Combatting the Counterfeit Drug Trade: Ashifi Gogo at TEDxBoston

Summary

Highlights

• Counterfeit drugs can contain harmful substances like heavy metals or rat poison, posing severe health risks. 😖
• The illicit drug trade is a $200 billion industry annually, impacting global health. 🌎
• It's often impossible to visually distinguish between fake and real medications, making consumer verification essential. 🔍
• Mobile verification technology provides an effective way for consumers to identify genuine drugs instantly. 📟
• Real-life applications of this technology have shown success, particularly in West Africa with anti-malarial drugs. 🌐
• Beyond pharmaceuticals, the verification system shows promise in sectors like automotive and agriculture. 🚜
• The spread of this innovation across industries emphasizes the importance of cross-border technology sharing. 🌌

Key Takeaways

• Counterfeit drugs are a major global issue, causing harm and fatalities—over 700,000 deaths annually from fake tuberculosis and malaria drugs alone. ⚠️
• A large-scale problem, the trade of counterfeit pharmaceuticals is estimated at $200 billion per year. 💸
• Genuine and counterfeit drugs often appear identical, making consumer testing and verification crucial. 🤔
• Empowering consumers with mobile technology to verify drugs can disrupt counterfeit trade and save lives. 📱
• This verification technology is already making a difference, shutting down pharmacies selling counterfeit drugs in places like West Africa. 🌍
• There is potential for this technology to be applied to other industries, such as car parts and agricultural supplies. 🚗🌾
• Innovations in developing markets can lead to solutions that eventually benefit more developed economies too. 🔄

Overview

Chapters

• 00:00 - 00:30: Introduction to Counterfeit Drugs The chapter opens with an intriguing question about the appeal of purchasing pharmaceutical products from a high-end, state-of-the-art manufacturing plant. The narrator employs an ironic tone, suggesting the listener might not even want to eat a sandwich there, hinting at possible irony or concealed truths about the quality of the drugs produced. This sets the stage for exploring the complexities and potential pitfalls of counterfeit drugs within the pharmaceutical industry.
• 00:30 - 01:00: Examples of Counterfeit Drugs The chapter discusses the alarming practice of counterfeit drug production, highlighting the use of substandard and unsanitary equipment. A specific example involves a cement mixer being utilized to mix pharmaceutical ingredients, indicating the lack of proper manufacturing standards. The chapter also touches upon the efforts of government inspectors in identifying such illicit operations. Importantly, it contrasts the professional appearance of inspectors with the often unsanitary conditions typical of counterfeit drug labs. Additionally, it raises the issue of undesirable and potentially harmful substances being present in counterfeit drugs.
• 01:00 - 01:30: Harmful Ingredients Found in Counterfeit Drugs The chapter discusses the harmful ingredients found in counterfeit drugs. Items such as corn starch and chalk are mentioned as relatively harmless, but the discussion quickly shifts to more dangerous elements like heavy metals, bones, animal pieces, rat poison, and chemicals found in antifreeze. These substances highlight the serious risks associated with counterfeit medications, which are often misconceived as placebos. The reality, however, is that they can be highly dangerous and have led to fatalities.
• 01:30 - 02:00: Global Impact of Counterfeit Drugs The chapter titled 'Global Impact of Counterfeit Drugs' delves into the economic and human cost of counterfeit pharmaceuticals. It highlights the staggering estimate by the World Customs Organization that approximately $200 billion worth of fake drugs are sold annually. The discussion emphasizes the difficulty in grasping the magnitude of this figure in today's economic climate characterized by financial bailouts and the abstract nature of such large sums. Moreover, the chapter shifts focus from financial implications to the more tangible impact on human lives, underscoring the personal toll of counterfeit drugs, an aspect that is quantifiable and universally significant.
• 02:00 - 02:30: The Challenge of Detecting Counterfeit Drugs The chapter titled 'The Challenge of Detecting Counterfeit Drugs' begins by highlighting the alarming impact of counterfeit tuberculosis and malaria drugs, which cause over 700,000 deaths annually. This staggering number is compared to the equivalent of four fully packed jumbo jets crashing every day, an event that would undoubtedly dominate headlines if it were so apparent. However, the insidious nature of counterfeit drugs means that patients may unknowingly attribute their prolonged illness and lack of recovery to reasons other than fake medication, such as medical errors, incurable diseases, or other unknown factors, without suspecting the true cause.
• 02:30 - 03:30: The Pharmaceutical Supply Chain The chapter titled 'The Pharmaceutical Supply Chain' discusses the significant global impact of counterfeit drugs. These drugs are difficult to detect and can be deadly. The chapter highlights that counterfeit drugs easily cross international borders without the need for visas, reaching pharmacies worldwide. It raises awareness about the complexity of identifying counterfeit drugs even when considering the high-end manufacturing sites where these drugs, or their counterfeit counterparts, might be produced. The difficulty in determining the origin of a drug, even when faced with visual comparisons from different factory sources, is underscored.
• 03:30 - 05:00: Introducing a Solution for Counterfeit Drugs The chapter discusses the challenge of distinguishing between genuine and counterfeit drugs in the pharmaceutical industry. It highlights the deceptive nature of counterfeit drugs, which often have packaging that looks identical to genuine products. Counterfeiters can afford to invest heavily in packaging since they spend little on production facilities, as counterfeit drugs are often produced in informal settings like kitchens, warehouses, or garages. The chapter underscores the importance of focusing beyond packaging to ensure the authenticity of drugs.
• 05:00 - 06:30: Case Study: Malaria Drug Theft The chapter discusses the issue of counterfeit malaria drugs in the pharmaceutical supply chain. It highlights the difficulty for consumers in distinguishing between genuine and fake products when purchasing from pharmacies. The narrative also addresses how these counterfeit products make their way into the supply chain, suggesting an idealized flow from manufacturers to wholesalers that is often disrupted by the infiltration of fake drugs.
• 06:30 - 08:30: Expansion of Anti-Counterfeit Solutions The chapter discusses the complexities of the pharmaceutical supply chain and the challenges posed by counterfeit products. Unlike the oversimplified perception of a straightforward supply chain, the reality involves many disruptions, from returns and payment issues to losses. As a result, patients often end up with counterfeit products, highlighting the need for robust anti-counterfeit solutions.
• 08:30 - 10:00: Potential Impacts on Developed Markets The chapter highlights the complexities and potential problems in the pharmaceutical supply chain, particularly within developed markets. It mentions the chaos caused when hospitals experience stock-outs and the added complications when counterfeit drugs are introduced into the supply chain. Highlighting that up to 30 different companies may handle a product before it reaches pharmacy shelves, the chapter underscores the challenges in ensuring the authenticity and availability of pharmaceuticals, which can have significant impacts on developed markets.

