While this group has produced some innovative solutions — for example, the Ghanaian entrepreneur Bright Simmons is using mobile technology to address the counterfeit-drug problem — many more local inventors and entrepreneurs must get involved.
The other group is made up of government officials, including regulators. They, too, are deeply concerned about the scourge of low-quality and fake drugs, but they are reluctant to rely on local innovation. In their minds, the solutions already exist, in the form of high-end technology designed and developed in the world’s richest countries. The challenge, for this group, lies in finding the financial resources to import these technologies.
For developing-country leaders, the effort needed to create an ecosystem that supports innovation simply appears too great, and the return on investment too little. At countless conferences and symposia, ministry officials and government personnel insist funds must be found to import solutions, à la carte. Research and innovation, or engagement with local entrepreneurs and inventors, is, unfortunately, never on the agenda. There simply is little interest in tapping into the enormous pool of intellect, passion, and energy at home.
Officials would be wise to reconsider. There is mounting evidence that sustainable solutions must have local support and local partners. Raising funds to import solutions from abroad addresses just one part of the challenge.
Many countries lack the resources to install, operate, and maintain equipment that has not been designed locally. As misuse and neglect causes equipment to malfunction, more funds become required or the programme dies. Not only does this approach fail to nurture local ecosystems of innovation, which is deeply frustrating; it also fails — repeatedly — to solve the problem.
While some solutions in the area of drug-quality testing have come from African entrepreneurs like Simmons, such examples are extremely rare, and many are developed in the diaspora with the support of organisations from outside the region. For the most part, such initiatives never engage local students. Local curricula do not focus on local challenges or promote local innovation.
And yet local talent is critical for solutions that are both original and sustainable. Indeed, by nurturing an inclusive culture of research, local innovation has the potential to provide benefits that extend far beyond the specific problem being addressed.
Nurturing the participation of underrepresented groups and creating opportunities for education and learning not only creates goodwill and promotes transparency and accountability. Building a stable foundation for future research also enables more productive public-private partnerships and stronger links between academia and domestic industry, thereby promoting economic growth. Foreign organisations, such as aid agencies or pharmaceutical companies, do have a role to play in boosting local innovation. They can support it financially, create new partnerships, and encourage policymakers to give it more credence.
The international community has a role to play as well. This year, the UN will adopt the Sustainable Development Goals, marking the start of the next phase of global efforts to eradicate poverty and improve health. As the example of developing countries’ ongoing fight against counterfeit and low-quality medicines shows, success will depend — far more often than not 4d1 on local innovation.
Muhammad Hamid Zaman is a professor of biomedical engineering at Boston University.
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