There's nothing covert
about Roxy -- a huge market in Abidjan selling counterfeit medicine, the
scourge of Africa and the cause of around 100,000 deaths annually on the
world's poorest continent.
Located
in the bustling Adjame quarter of Côte d'Ivoire's main city and commercial hub,
the haven for fake medicine has been targeted time and again by authorities and
stockpiles burnt.
But
it resurfaces every time.
"The
police hassle us but they themselves buy these medicines," said Mariam,
one of the many mainly illiterate vendors who hawk everything from painkillers
and antibiotics to anti-malaria and anti-retroviral treatments.
"When
we are harassed we always come to an arrangement with them to resume our
activities," she said.
Fatima,
another hawker, said: "Many people come here with their prescriptions to
buy medicine, even the owners of private clinics."
She
said there was a "syndicate" controlling the sector that held regular
meetings to fix prices and supply levels.
Fake
medicines bring about some 100,000 deaths a year in the continent, according to
the World Health Organization (WHO).
The
illicit sector has a turnover of at least 10% of the world pharmaceutical
business, meaning that it earns tens of billions of dollars a year, the
Switzerland-based World Economic Forum estimates, adding that the figure has
nearly tripled in five years.
"To
sell fake medicines, you need a clientele. The ailing poor are more numerous in
Africa than anywhere in the world," said Marc Gentilini, an expert on
infectious and tropical diseases and a former head of the French Red Cross.
Double-edged crime
Gentilini
said some meningitis vaccines sent a few years ago after an outbreak in arid
Niger were fake. The disease kills thousands every year in the arid West
African nation.
The
WHO estimates that one out of 10 medicines in the world is fake but the figure
can be as high as seven out of 10 in certain countries, especially in Africa.
The
American Society of Tropical Medicine and Hygiene estimated in 2015 that
122,000 children under five died due to taking poor-quality antimalarials in
sub-Saharan Africa, which, along with antibiotics as the two most in-demand,
are the medicines most likely to be out-of-date or bad copies.
Interpol
in August announced the seizure of 420 tonnes of counterfeit medicine in West
Africa in a massive operation that involved about 1,000 police, customs and
health officials in seven countries: Benin, Burkina Faso, Côte d'Ivoire, Mali,
Niger, Nigeria and Togo.
Geoffroy
Bessaud, the head of anti-counterfeit coordination at French pharmaceutical
giant Sanofi, said fake medicines were biggest illicit business in the world.
"This
phenomenon is spreading: it's financial attractiveness draws criminal organizations
of all sizes," he said.
"An
investment of US$1,000 can bring returns of up to US$500,000 while for the same
kind of investment in the heroin trade or in counterfeit money the amount will
be around US$20,000."
Ivorian
authorities in May burnt 40 tonnes of fake medicines in Adjame, the biggest
street market of fake medicines in West Africa which accounts for 30% of
medicine sales in Côte d'Ivoire.
Offenders go unpunished
Offenders
remain largely unpunished worldwide and are mainly targeted for breaching
intellectual property rights instead of being responsible for the deaths of
hundreds of thousands of people, the Paris-based International Institute of Research
Against Counterfeit Medicine says.
Experts
have called for a global fight against the scourge.
Sanofi
said it had in 2016 helped dismantle 27 clandestine laboratories, including 22
in China and the rest in Indonesia, Ukraine and Poland.
In
countries where medical expenses -- from drugs to hospitalization -- are not
even partly reimbursed by the state, the relatively cheap price of street
medication trumps the risk factor for many.
The outstanding exception on the continent in fighting the illicit drug trade is South Africa, which has a strictly-enforced licencing system.
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