Combatting the Counterfeit Drug Trade: Ashifi Gogo at TEDxBoston Transcription

• 00:00 - 00:30 [Music] [Applause] [Music] [Applause] [Music] hello everyone how would you like to buy some life-saving pharmaceutical products made in this high-end Pharmaceutical Plant where you probably don't even want to have a sandwich using the world's latest manufacturing techniques um which result in lots and lots of pills that look really good but
• 00:30 - 01:00 actually contain nothing but pretty bad stuff so here's an example on the screen that shows a cement mixer that's used to mix your pharmaceutical ingredients um and the folks in the picture actually the government inspectors that discovered this lab and not the counterfeits I'll be surprised if they've dressed this nicely and work in an environment that doesn't look so sanitary um what do you typically find in a counterfeit drug you find things
• 01:00 - 01:30 from corn starch to chalk uh which are relatively harmless uh until you start looking at heavy metals uh bones uh pieces of animals um rat poison we've seen in in some cases or uh chemicals found in antifreeze which I don't think you should actually buy and use to treat any disease so by and large counterfeit medications people tend to think of them as placebos but they actually quite harmful and people have died due to the
• 01:30 - 02:00 consumption of these fake drugs so what's the impact the world Customs organization estimates that it's about $200 billion do of these fake pharmaceutical products being sold every year someone's making a lot of money but in this age of bailouts who really knows how much $200 billion is worth right it could be stack of money somebody prints it out somebody borrows it never returns it who knows right so let's look at some some lives because that's something we can count everybody has one not
• 02:00 - 02:30 everybody has 200 billion or stash of billion somewhere and so due to fake tuberculosis and malaria drugs alone over 700,000 people die every year and that's equivalent to four fully packed jumbo jets crashing every day now that would make the headlines if we're that obvious but people take these pills and you're ill anyways and something happens and you don't really get better you don't really attribute that to counterfeit meds could be the doctor screwed up could be some incurable disease could be alien who knows right
• 02:30 - 03:00 so counterfeit drugs kill people and it's hard to detect but these studies show that there's quite an impact and it's a global impact because these fake drugs do not need visas to cross boundaries and reach our pharmacies so take a look again at the high-end manufacturing plants where some of these spills are made and uh tell me if you can determine which one came from that factory anyone is there on the left on the right well you're pretty smart not
• 03:00 - 03:30 to bet I used to try to bet on these things and S of try to figure out as an expert and i i s of really this is a bad idea because as you can see they look pretty much identical one is genuine made in high-end Pharmaceutical Plant the other one's made in someone's kitchen or Warehouse or garage or something but because they don't have to spend much money on the production sites they can spend all the money on the packaging and when you go take your drug it's a packaging that counts right look really cool shiny it has a hologram on
• 03:30 - 04:00 it so you buy the one that looks shiny and then you end up being duped right so in this case you can see it's very tough for a consumer who walks into a pharmacy to tell the difference between a genuine product and then a fake product how do these fake products end up on the pharmacy shelves anyways right when you think of the pharmaceutical supply chain typically think of this straight line uh distribution chain where the manufacturer make the product it'll go to a happy independent wholesaler they'll stick a smiley face
• 04:00 - 04:30 or something and ship it onto a distributor puts it on an airplane it flies over somewhere retailer gets a hold of it puts a nice price tag on it insurance pays for it and you consume the product however the real pharmaceutical supply chain looks a bit more like this the pharmaceutical manufacturer makes a product it goes out there distributor doesn't like it gets returned there's some payment issues and then the products disappear they get lost and then patients get the product and say oh this is fake I don't want it anymore resell to a pharmacy or a
• 04:30 - 05:00 hospital that has a stock out it's quite a mess and this is only the genuine pharmaceutical supply chain so if you tossed a couple of counterfeits and mega counterfeits who make active ingredients that are fake that going to real pharmaceutical companies it really looks like quite a mess right you don't want to be studying this this supply chain uh some Studies have shown that up to 30 different companies can touch a product before it ends up on the pharmace shelf
