A significant proportion of malaria drugs sold in Kenya’s private sector are not approved by recommended global health organisations.
According to a new study published in the current issue of Malaria journal, more than 40 per cent of private sector outlets (mainly pharmacies, chemists and clinics) sell malaria treatment medicines — known as Artemisinin Combination Therapies (ACTs) — that lack approval from the World Health Organisation (WHO), the Global Fund or the European Medicines Agency (EMA) quality assurance programmes.
The findings show that the availability of these non-approved drugs has increased two-fold from 21 per cent in 2010 to the current figure of 41.6 per cent in the private sector. As a result, the researchers warn that the market share for these medicines is on the rise and they could potentially harm patients if appropriate measures are not put in place to assess their quality.
The WHO-approved drugs are procured by the Ministry of Health (MOH) with donor support for use in the public health sector where most Kenyans receive malaria treatment at no cost.
Dr Kiambo Njagi, a senior officer at MoH’s malaria division, said malaria drugs lacking WHO’s approval can only be considered as safe and of good quality if they are locally approved by the Kenya Pharmacy and Poisons Board (KPPB).
But with the existence of briefcase pharmacies and quack clinics operating illegally in Kenya’s private health sector, it is often hard to ascertain whether ACTs lacking the WHO approval in these outlets are genuine or substandard.
Health experts are concerned that Kenyans who unknowingly seek treatment in some of these questionable private sector outlets could be exposed to counterfeit or substandard malaria drugs which have adverse consequences.
The current Kenya Malaria Indictor Survey (KAIS 2015) shows that about 25 per cent of children below a year with malaria are treated in private health facilities. This is the age group that is most threatened by the disease due to their low immunity
This figure shoots to slightly over 40 per cent in urban centres where there is high concentration of ACTs lacking international approval, according to the Malaria journal.
It is also common for Kenyans to go directly to private pharmacies or chemists whenever they exhibit malaria-like symptoms or when there are stock-outs of ACTs in public hospitals.
“We want people seeking treatment in the private sector to be able to get proper diagnosis and quality ACTs just as those treated in public hospitals,” said Dr Njagi.
Substandard and counterfeit medicines sold by unscrupulous private outlets contribute to the high malaria deaths in the country whilst providing a breeding ground for drug resistant parasites that could eventually compromise the efficacy of the drugs altogether.
The Global Fund has been assisting private sector pharmacies to procure the WHO approved ACTs at subsidised prices with the aim of addressing this challenge. The drugs are then sold at a fixed price of Sh100 so as to make them affordable to Kenyans.
“Many of our members are now selling WHO approved malaria drugs as their prices are more favourable to buyers. So the demand is high,” Dr Paul Mwaniki, chair of the Pharmaceutical Society of Kenya, told the Business Daily.
He urged Kenyans to buy drugs in legally accredited pharmacies which can be identified by a green cross signage as well as a Kenya Pharmacy and Poisons Board banner. Malaria is the leading cause of registered deaths in this country, killing about 16,000 people each year, according to the 2017 Economic Survey.