On the occasion of World Patient Safety Day 2021, Kawaldip Sehmi, the CEO of Fight the Fakes member the International Alliance of Patients’ Organizations‘ (IAPO), talked about the dramatic situation of pregnant women and mothers in low- and middle-income countries due to substandard and falsified medicines with Health Policy Watch.
Iconic places across the world will be lit up in orange on World Patient Safety Day on Friday to highlight the global campaign to reduce preventable deaths in childbirth and pregnancy and deliver safe maternal and newborn care.
The International Alliance of Patients’ Organisation (IAPO), which I lead, and the alliance we are a member of, Fight the Fakes Alliance (FTF), will actively participate.
Afghan women, many already fearing for their lives with the return of the Taliban, may well be watching too. In the two decades of civilian rule since the Taliban were defeated in 2001, infant and child mortality has dropped by some 70% – the fastest reduction among low-income countries. The rate went down from 191 deaths per 1000 live births in 2007 to 49 in 2018, according to Dr Mohammad Razai, an Afghan doctor working in London.
What’s more, Razai says, maternal mortality was more than halved, declining from 1100 deaths per 100,000 live births to 396 as access to healthcare and sanitation rose dramatically.
All of this is now at serious risk, as is the progress the world made in the same period to combat preventable deaths in pregnancy and childbirth, far too many of them caused by sub-standard and falsified medicines.
The COVID-19 pandemic has negatively affected the often-fragile lives of mothers and their babies, and also brought a surge in the purchase and use of falsified medicines and the promotion of fake treatments.
Ensuring mothers and babies get high-quality medicine
That is why, on this special day, we are urging the global community to back moves to provide mothers and newborns with the extra care and high-quality medicines they need.
Every single day, approximately 800 women and 6 700 babies lose their lives around the time of childbirth, according to the World Health Organization (WHO). In addition, nearly 5,400 babies are stillborn daily, with 40% of these deaths occurring in relation to labour and childbirth.
Most stillbirths, maternal and newborn deaths and harm can be avoided by safe, respectful and quality care during pregnancy, childbirth and in the first days of a baby’s life. Sub-Saharan Africa and South Asia, two of the epicentres of fake medicines, account for 86% of these deaths.
Safe and quality care provided by skilled health professionals working in supportive environments is key. But there are other, smaller things we can do. One is to ensure that patients are safe and secure and, critically, can trust their local health services.
Fake and sub-standard medicines to manage hemorrhages, pre-eclampsia, eclampsia and sepsis proliferate in low- and middle-income countries (LMIC), according to a recent article.
Almost half the samples of uterotonic medicines to induce or speed up labour failed quality tests. Three-quarters of ergometrine supplies failed, while almost 40% of oxytocin and misoprostol also failed.
These drugs are deemed by the WHO to be “the most effective and safest drug of choice for the control, prevention, and management of postpartum haemorrhage — the leading cause of maternal mortality globally.”
Fake products undermine patient trust
In Nigeria, one of the richest countries in Africa, the likelihood of a woman receiving poor-quality or even fake oxytocin is very high, Devex reported, citing Dr Chimezie Anyakora, chief of party in Nigeria for the Promoting the Quality of Medicines.
It also quotes a prominent local gynaecologist who recountedd how he had to go out on a Sunday and find genuine oxytocin after that which he had administered was manifestly not working.
Fight the Fakes has also reported on the experiences of Ghanaian patient Victoria Amponsah who first received fake malaria medicine while two months’ pregnant then, at the end of her pregnancy, she was deceived by a fake version of oxytocin in an official-looking package.
“Within 30 minutes, Victoria started sweating, shaking, vomiting and bleeding. She was in the hospital for two days, nearly lost her baby and had to return to the hospital every week after the incident for some time,” according to Fight the Fakes.
In line with the WHO in its Global Patient Safety Action Plan 2021-2030, we call on the global and local communities to step up their efforts to stamp out unsafe and fake products.
To build back better and ensure we have people-centred, accessible, acceptable, affordable, and quality healthcare and universal health coverage, we first must ensure patient safety.
Safe care fosters trust in health systems, health professionals and medical products – but products that do not adhere to the highest standards of quality can undermine this trust Addressing fake and sub-standard medicine will require monumental effort on all our parts. But one key lesson from the pandemic is that we are all in this together.