• 05:00 - 05:30 so it's quite a mess you don't want to be involved in this and if you're the consumer the receiving end so we need something to solve this problem and the way we've decided to do it is to influence demand so that we can impact Supply people wouldn't make things that people don't buy right it doesn't make sense why would you do it and so let's figure out how to empower the patients so they can make a determination and only buy the things that they actually want to buy and not get tricked into buying drugs that they don't want to buy
• 05:30 - 06:00 so if you're' trying to S solve the lever there's actually no way to get to the other end if you staring at it there um so don't get confused if you're s of tracing around and and and there is there is no no way to get to the patient uh but effectively what we're saying is we're going to empower patients with technology that they car in your pockets every day so they can avoid playing Russian roulette with your health and be able to find the right drugs at the right time time in a in an easy and and
• 06:00 - 06:30 free way and to we be able to build a business around it we put scratch labels on the pharmaceutical products at a point of purchase the consumer would take out his cell phone scratch the panel the see a number texted and get get a response saying genuine or fake right it's very simple and all of these markets overseas where counterfeiting is is more of a problem than than is here in the US the drugs aren't in the owl so you walk up to a counter and you say I like to buy drug X and they pull it off
• 06:30 - 07:00 the shelf and you could scratch and text and say Here's my money I'm going to buy it but I want a check and then you get a response and then you go off if it's fake you call it in and then authorities come and actually do investigations and shut down pharmacies and we've seen this happen uh in West Africa thanks to Vigilant consumers what does it look like uh here's an example of a live product in the market um so on the blister pack I think I have a another sample here I could take a look at
• 07:00 - 07:30 uh on the blister pack you have a scratch off panel with a unique number to that blister right so each different blister has a different number and then you scratch off the panel you text it in the future could actually even use a 2d barcode take a picture of 2D barcode so you don't have to do any scratching or texting and then there's a serial number on the side to help with tracking the products in case some get lost and so we actually use that I'll talk about that in a second when you send a text message here's the
• 07:30 - 08:00 response you get so it's designed to be very um direct with the message I want to get across if you don't have time to read even a text message which is sort of where we're heading with people's attention spun these days you just need to read the first line first line says okay or it says fake right you could ignore everything else right but you know what you're essentially required to do if if it says genuine or fake in the first line of the message we also have a call center so if you have a question or
• 08:00 - 08:30 something you just call it in and speak to a live Human uh we can help you out and uh growing over time as phones get fun here and people get more sophisticated technology you could use the web to verify products as well and eventually we'll get to RFID where you could just tap the product with your phone and get a reading so you have to do any of this stuff at all but technology infrastructure isn't there uh just yet but ready for it and so as these data points come in we're able to pinpoint some of the hot spots of
• 08:30 - 09:00 counterfeiting so here has a map of Nigeria where the service is live and the pins indicate s of where the suspicious activity is so if you're a law enforcement agent in the past what you've had to do is sort of do random sampling so you wake up one day roll a dies and say it feels good to be in this western part of the country today you probably do something fancier but effectively you have the same outcome that they go to a place and discover that yeah probably the counter Fitters aren't here today they're somewhere else so it's not a very smart way if you don't have a whole bunch of money uh especially in these Emerging Markets to
• 09:00 - 09:30 find where the counterfeits are you want to do something like this where you could see the hotpots called in by consumers so you could send your SWAT team to go take out a pharmacy that's selling fake drugs on the Fly while the fake drugs are still there before they get carded out based on S of whoever is informing the counterfeits that the police is coming around so let's look at an actual example last year in November uh a manufacturer of a very popular antim malar drug experien theft cargo theft
