Dora Nkem Akunyili, a true hero in the fight against global counterfeits, spoke in Washington, DC. last Tuesday. Dr. Akunyili’s experience shows that the fight against counterfeits can be won, although the efforts must be multi-pronged and consistent. Her Nigerian strategy also suggests some new ideas for our attempts to secure the U.S. pharmacy supply chain.

Dr. Akunyili is the director general of Nigeria’s National Agency for Food and Drug Administration and Control (NAFDAC). When she took over NAFDAC in 2001, she estimated that 41% (!) of drugs in her country were fake or sub-standard. Today, the Nigerian national average has reportedly dropped to a still-troubling 15%.

In an interview to accompany her speech, Dr. Akunyili describes the many steps that NAFDAC has taken to stop counterfeits, starting with education:

“We realized that the first step in solving a problem is to sit down and accept that there is a problem; to tell people that there is a problem so that people will stop being deceived; to sensitize people to be vigilant about what they buy, what they use, and what they eat.”

NAFDAC has also focused on “mopping up what is already in circulation, especially counterfeits from (where else) India and China, which required a zero tolerance policy for pharmacies: “[W]e found that some people when we find fake drugs in their shops, they give us fake receipts, and that’s made it impossible for us to trace who imported it, who produced it. So we put up a guideline that if such receipts were ever given by any shop, everything in that shop would be evacuated and destroyed. That is how we were able to find the thirty Indian and Chinese companies and one Pakistani company that we banned from importing drugs into Nigeria.”

Naturally, any potential problems with counterfeit drugs in the U.S. pale in comparison with the Nigerian situation. Yet the Nigerian experience raises some intriguing questions for the U.S. supply chain:

• How can we better educate consumers to the dangers of purchasing from unsafe sources such as importation and online pharmacies?
• What can we do to ensure that pharmacies are not a weak link in guarding the U.S. supply chain against counterfeits and diversion?
• How can pharmacies signal to consumers that all drugs were purchased from a legitimate supplier who provided a valid pedigree?
• How could drug makers partner with dispensing pharmacies in the U.S. to help consumers identify and validate legitimate pharmacies that practice “safe sourcing?”

No easy answers, but at least the questions are getting clearer.