Malaria Drug Challenges in Kenya

duo_cotecxin.jpgDespite a call for pharmacovigilence by the Kenya Pharmacy Board, fake duo-cotexin and cotexin were found in Kenya recently. The producers of duo-cotexin [40mg of dihydroartemisinin (DHA) and 320mg of piperaquine (PPQ)] have promised to introduce counterfeit-proof packaging with features such as a hologram, but in the meantime in Kenya, let the buyer beware. As a Daily Nation editorial opines, at present, “The average person is hardly in a position to differentiate between the counterfeit and the genuine drug. This would mean that there are people who are unnecessarily losing their lives.”

The Daily Nation pinpoints the problem within the Pharmacy Board. “Although the Pharmacy and Poisons Board has drug inspectors who are tasked to not only combat counterfeit drugs but also to ensure that drugs in the market are duly registered, it would appear that they are ill-equipped to police the drug market,” even though the Board claims that, “We ensure that all drugs, locally manufactured, imported and/or exported and registered to ensure their safety quality and efficacy” (sic).

With the presence of major donor programs such as the Global Fund and the President’s Malaria Initiative, Kenya may feel that much of its malaria drug need is being met with provisions of the only WHO prequalified arteseminin-based combination therapy antimalarial, Coartem, but that does not account for the private sector where the fake duo-cotexin appeared. Donor support is needed, not only to import more Coartem, but also to improve the capacity of the National Pharmacy Board and National Quality Control Laboratory to ensure that all Kenyans have access to safe and effective malaria medicines, whether they use the public or private sectors. This same need holds true for other countries in the region.

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