• 09:30 - 10:00 happens in the pharmaceutical industry things magically fall off the truck and grow legs and walk away um and nobody claims ownership for for that so they had 3,000 blisters stolen and these are high value life-saving drugs could have cured malaria and 3,000 uh people and it's about $10,000 of of money uh lost and so what they did is they used the serial number the overt number on the side that I showed you earlier on to tell us which numbers which range was
• 10:00 - 10:30 missing we changed the response instead of saying okay genuine to say stolen products make sure you get a receipt and call this number within 3 days we're able to pinpoint thees that were selling the stolen products stolen product moves very fast right those legs on the boxes actually uh run quite quickly and uh the the the government was able to shut down uh the pharmacies involved we're able to go up the supply chain and discover the distributor that supplied the stolen products to thees sometimes pharmacists
• 10:30 - 11:00 don't know they're getting suspicious product sometimes you could kind of question the ignorance uh but very often they're not trained as product Security Experts they're trained as Pharmacists and so in the future we see having a separate layer of scratch off technology so that the far the pharmacist themselves can check the products before they buy them and then hand those off to their patients so that they also get covered and then so on we go up the supply chain all the way to the
• 11:00 - 11:30 manufacturer and perhaps even Upstream because there are issues with the supply chain Upstream as well so does this stuff work it works quite well so here's where we've seen the most traction uh worldwide with the solution and this represents what's been done and what's coming up uh so pharmaceutical is a big play lots of fake Pharmaceuticals are now being tagged we've done tens of millions of these individual blisters uh we've already seen over a million patients texting the the the codes on the
• 11:30 - 12:00 products we're beginning to see some interesting non-pharmaceutical uses as well uh so we're now working with car part manufacturers if you've been in a taxi ride in hyderbad or Delhi uh it's terrifying enough with genuine brakes imagine being in there with with fake brakes and then you probably would would get fitter and start walking or or or do something you know smart cities um but but with uh with uh pharmac itical and so on we've seen expansion to
• 12:00 - 12:30 agrochemicals so imagine you're a farmer and you got ripped off and you bought these seeds that supposed to be the fany hybrids but they're not and then you plant them and two weeks one month later you realize that you got no crops right so you're not going to diet you to some fake drug you're probably going to experience economic hardship which could lead to quite severe outcomes so fake seeds fake agrochemical inputs fake fertilizer is a problem especially in East Africa that we're able to address with this technology and sports drinks
• 12:30 - 13:00 and Shakes and so on again imagine the Olympics are coming up you've trained all this time and you took some milkshake thing or other to boost your performance and then you realize it has some band substance in it and so now you're disqualified and you go cry along for a long time I mean that's not a very happy story so we help people avoid these outcomes using technology so they can verify the products and make sure that they're paying for what they think they're getting what does this mean for
• 13:00 - 13:30 you typically technology that's developed in Emerging Markets is not a very common thing right because typically technology goes from the developed world as it's sort of getting old it ends up in developing nations but technology developed in developing Emerging Markets could one way make their way back into emerged or developed markets because it's faster to turn around of these things especially in the pharmaceutical industry overseas because there a little less regulation and so on so we may see in the US the ability for
• 13:30 - 14:00 patients to verify products before they take them why is that important according to the who when you hit those illegal websites and buy Viagra for 50 cents or whatever they're selling these days online pharmacies that conceal their addresses and do not require prescriptions uh tend to serve fake drugs 50% of the time so you think you're getting a good deal and they're getting a good deal because it's telling you Conn starch with blue color and you think you're going to get
• 14:00 - 14:30 performance enhancements which really don't come uh when you take the pills so this is a a pressing issue even for developed markets because of Internet pharmacies and if only you could have a way to tell when you're buying a drug from the internet at a good price that you are actually getting a genuine product thank [Applause] you