ANB-BIA SUPPLEMENT

ISSUE/EDITION Nr 323 - 01/05/1997

The Congo

Generic medicines versus branded products

by Carole Goma-Makaya, Congo, January 1997

THEME = HEALTH

INTRODUCTION

The serious deterioration in the economic and health situation in the Congo, has brought about an explosion in the number of clandestine markets and small retailers. Chemist shops face competition from street traders who are offering people medicines which are exposed to the elements. In an attempt to rein in this practice, the authorities have decided to place on the market, low-priced generic medicines

The sellers are for the most part young people with some education, but without any medical qualifications. They work for profit. The most widely sold medicines are for ailments like diarrhoea, intestinal parasites, malaria and sexually transmitted diseases. Tablets and gels sell well because they can be taken out of their packaging and sold in "units", which is a characteristic of the black market.
The street traders, called "bana doc" (child Doctors), get their stocks from Zairian wholesalers. But the main source undoubtedly comes from local pharmacies who pass on their out-of-date products; or from medical schools or medical personnel who sell the free samples they receive from the pharmaceutical companies.
The smuggled medicines originating in Zaire, provide most of the products found in the Congo's black market. "We buy goods which do not need to be kept cool: syringes, tablets, gels, cotton, alcohol...Our daily turnover varies between 8,000 and 10,000 CFA francs", one seller explains. The buyers have a more or less, low standard of education and very little money. The seller goes on to say: "We avoid the risks which sellers can run, since the buyers claim to know the nature of their illness".

Worrying situation

Before a buyer obtains a medicine, he consults a friend or acquaintance, but rarely a medically qualified person. He buys the three capsules which are strictly necessary for one treatment. The capsules cost 15 to 25 francs each.
The illicit sale of pharmaceutical products in the Congo is very worrying. Before the devaluation of the franc in January 1994, according to the World Health Organisation (WHO) and the World Bank, less than 30% of Congolese could buy medicines recommended by chemists. Nowadays, this percentage could be even less. Thus, the medicines sold more cheaply by street peddlers, are often the only source left to less well-off people. The chief problems with this kind of market are the complete lack of education by the sellers, the adverse conditions in which the products are stored and the absence of quality control. The sale of fraudulent and out-of-date products is often completely blatant.

"Generic" low-cost medicines

To enable Congolese, even the least well-off, to get products of quality at less cost, the Congo's chemists are thinking of popularising generic products, which have long been available in the dispensaries, but are unknown to people at large and rarely recommended by chemists.
Generic or unbranded products, are copies of existing medicines. They are called "generic" because they have exactly the same chemical components as branded medicines, which are owned by pharmaceutical companies, but have not been accepted by the public. Jerome Loutonto, president of the National Union of Chemists in the Congo explains: "These products are legally sold commercially and are equal to other medicines. They are merely a copy as regards their active elements, proportions, pharmaceutical contents, directions for use and dosage". According to him, generic medicines, which are 50% cheaper, represent a loss of profit on turnover, since they compete with branded products. Besides selling generic medicines which are copies of already existing brands, chemists also want to split up specialised products. That is to say, they want to sell smaller units of solid forms (pills and gels) and phials of drinkable and injectable medicines. They want to do this in agreement with the one who writes the prescription. This is new. According to Mr.Loutonto: "Instead of selling 30 tablets to the patient which he will not finish, only the quantity essential to his treatment will be sold to him".
However, to put this procedure into practice, medical practitioners are waiting for an amendment of the law, to authorise them to break up packages of drugs, or to draw up and publish lists to guide medical personnel on the amounts of drugs which are essential for a treatment, and which may be sold retail by chemist. Nevertheless, some chemists, at the request of their customers, have already begun to sell drugs in smaller quantities.
The popularisation of generic drugs and the splitting up branded drugs, is intended to curb the number of street traders. Economic difficulties encourage people to make a success of this new way of doing things, so that consumers can be assured of the quality of their medicines.
Mr.Loutonto asserts: "Medicines are chemical substances. Exposed to the elements they can perhaps be altered and become poisons. Many cases of cancer and ulcers have been recorded, resulting from improper use of non controlled products".

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PeaceLink 1997 - Reproduction authorised, with usual acknowledgement