Contact: The Growing Concern Over Counterfeit Medicine

Mike Smith: Mr. Grey could you provide us with a bit of information on The Bahamas Pharmaceutical Association and its objectives?

Phillip Gray: The Bahamas Pharmaceutical Association has been around for many years now, most of us would identify with the name – he has become an icon in the field of Pharmacy – the late Pedro Roberts, who we lost late last year. But, sometime ago, being affiliated with the Commonwealth Association of Pharmacies there were branches that were formed and The Bahamas branch of pharmacies was formed. Principally it’s the function of the association is for visionary aspects development of the whole field of pharmacy for comradery of associates members in the field of pharmacy. And certainly as we look for the way forward what we are heavily engaged in at this time as we get ready for Summit 2006, were we are about to launch a strategic plan.

Mr. Smith: Why this Summit 2006?

Mr. Gray: Well, what we have been looking at is the fact that as the field of pharmacy changes significantly, we are living in a global market now, FTAA is here and I am sure you would have been aware of Caribbean initiatives and the last two years we were heavily involved with the Ministry of Foreign Affairs and the Ministry of Health in discussions in relation to opening up our borders. When we look at that, when we look at what we have in place in terms of legislation and other issues in the country, we see an exciting time, we are hoping to have the current legislation that is enacted, which is antiquated by the way, repealed, and there certainly are some other initiatives that we are focusing on so that we take the profession and certainly the association to the next level.

Mr. Smith: Mrs. Charlton, are all the pharmacists in the country members of the association?

Mrs. Charlton: They are not all members, but they are all free to become members, and I would dare say probably more than 60% of the pharmacists are members of the association, but its not mandatory to be a member of the association.

Mr. Smith: So it is not a regulatory body as such?

Mr. Gray: No. We are actually currently regulated by the Health Professional Council, which is an entity that actually governs all of the allied health professions. However we quickly state that pharmacy should not be governed under such a body. This is the position of The Bahamas Pharmaceutical Association, it is one of the leading professions in health care and really we seek to have our own council and to have the association being governed principally by pharmacists. My personal position is when you look at what we bring to the picture from the perspective of manufacturers, pharmacists, retail stores, the impact that we make on the whole healthcare system, when you look at what we produce in terms of the national gross product, it is an entity that should stand on its own and not be governed by such a body. So that is the position of The Bahamas Pharmaceutical Association and the legislation that we hope to be repealed, and the new legislation being enacted we hope to address those particular issues.

Mr. Smith: Who then is the regulatory body for medicine coming into the country? Or is there a regulatory body?

Mrs. Charlton: The Bahamas National Drug Agency is the body that is responsible for the drugs that would come into the country, however it is not as regulated as it ought to be and as individual pharmacy owners and pharmacists we then have to be at the forefront to be sure that the products we are actually dispensing to the Bahamian public is safe and is from the proper sources. I reserve comments on that part of it in terms of regulations because I am not too informed about the agency and exactly how it works, but I am sure that in another show we would have the proper authorities here to deal specifically with that, but that is the agency that is responsible for that.

Mr. Gray: To add to what Laura said is that The Bahamas National Drug Agency, being spearheaded by its director, Mrs. Vivian Lockhart, who is the former chief pharmacist in the country, and then Dr. Marvin Smith, the assistant director those two persons have been one of the strategic persons that have been involved in the actual legislation – the writing of the legislation, and what the legislation seeks to (draft legislation that is being proposed) – draft legislation that is actually at the Attorney General’s Office at this time – and we are hoping that in short order that the legislation will in fact go to parliament for ratification. But they have been spearheading that project in a major way looking at legislation from the Caribbean and other areas, certainly our neighbours and the proximity to the US, looking at our neighbours to the north and looking at our unique scenario – being an archipelago of islands – and seeking to bring another level of standard in terms of the governance and regulations in the country in relation to medication administration and the whole process.

Mr. Smith: What is the relationship between the association and the National Drug Agency?

Mr. Gray: The relationship is simply the fact that the pharmacists that work for the National Drug Agency most are members of the association, there is no reporting relationship, however it is a quasi-government entity that functions under the Public Health Authority and ultimately to the Ministry of Health. But The Bahamas National Drug Agency often seeks the advice from the association and likewise the association from The Bahamas National Drug Agency.

Mr. Smith: How big a problem is the challenge or is counterfeit drugs a problem in The Bahamas?

Mr. Gray: We have not had noted or brought to our attention any incidences where we have uncovered that persons have received counterfeit medication. However, the problem is a growing issue globally and certainly at the advent of Internet pharmacy and we know that there has been a site or two in The Bahamas. It is an issue and for us we consider it a grave issue because one counterfeit medication could cause someone his or her life. So certainly it is something that we are monitoring closely. The issue is such that I recall a presentation done by one of the local drug houses - at one point and the issues is such that the drugs can actually mirror the patented brand so closely that even the trained eye may not be able to detect the difference in terms of sight vision. However when you break the components down, the ability for the drug to do what it ought to it is significantly less potent in some incidences as the authentic product, and in some cases it doesn’t even have the active ingredient (at all). And then what they have lined the drug with sometimes can be dangerous and certainly if you are on other medication, what you may have the product may be contra-indicated to what you are already on. The issue can be a serious matter.

Mr. Smith: Mrs. Charlton, any of your patients, or at what level is the concern as far as you are aware?

Mrs. Charlton: There is a growing concern about counterfeit drugs and if you don’t mind if I could just briefly explain what counterfeit drugs are. Counterfeit drugs are what we would call fake drugs. It doesn’t mean always that it doesn’t have active ingredients in it, some of them can have the active ingredient of the drug that it is supposed to be mimicking, others may not have anything at all and then others may have things that could be very harmful to the patient. Like Mr. Gray mentioned, sometimes it is difficult to detect what is fake and what is authentic, because you would find that in some of the cases when they would have shown us the counterfeit drug versus the authentic drug – to be honest with you some of the counterfeit drugs were looking more authentic than the authentic drugs, so to the untrained professional or to the patient out there and maybe even some of us – it is difficult for us to detect it. That is where as pharmacists we have to be vigilant, and we have to be sure that we are procuring our jobs through the proper channels. As to the consumers, if you detect anything that is different in your drug, be it the appearance or the taste even that is something you would bring to the attention of the pharmacist. But there is a growing concern and you would find that patients, because they are listening to the US media, because there is growing concern there especially. In the US they have a task force that has been investigating counterfeit drug and its traffic and of course they are trying to keep it out of the United States and our proximity to the US makes us a transshipment point for counterfeit drugs. As Mr. Gray mentioned, we, as far as I am aware, have not had any documented cases in The Bahamas in terms of persons in The Bahamas consuming or receiving counterfeit drugs. But yes, there was a case last year where there was the Canada Rx Internet site that was transporting drugs through.

Correction:

Recently in articles on "IICA’s Role In The Bahamas" dated June 8th and 15th, which featured representative Dr. Markis Alvarez commenting on the achievements of the Inter-American Institute for Cooperation on Agriculture, he referred to the Jagdeo Initiative, which is named after the President of Guyana. The Jagdeo Initiative was incorrectly spelt. We apologize to Dr. Markis Alvarez and all concerned.

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