The New Times (Kigali)

7 February 2013

Rwanda: Officials Dismiss Report of Fake Tuberculosis Drugs

Health officials have dismissed allegations that Rwanda is among the many countries named in a survey conducted by a group of investigators as having fake Tuberculosis drugs in the pharmacies.

According to the survey, published in the International Journal of Tuberculosis and Lung Disease, United States based investigators asked local people in 19 cities in 17 countries, including Rwanda, to purchase, from a private-sector pharmacy, isoniazid and rifampicin, the most common antibiotics used by TB patients.

The samples were examined by chromatography which is a technique that detects chemical signature, for their active ingredient. They were also tested for disintegration, to see if they properly broke up in water at body temperature within 30 minutes.

Out of 713 samples, 9.1 per cent failed these basic quality control tests.

The failure rate was 16.6 per cent in Africa, 10.1 per cent in India, and 3.9 per cent in Brazil, China, Thailand, Turkey and Russia.

Patrick Mwesigye, the Coordinator of the Pharmacy Task Force in the Ministry of Health refuted the findings of the report, saying the TB drugs mentioned can only be accessed from public hospitals and not in any private pharmacies or hospitals.

He noted that all TB Patients get free medication from public hospitals, adding that no one in private sector imports TB medication.

"We have never gotten any TB patients in Rwanda complaining about this medication being resistant and ineffective. All the drugs we bring in here are bought from manufacturers approved by World Health Organisation and the Global Fund. This survey is based on rumours and not evidence and these so called experts should come and prove to us with evidence that they found those fake TB drugs here in Rwanda," he said.

Mwesigye added that they do preliminary tests of the drugs and are even working on establishing another laboratory for testing the drugs.

Floribert Biziyaremye, who is a pharmacist in the TB Division at the Rwanda Biomedical Centre, also confirmed that the drugs that are used in Rwanda are bought from manufacturers approved by the World Health Organisation (WHO) and Global Fund.

"We also have a contract with a quality control laboratory in Canada that tests these drugs. It therefore, does not add up saying that these TB drugs we have are fake yet the users find them effective and we haven't received any complaints," he said.

Possibility

However, a pharmacist from one of the top hospitals in Kigali who spoke on condition of anonymity confirmed that these drugs are currently being used in Rwanda although he could not say whether they were ineffective or not.

The pharmacist, however, added that there have been a few cases of TB patients who are resistant to this medication though not necessarily because it's fake.

"Sometimes counterfeits end up in Rwanda and anti TB drugs can't be exception. We haven't heard of a particular complaint about inefficacy of any of these drugs in our hospitals unless not taken as prescribed," he said.

According to the survey, some of the other pharmacies where the drugs were purchased were in countries including Brazil, China, Democratic Republic of Congo, Egypt, India, Kenya, Nigeria, Ethiopia, Ghana, Chennai, Moscow, Russia, Tanzania, Thailand; Turkey, Uganda, Zambia amongs.

The 2011 treatment success rate of Tuberculosis in Rwanda stood at 87.6 per cent. Between 6,000 and 8,000 cases of TB are reported in the country annually.

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