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Scratch and win for authentic malaria drugs

Here’s a problem most people in rich countries don’t often have to deal with: wondering whether the drugs you’ve just picked up from your local pharmacy will kill you, save your life, or give you just enough active ingredients to create a new drug-resistant strain of an otherwise curable disease.

Counterfeiting does happen in rich countries, but more prevalently with “lifestyle drugs” like Viagra or allergy meds. Poor countries often have thriving counterfeit markets for drugs needed to combat more life-threatening diseases like malaria—for example in a recent study in Madagascar, Senegal and Uganda, between 26 and 44 percent of antimalarial drugs failed quality tests.

What if consumers could scratch off a panel on a drug package, send a text message containing that package’s unique 10-digit code, and get back a message that the drugs were authentic and safe to use, or fake? This is the idea behind mPedigree, a start-up led by Ghanaian social entrepreneur Bright Simons. According to a recent Bloomberg article mPedigree is planning a trial of their system using 125,000 packets of antimalarials in Ghana and Nigeria later this year. A rival service called Sproxil, started by another of mPedigree’s founders, Ashifi Gogo, is being deployed in Nigeria.

The idea’s brilliance lies in its reliance on two existing, affordable, and familiar technologies: the cell phone and the scratch card. Access to cell phones in Ghana and Africa as a whole has increased rapidly over the last decade, and scratch cards are a common way for people to top up their pre-paid cell phones.

The potential benefits are clear. From the perspective of the consumer, mPedigree is a quick, easy and cheap way to discover whether just-purchased drugs are real or fake. For drug makers, the new service will allow them to capture a greater share of the market as they drive out fakes and low-quality competitors.

On the other hand, this raises the question of who will be protected and who will be excluded if the services become widespread. If the idea spreads to drugs for which there are locally-made versions or legitimate generics available, will larger drug makers who use mPedigree be able to drive smaller firms who can’t afford it out of business? Or will mPedigree strive to include all the legitimate drug makers in the market?

mPedigree’s scratch and win panels are no permanent substitute for what’s missing in those markets where counterfeit antimalarials flourish—namely a well-functioning drug regulatory system, good consumer education about the danger of fakes, and a plentiful supply of effective antimalarials that are affordable and available to all who need them. But as a stopgap measure, they might be a winner.

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14 Comments

  1. Armatequaye wrote:

    Dear Laura, brilliant insights these. I know the mPedigree program inside out. You are absolutely right. It is no substitute for a well functioning regulatory system. The way it has been set-up actually is as a complementary system. In fact in both Ghana and Nigeria, the regulators have been very involved in the design of the system. The idea is that it shall provide critical intelligence about real-time developments in the supply chain (as people text in to check on the medicines) so that regulators can focus their efforts. Imagine how improved the current system shall be if sub-standard medicines could be removed from the market by regulators through text messages, or condition-specific health and wellness info could be sent directly to consumers phones based on the tags pre-programmed by the regulators working in partnership with ministries of health and of course the drug makers themselves. I agree though that mpedigree should communicate more about the wider public health benefits of this system so that people dont mistake it for an IPR defence system.

    Posted May 18, 2010 at 5:17 am | Permalink
  2. Alanna wrote:

    I never understand the scratch off part. if someone wanted to pirate the code, couldn’t they just buy the drug to scratch off and get a good cade?

    Posted May 18, 2010 at 9:20 am | Permalink
  3. Nick Gogerty wrote:

    Alanna: each code is unique and registered most likely for a single use. The codes are probably non-sequential or randomly generated.

    Thus producing unique bottles, with unique codes.

    the risk is a counterfitter producing a parallel system of entire distribution with their own codes telephone call in system. The nice thing is this could be shut down or tracked using the phone service. The distribution system becomes quasi public.

    Few mentions of privacy (drugs tied to telco) records as efficacy & public health trumps privacy risk correctly in this situation.

    Posted May 18, 2010 at 9:58 am | Permalink
  4. IdealistNYC wrote:

    @Alanna

    If you’re a consumer, you simply wouldn’t buy a bottle with the code scratched off. Just like you wouldn’t buy a bottle of aspirin in the U.S. if the packaging has been tampered with.

    I think this is a brilliant idea and hope it succeeds. Counterfeits are helping no one and hurting millions of people as diseases become resistant to drugs.

    Posted May 18, 2010 at 9:59 am | Permalink
  5. Matt Richmond wrote:

    @Alanna I don’t think anyone actually answered your question.

    The pirates wouldn’t buy the bottle because they sell the drugs either at an equal or lesser price than the real drugs. In order to make a profit, then, it would be necessary to sell the fakes at a higher price than the real drugs because their “manufacturing” cost includes the cost of the real drug.

    They would then be driven out of business.

    Posted May 18, 2010 at 10:46 am | Permalink
  6. Jeff Barnes wrote:

    Great post, and thank you for raising legitimate concerns about this innovation. While I think this is an excellent innovation, it is not a magic bullet (they never are). The other ingredient required to make this a success (besides a regulatory body with some enforcement teeth) is significant promotional investment so consumers understand it and refuse to purchase drugs without the code and to drug manufacturers so they are willing to share the costs of conforming to the system.

