Program Trains Pharmacists to Recognize Fake Medicine

March 27, 2003
By Kate Woodsome
The Cambodia Daily

Pharmacists and malaria control officers usually are the authorities who dole out instructions on how to use anti-malaria medicine. But this week, provincial pharmacists were the ones taking notes.

Like high school students in a chemistry class, a group of 29 officials from provincial pharmacies, the World Health Organization, the government's National Laboratory, the Ministry of Health's Central Medical Store and the National Malaria Center scribbled instructions in their notebooks on how to appropriately collect, store and analyze anti-malaria medicine with the help of disposable drug-testing units newly arrived from Germany.

Their teachers are two officials from the US Agency for International Development's subsidiary US Pharmacopeia, who flew in for 10 days from the US to help Cambodia clear pharmacy shelves of weak and counterfeit drugs.

"Counterfeit products are available everywhere," said Dr Souly Phanouvong, a US Pharmacopeia technical adviser for drug-quality control who is conducting the training at the National Laboratory.

The presence of fake drugs in Cambodia is no different from their existence in other countries, he said. The difference is in the progress the country has made in eradicating the problem.

Last week a drug-use survey conducted by the Ministry of Health in collaboration with Management Sciences for Health and other donors helped to identify the drug-taking behavior of malaria patients throughout the country. These new findings, combined with drug-quality tests, could help improve the drugs offered to and used by sick Cambodians.

Although the government is working to improve the country's drug quality, Souly Phanouvong stressed the importance of making drug storage containers tamper-proof. He said this would help assure that a "conflict of interest" didn't prompt individuals to accept bribes from big-business pharmaceuticals to alter the drug tests.

Pharmacists participating in the workshop traveled from Pursat, Pailin, Battambang, Preah Vihear and Koh Kong provinces near the Thai border, through which counterfeit drugs often flow.

Because a lot of new information must be learned throughout the workshop, Souly Phanouvong said he initially was concerned that the language disconnect between students and teachers could impede pharmacists' understanding of complex concepts.
But Dr Reiko Tsuyuoka, a WHO malaria control scientist, said she is confident that translators facilitated the pharmacists ability to adapt.

"They are skilled in knowledge and motivation," she said. "The training was very effective."

Now the test lies in turning theory into action. Workshop participants fanned across the city on Tuesday to collect anti-malaria drugs from Phsar O'Russei, Phsar Olympic and Phsar Thmei, as well from private clinics.

They are practicing how to use the mini-labs, equipped with an apparatus that provides a very basic analysis of the chemical composition of anti-malaria drugs and 40 other essential medicines.

The participants' performance during the training will determine whether US Pharmacopeia brings in more sophisticated equipment, Souly Phanouvong said.