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Substandard and falsified (SF) medical products pose a major threat to public health and socioeconomic development, particularly in low- and middle-income countries. In response, public education campaigns have been developed to alert consumers about the risks of SF medicines and provide guidance on 'safer' practices, along with other demand- and supply-side measures. However, little is currently known about the potential effectiveness of such campaigns while structural constraints to accessing quality-assured medicines persist. This paper analyses survey data on medicine purchasing practices, information and constraints from four African countries (Ghana, Nigeria, Sierra Leone and Uganda; n > 1000 per country). Using multivariate regression and structural equation modelling, we present what we believe to be the first attempt to tease apart, statistically, the effects of an information gap vs structural constraints in driving potential public exposure to SF medicines. The analysis confirms that less privileged groups (including, variously, those in rural settlements, with low levels of formal education, not in paid employment, often women and households with a disability or long-term sickness) are disproportionately potentially exposed to SF medicines; these same demographic groups also tend to have lower levels of awareness and experience greater levels of constraint. Despite the constraints, our models suggest that public health education may have an important role to play in modifying some (but not all) risky practices. Appropriately targeted public messaging can thus be a useful part of the toolbox in the fight against SF medicines, but it can only work effectively in combination with wider-reaching reforms to address higher-level vulnerabilities in pharmaceutical supply chains in Africa and expand access to quality-assured public-sector health services., (© The Author(s) 2024. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.)

Background: Mobile Authentication Service (MAS) is a mobile health technology deployed to hinder the retailing of falsified medicines to consumers in Nigeria. But, some community pharmacists reported that points of failures of MAS have negatively impacted their practices. Objectives: The objectives of this study were (1) to assess the acceptance of MAS by community pharmacists; (2) to explore the views of MAS providers on the challenges and successes of MAS deployment in Nigeria. Methods: A quantitative cross sectional survey was used to investigate community pharmacists' acceptance of MAS. A validated structured questionnaire, based on Technology Acceptance Model, was distributed to 326 community pharmacists. In addition, a structured interview guide was employed to explore MAS providers' views of challenges and successes of MAS deployment in Nigeria. Results: Just about half (53%) of responding community pharmacists were keen on using MAS. In addition, 51% of them would recommend the service to other practitioners and 54% would encourage their clients to use it. The results of the study indicated that both awareness and perceived reliability played important role in the behavioural intention to use the MAS. The findings from the exploration of MAS providers' views showed that the problems encountered with MAS (no response and wrong response) were mainly due to contextual challenges in the Nigerian setting. These contextual challenges like the Global System Mobile downtime, incessant power outages and limited ability of consumers to use the Short Message Service, all contributed to the limited success of MAS in Nigeria. Conclusions: Acceptance of mobile authentication service by community pharmacists is moderate. Perceived reliability and awareness are important factors that affect behavioural intention to use MAS. The limited success of MAS deployment appeared to be as a result of its interaction with the local context, where it has been deployed. [ABSTRACT FROM AUTHOR]

Introduction: Over the years, counterfeit pharmaceuticals have posed immense concerns for global health and patient safety. This menace encompasses various classes of medications. Given the criticality of pharmacists' interventions in drug distribution and supply, this study aimed at exploring their role in the prevention and control of counterfeit pharmaceutical products in Nigeria., Methods: A cross-sectional study was undertaken, using questionnaires to collect data from pharmacists across various sectors of pharmacy practice in Nigeria. Face and content validity was undertaken on the study tool prior to data collection. Ethical approval was obtained from the National Institute for Pharmaceutical Research and Development Health Research Ethics Committee, and confidentiality was strictly maintained during data collection process. Data were analyzed using Statistical Package for Social Sciences. Descriptive statistical analysis was undertaken and chi square was used to determine association between socio-demographic characteristics and variables., Results: The responses comprised 205 (52.6%) female and 185 (47.4%) male participants. Almost all the participants (98.4%) agreed that strict enforcement of drug laws can contribute to adequate control of counterfeit medicines in Nigeria, and majority of the study sample (64.7%) indicated that the poor implementation of these laws was a major factor influencing the preponderance of counterfeit medicines in the country. Two-thirds (63.5%) of the participants supported the need for pharmacists to provide adequate education to patients on strategies to identify counterfeit medicines, and a similar proportion (68.0%) were of the opinion that it was the responsibility of pharmacists to ensure that drugs are purchased from credible sources., Conclusion: Findings from this study, in addition to confirming pharmacists' instrumentality in the fight against counterfeit medicines, identified certain context specific factors that can strengthen the regulation, policy and the entire healthcare system. Government and relevant stakeholders can therefore begin to articulate strategic reforms for contextual policy intervention that address medicines' counterfeiting, whilst prioritising pharmacists' role in other critical areas in the healthcare system., Competing Interests: The author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Adigwe.)

Competing Interests: Competing interests: We have read and understood BMJ policy on declaration of interests and declare the following interests. This project was funded by the European Journalism Centre through the Global Health Security Call. This programme is supported by the Bill & Melinda Gates Foundation.

Background: Substandard and falsified medicines pose a serious threat to public health throughout the world but disproportionately afflict under-resourced nations with weak pharmaceutical regulatory mechanisms. The prescription of medicines is an event in which a medical practitioner(MP) is a decision maker for the ultimate consumer who is the patient., Aim: The study was aimed at describing awareness, identification, utilization, and barriers to utilization of point of-care overt anti-counterfeit medicine technologies(ACMTs) and the drivers, dangers and preventive measures of substandard and falsified medicines among MPs in Abia State., Methods: This was a cross-sectional study done on 178 MPs in Abia State, Nigeria. Data were collected using a self-administered questionnaire that elicited information on awareness, identification, utilization of overt ACMTs and its barriers. The drivers, dangers and preventive measures for substandard and falsified medicines were also studied., Results: The mean age±SD of the respondents was 34±8.2 (Range 24-72 years). There were 159(89.3%) males. All the respondents (100%) were aware of the point-of-care overt ACMTs with the most commonly identified types being labelling (100%), packaging (100%), printing graphics (100%), and mobile authentication numbers(MAN) (100%). The most commonly utilized ACMTs were labelling (100%), packaging (100%) and printing (100%) technologies. Time constraint (100%) was the predominant predisposing barrier to utilization of overt ACMTs. The commonest classes of falsified and substandard medicines were anti-malarial (100%), anti-bacterial (100%) and analgesics (100%). The most common driver and danger of substandard and falsified medicines alluded to by the respondents were poor pharmaceutical products regulatory systems (100%) and treatment failures (100%), respectively. The most recommended preventive measure was securing supply chain of medicines (100%)., Conclusion: Awareness of point-of-care overt ACMTs was very high but did not appear to translate to comparable utilizations for all types. The most commonly utilized overt ACMTs were labelling, packaging and printing technologies. Time constraint was identified as a possible predominant barrier to utilization of overt ACMTs. The commonest classes of substandard and falsified medicines were anti-malarial, anti-bacterial and analgesic medicines. It was believed that the commonest driver of substandard and falsified medicines was poor pharmaceutical products regulatory system and all these could result in treatment failures. Securing supply chain of medicinal products may serve as an effective preventive measure., Competing Interests: The Authors declare that no competing interest exists, (Copyright © 2021 by West African Journal of Medicine.)