Counterfeit and Substandard Medicines: A Public Health Concern in Afghanistan
Keywords: Afghanistan, Counterfeit medicines, Medicine verification, Public health, Regulatory enforcement
Irfan Ullah Stanikzai
Abstract
This study shows counterfeit and substandard medicines to public health in Afghanistan and seeks to determine appropriate measures to address the challenges using mixed methods. Quantitative and qualitative data were collected in the study. For quantitative data, a structured questionnaire was administered to 330 participants. For qualitative data, semi-structured interviews and a focus group discussion with 12 key informants were conducted. Quantitative data were analyzed using descriptive statistics, correlation, and regression, and qualitative data were analyzed using thematic analysis. The main issues include the lack of enforcement, legislative gaps around the challenged posed by counterfeit medicines, the absence of tools to verify medicines, the absence of public awareness, and informal networks among the pharmaceutical sectors the governance around counterfeit medicines. The thematic analysis resulted in the identification of six strategic layers: formalizing supply chains, enhancing the capacity of the health workforce, the formation of strategic alliances on health at the global level, and awareness of the public around health issues. According to quantitative data, the correlation between public awareness and preventive measures, and the perceived health consequences and preventive measures were strongly positive (r = .838 and r = .648, respectively). The health impact was predicted by awareness and the preventive measures meanwhile the sources and causes were not statistically significant. The findings highlight remedying the public health threat of counterfeit medicine through the integrative approaches of awareness, regulatory changes, and advancing technology. This finding assists the development of reforms directed toward the oversight of the pharmaceutical industry in Afghanistan.
