Polypharmacy Exposure, Aging Populations, and COVID-19: Considerations for Healthcare Providers and Public Health Practitioners in Africa

Given the continent’s growing aging population and expanding prevalence of multimorbidity, polypharmacy is an increasingly dire threat to the health of persons living in Africa. The COVID-19 pandemic has only exacerbated these issues. Widespread misinformation, lack of vaccine access, and attempts to avoid being infected have resulted in increases in Africans’ willingness to take multiple prescription and nonprescription medications and supplements. Issues with counterfeit pharmaceuticals and the relatively new recognition of emergency medicine as a specialty across the continent also create unique challenges for addressing this urgent public health need. Experts have called for more robust pharmaceutical regulation and healthcare/public health infrastructure investments across the continent. However, these changes take time, and more near-term strategies are needed to mitigate current health needs. In this commentary, we present a nonexhaustive set of immediately implementable recommendations that can serve as local strategies to address current polypharmacy-related health needs of Africans. Importantly, our recommendations take into consideration that not all healthcare providers are emergency medicine trained and that local trends related to polypharmacy will change over time and require ever-evolving public health initiatives. Still, by bolstering training to safeguard against provider availability biases, practicing evidence-based prescribing and shared decision making, and tracking and sharing local trends related to polypharmacy, African healthcare providers and public health practitioners can better position themselves to meet population needs. Furthermore, although these recommendations are tailored to Africans, they may also prove useful to providers and practitioners in other regions facing similar challenges.

Proof-of-Concept of Detection of Counterfeit Medicine through Polymeric Materials Analysis of Plastics Packaging

The detection of counterfeit pharmaceuticals is always a major challenge, but the early detection of counterfeit medicine in a country will reduce the fatal risk among consumers. Technically, fast laboratory testing is vital to develop an effective surveillance and monitoring system of counterfeit medicines. This study proposed the combination of Attenuated Total Reflectance Fourier Transform Infrared (ATR-FTIR) and Differential Scanning Calorimetry (DSC) for the quick detection of counterfeit medicines, through the polymer analysis of blister packaging materials. A sample set containing three sets of original and counterfeit medicine was analyzed using ATR-FTIR and DSC, while the spectra from ATR-FTIR were employed as a fingerprint for the polymer characterization. Intending to analyze the polymeric material of each sample, DSC was set at a heating rate of 10 °C min−l and within a temperature range of 0- 400 °C, with nitrogen as a purge gas at a flow rate of 20 ml min−an. The ATR-FTIR spectra revealed the chemical characteristics of the plastic packaging of fake and original medicines. Further analysis of the counterfeit medicine’s packaging with DSC exhibited a distinct difference from the original due to the composition of polymers in the packaging material used. Overall, this study confirmed that the rapid analysis of polymeric materials through ATR-FTIR and comparing DSC thermograms of the plastic in their packaging effectively distinguished counterfeit drug products.

National security: health care, pandemic (COVID-19) and the global trade in counterfeit pharmaceuticals (part 2)

Ukraine’s healthcare system faces unprecedented national security challenges in the third wave of the COVID-19 pandemic. A particularly acute issue is countering counterfeit pharmaceuticals, preventing drug shortages, joining efforts of the authorities and national manufacturers of drugs and medical supplies. According to the UN, more than 60 % of the population lives below the poverty line in Ukraine. Timely response to these challenges and taking preventive measures will save lives, minimize the volume and consequences of the pandemic. The paper provides an economic and legal analysis, trends, risks and threats to national security of the state and health protection during a pandemic, in order to protect intellectual property rights, adequate coordination of actions at the national and international levels. The impact of counterfeiting on the criminal landscape in the EU, and also business and economy, is shown based on the analysis of studies by the OECD, the EU Intellectual Property Office (EUIPO) and Europol. The foundations of anti-counterfeiting management, measures to implement a standard anti-counterfeiting strategy are proposed.

National security: health care, pandemic (COVID-­19) and the global trade in counterfeit pharmaceuticals (Part 1)

Ukraine’s healthcare system faces unprecedented national security challenges in the third wave of the COVID-19 pandemic. A particularly acute issue is countering counterfeit pharmaceuticals, preventing drug shortages, joining efforts of the authorities and national manufacturers of drugs and medicines. According to the UN in Ukraine more than 60% of the population lives below the poverty line. Timely response to these challenges and taking preventive measures will save lives, minimize the volume and consequences of the pandemic. The work provides an economic and legal analysis, trends, risks and threats to the national security of the state and health protection during a pandemic, in order to protect intellectual property rights, adequate coordination of actions at the national and international levels. Based on the analysis of studies by the OECD, the EU Intellectual Property Office (EUIPO) and Europol shows the impact of counterfeiting on business and the economy, the criminal landscape in the EU. The basics of the anti-counterfeiting management, measures to implement a standard anti-counterfeiting strategy are proposed.