    Posted May 18, 2010 at 10:55 am | Permalink
  7. Laura mentions that Sproxil is also in trials in Nigeria but actually this program is up and running, in live use.

    Sproxil (www.sproxil.com), a U.S. based company recently launched the first mobile anti-counterfeiting solution to be offered broadly in all of Africa. Simple, easy to use and with no consumer capital investment, Sproxil offers an anti-counterfeiting service for cash-based societies, one that can be used anywhere mobile phones exist.

    Combining several “interlocking” approaches to block counterfeiters, and endorsed by Nigeria’s National Agency for Food, Drug Administration and Control (NAFDAC), Sproxil’s is the first electronic anti-counterfeit scheme that goes direct to consumers in the developing world.

    Delivering automatic protection, simple labels and robust back-end analytics with its Mobile Product AuthenticationTM (MPA) solution, Sproxil, a privately backed organization, enables consumers to text message an item-unique code for a rapid response that confirms a brand’s genuineness. For example, in Nigeria, consumers purchase medications with a scratch card attached to the package. They then scratch and text the unique numbers on the scratch card to a shortcode to instantly receive an SMS reply confirming the genuineness or fakeness of the product. To date, the company has coded more than 700,000 coded packages of Glucophage, a drug used to treat diabetes.

    It is even free to send the confirmatory text message, allowing users to borrow a mobile phone from someone else if they do not own one themselves. Responses on the Mobile Authentication Service (MAS) platform are delivered in a timely way. Studies indicate that SMS responses are often received within one minute.

    The system runs on Sproxil’s MAS technology, based on asymmetric encryption, which also underpins bank transfers and e-commerce. With Cascading AuthenticationTM, the company ensures only trusted agents handle its clients’ products, while each supply chain agent can individually verify the authenticity of products as they disperse through the distribution network. It’s more secure than holograms; in fact, the booming multi-billion dollar mobile phone market has been using a method similar to Sproxil’s for the last 15 years without any major flaws.

    Sproxil’s solution provides numerous benefits for governments, drug regulators and law enforcers, industry and professionals, foreign donors, foundations and non-profits, telecom operators and consumers.

    Posted May 18, 2010 at 3:12 pm | Permalink
  8. Laura Freschi wrote:

    Amanda, I’ve made a change in the sentence discussing Sproxil to reflect that Sproxil’s services are “being deployed” rather than “in trials.” Thanks for the information. Laura

    Posted May 18, 2010 at 3:38 pm | Permalink
  9. Jelena wrote:

    @Amanda Griffiths: the Nigerian regulator stated at the launch of the sproxil solution that it is in trials and shall be reviewed before actual runs: http://allafrica.com/stories/201002030624.html. Where did you get your information?

    Posted May 18, 2010 at 4:54 pm | Permalink
  10. Frank wrote:

    Amanda Sina Griffith is a Principal of Bumble PR, public relations people for Sproxil Inc. We understand her passion for her clients. But at this stage we are only interested in examining the merits of the technology not the gorgeousness of the companies deploying or trialling them.

    Frank

    Posted May 18, 2010 at 5:09 pm | Permalink
  11. Yaw wrote:

    Well, being a PR expert (http://www.elance.com/s/asinagriffith/) doesnt mean being blind to facts in a bid to push an angle. Everyone who has followed the fake drugs problem in West Africa knows that the mPedigree solution was launched first (news.myjoyonline.com/health/200803/14868.asp). What is more interesting is finding out what 2 years of pilots and research has taught the folks proposing this as a solution about how to get this right. Issues of privacy for instance are addressed through the well-known hashing technique, as I learnt from one email to those directly involved. This is a major global public health issue and not the place for pr gimmicks.

    Posted May 18, 2010 at 5:23 pm | Permalink
  12. Kwabena Obeng wrote:

    I’m in Ghana now and I am yet to see any drugs protected by the mPedigree system. I have heard about this story a lot but when you walk into a pharmacy here on ground, there is little knowledge about it. Please make sure you check your facts before publishing articles. The internet makes getting good PR easy without much validation.

    Posted May 19, 2010 at 8:45 pm | Permalink
  13. Yaw wrote:

    It seems in this case it is @kwabena who must do the fact-checking. Both this blogpost and the article it cites clearly state that the initiative is yet to launch and that a pilot happened in 2008. Nowhere was it stated that every corner pharmacy in Ghana is already using it NOW. It seems like basic english grammar to me. the internet makes pr possible but it also makes fact-checking easier if only readers can pay attention.

    Posted May 20, 2010 at 11:30 am | Permalink
  14. Laura Freschi wrote:

    Kwabena, I have read about mPedigree in many reliable sources and exchanged emails with the founder, so I can assure you they are not a PR invention.

    However, as with any startup initiative, success is not assured, and there is no doubt that there are many steps still remaining before you can walk into a pharmacy in Ghana and reliably find SMS-protected drugs.

    As Bloomberg reported, 125,000 packets of antimalarials protected by mPedigree will be introduced into Ghanaian markets at the end of the year, with the possibility of more depending on the results of negotiations with other drug makers.

    Even if all goes as planned, it would still be at least another year after that before the service is widespread enough to be reliably found in pharmacies across Ghana.

    Posted May 20, 2010 at 11:37 am | Permalink

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