Delegates at the WHPA medicines counterfeiting workshop in Nigeria gather around the Be Aware: Take Action message
Delegates at the WHPA medicines counterfeiting workshop in Nigeria gather around the Be Aware: Take Action message

Physical therapists called to action on counterfeit products

Physical therapists have been central to two new calls-to-action on the threat of counterfeit medicines and equipment. Major meetings in Costa Rica and Nigeria of the World Health Professions Alliance, of which WCPT is a member, have agreed a set of messages to communicate to patients, professionals and governments about the harmful impact of falsified and counterfeit medical products.

Attending the workshop in San José, Costa Rica, in October were Mabel Yvonne Espinel González and Jaime Rebollo Vazquez from the physical therapists’ associations in Colombia and Mexico respectively. A parallel meeting was held in Abuja, Nigeria, in November. It was attended by Olaseinde Raymond Oluseyi, Jean Damascene Gasherebuka, Dionysius Mubez and Robert Katsigazi from the Nigerian, Rwandan, Tanzanian and Ugandan physical therapy associations.

According to Jean Damascene Gasherebuka, Head of the Physiotherapy Department at King Faisal Hospital in Rwanda, the Nigeria meeting was highly relevant to physical therapists in Africa. 

“This problem of counterfeit medicines and equipment, and even counterfeit practices, is common in Africa where regulations do not exist or not reinforced, and where poor people cannot afford to buy genuine medications. It affects our daily work, as patients will first use these cheap ways of seeking healing instead of going to consult a physiotherapist. When they have tried all and failed, they will then come to seek help from the physiotherapist and sometimes it is too late.  The end result can be that they present with permanent disabilities.” 

He believes that physiotherapists in Africa must work with other professionals on this issue, in the interests of patients. Xuanhao Chan of the International Pharmaceutical Federation, who is a driving force in the WHPA campaign, agrees that physical therapists have an important role. 

“What came out of both workshops was the importance of collaboration between health professionals on this issue,” he said. “They need to communicate and keep each other informed about what’s happening with their patients. If this happens, it’s much more likely that together they’ll be able to bring cases of counterfeit medicines to light. The WHPA, in bringing people together, can be a great platform for this approach.” The WHPA is an alliance of the International Council of Nurses, the International Pharmaceutical Federation, the World Confederation for Physical Therapy, the World Dental Federation  and the World Medical Association. It addresses global health issues and is a key point of global access to health care professionals within the five disciplines.

“We all spend time with patients, and by talking to them can help communicate messages about counterfeit products, and also learn from them about how the issue is affecting them,” says Xuanhao Chan.

According to the World Health Organization, 10% of the global medicine supply could be counterfeit. In 2008, European Customs detected over 3,200 attempts to import bogus drugs. According to the United Nations Office on Drugs and Crime, in Africa, Asia and Latin America, counterfeits comprise between 10 and 30% of the market, and as much as half of the anti-infective medications tested in parts of Asia and Africa have been found to have active ingredients outside acceptable limits.

For example, one of the most commonly counterfeited drugs is artesunate, an antimalarial widely used in South-East Asia and Africa. In 2003, researchers conducted a randomised study of artesunate tablets sold in the Lao People’s Democratic Republic. Of the 25 outlets examined, 22 sold counterfeit artesunate.

Jean Damascene Gasherebuka says that he’s often encountered substances being peddled as remedies which at best have no effect, and at worst can cause harm. 

“In Africa, many people still do not know anything about the role of physiotherapy. Therefore, when they get injured or sick, they still seek help from traditional healers who are closer to them in their community. I had one patient who was suffering from lower back pain radiating to both legs which clinically was caused by sciatic nerve compression. But before he came to see me, he had been prescribed some remedy by a fake reflexologist to relieve his pain. After a few weeks the condition was still the same. When he came to see us we examined him, explained his condition, then started physiotherapy treatment. Now he has completely recovered.”

The WHPA Abuja workshop attracted 92 participants from African countries – patient advocates as well as professional representatives. It was the first-ever multi-professional workshop on counterfeit medical products in Africa. The workshop developed joint strategies among the five health professions to identify, report and purge counterfeit medical products from the supply chain, and to empower patients to make the best decisions when it comes to acquiring, carefully checking and using medical products.

The workshop recognised that counterfeit medical products are a public health problem and a threat to patient safety with consequences in terms of increased disease burden, mortality and costs for healthcare systems.

The meeting in Costa Rica resulted in the launch of the San José Call-To-Action on counterfeit medical products, calling for action from the general public, health care professionals and government health officials.

The full statements that arose from the meetings can be viewed at

"In general, physical therapists can encourage their patients and the general public to always buy medical products from known and reliable sources," says Janice Blondeau of the WHPA Counterfeit Medical Products Campaign. "In developed countries, there is an increasing trend for people to purchase medical products online. In over 50% of cases, medicines purchased over the Internet from illegal sites that conceal their physical address have been found to be counterfeit. A key message is: if you must buy from the Internet, ensure that the website is that of a pharmacy you know and trust."  According to Janice Blondeau, health professionals can educate patients to check for the following information from e-pharmacy websites:

  • the name of the pharmacy providing the service;
  • the geographic addresses at which the pharmacy is established;
  • the pharmacy’s telephone and fax numbers, and e-mail address;
  • the professional title of the pharmacist responsible, and the country where their qualification was granted;
  • the professional body with which the pharmacist responsible is registered and the relevant supervisory authority (where applicable);
  • the means to access the professional rules in the country of establishment.

Follow-up of the two regional workshops, a new regional workshop and new tools for physical therapists and other health professionals are all planned as part of the campaign in 2011.