The unprecedented crisis of the COVID-19 pandemic showed the world the breadth and complexity of human nature. We lauded the otherwise unsung heroes and front-line warriors who bent over backward to pull humanity out of the clutches of the dark plague. But we were caught off-guard by the unabashed human greed that sought to profit even at the cost of a fellow beings’ life. Weathering the grave economic and healthcare challenges, the common people held on to hope. The research on vaccines and potential medicines to alleviate the symptoms of the infection offer a glimmer of light in the dark.
With the vaccination drive picking pace slowly and the tsunami effect of the second wave in India, the stress on potential medicines like Remdesivir approved as a treatment protocol for Covid increased exponentially.
At the peak of the demand cycle, a single vial of Remdesivir could potentially cost up to 25 to 30K to a desperate buyer. Despite the jacked-up prices, people queued up for the precious drugs and were met with closed shutters and run-out aisles. Many pharmaceuticals have taken up the herculean task of manufacturing medicines approved for treating COVID 19 in India. While the official cost of Remdesivir is not more than 5K to 6K, the government has been strictly regulating the prices and sale of the drug. Yet, hoarding, black marketing, and counterfeiting have continued to remain a hazard.
Vikas Jain, the founder of ACVISS, a brand dedicated to using technology to counter the counterfeit market, says, “people would go to any extent to save their loved ones. After all, there can be no price tag on human life. But it is not just about spending a ridiculous amount of money for a few vials of Remdesivir or any other COVID 19 related drug. It is about whether or not one is even getting the genuine product or not.” Speaking on the demand and supply issue, Vikas elaborates, “The government of India has approved nearly 25 manufacturing sites to produce Remdesivir. These make 90 lakh vials available per month in India.
The near-nil demand for the drug by the end of the first wave and lack of stockpiling was a disaster in the making as we approached the second wave. Also, we were largely dependent on contract manufacturers and their subsidiaries. One can say that the second wave of COVID 19 was a black swan event for the pharmaceuticals and the policy-makers.” While the rise in demand may have caught us unprepared, manufacturers rose to the occasion by doubling their production of COVID 19 medicines in just a few months. Vikas adds, “Reputed brands like Cipla, Hetero Drugs, Dr. Reddy’s, and many more nearly doubled their production, but we still kept falling short.
The government of India has also been mulling over invoking the compulsory licensing section of the Patent Act to ensure equitable distribution of the drug. These are steps in the right direction but do little to deter black marketing and hoarding, resulting in sky-rocketing prices. Also, when demand, coupled with panic, keeps rising sharply, boosting manufacturing is never going to be sufficient. While we continue to increase quantity, we need to take a relook at quality assurance as well. But in a pandemic, with manufacturers and the healthcare system being overworked, we are left with little or no time to look at the supply chain leaks.
“ Counterfeit medicines and medical equipment is not a new menace. However, the once-in-a-century pandemic has caused further disruptions to the complex and fragile supply chains. While addressing the issue of fake Remdesivir and other COVID 19 medicines approved for emergency use, we need to keep in mind that:
- An unimaginable rise in demand and the importance of timely administration of the drugs in a pandemic scenario is a breeding ground for counterfeit goods.
- Manufacturers are expanding their networks to increase production and supply. New networks could mean an increase in loopholes in the supply chain as workflow patterns change.
- India has the most stringent regulations for pharmaceutical exports. But in the domestic market, serializations, track and trace using overt and covert markers, RFIDS, and other methods to check counterfeit has been broadly suggestive.
- Since Remdesivir has been repurposed for use in COVID patients, the research on the medicine is still exploratory. So it is perhaps difficult to understand whether anomalies are due to a fake or spurious drug or uncommon side effects.
So how can we stop fakes, especially when lives are at stake? The good news is that people are already more vigilant about fake Remdesivir making rounds in the market. To add to that, manufacturers like Cipla had started a dedicated helpline number for emergency cases so that customers can procure the product directly from the company or trusted sources. Additionally, Twitter is filled with tips and tricks to identify physical differences in the packaging of fake and genuine Remdesivir and other COVID medicines. Often counterfeit products do not carry the Rx symbol and have common spelling or capitalization errors.
“However, beyond physical identifiers, we must harness anti counterfeit technology to secure the supply chain so that fake products do not make it to the end-users. Integrating machine learning and computer visioning with anti-counterfeit technology like serialization, blockchain, track and trace, can remove counterfeits from the supply chain. The technology is user-friendly and integrates with packaging,” says Vikas, who has been helping pharmacies across the nation to secure their products from counterfeit. He further believes that tamper-proof packaging is a must for essential drugs like Remdesivir. Every year, we lose 70,000 people to fake malaria and tuberculosis drugs alone. But lives lost due to counterfeit medicines get buried and lost in statistics.
“Human greed is an endless abyss. People who profit from the suffering of fellow human beings are perhaps beyond redemption. Although we cannot change people, we can change the situation that aids such people. There cannot be a better time for incorporating anti-counterfeit technology in their packaging and distribution for pharmacies in India. Now is the time to vow that we will not lose a single life due to fake medicines”, concludes Vikas.