Global Anti-Counterfeiting Challenges

Mark Davison
© John Steven Hernandez

Agenda
 What are the global issues?
 What anti-counterfeiting technologies could work
everywhere?
 How do we best serve developing countries?
 What do the patients want?
mark.davison@bluespherehealth.com 2

No Man is an Island…

How We See the World:
People or Territory?

World Map by Land Area
© SASI Group (University of Sheffield) and Mark Newman (University of Michigan)

“Headline” Counterfeit Flows

Response: Logistics-Based Security
 Control the product
flow, control the crime…
 Serialization, pedigree,
RFID etc.
 Tech-centric approaches
 Infrastructure
requirements
 Pay-offs in patient safety,
logistics efficiency
 Reduces opportunity for
large-scale crime
 Provides a modular,
scalable, global
framework

Deadliest Counterfeit Flows

“Internal”Counterfeits

Logistics is Only One Aspect
 Tech-centric approaches are difficult in developing
countries
 Doesn’t deal with locally-produced fakes
 Wider approach is needed

Global Share of Land…

… Share of Population

…and Share of Poverty

Who Pays the Costs of
Anti-Counterfeiting?
“The costs associated with implementing E-pedigree will
be too high for some California pharmacists to absorb.
This means even more small business pharmacies will
be put in jeopardy. This will harm patient access to
prescription drugs and consultation care.”
National Community Pharmacists Association, Dec 2007
http://www.pharmacy.ca.gov/meetings/minutes/2007/07_dec_enf1.pdf

#8
GDP
Worldwide.
If California
cant afford it,
who can?

“Ubiquitous Anti-Counterfeiting
Technology” Must Be:
 Secure
 Easy to use with minimal / no training
 Physically robust
 Low entry costs (or subsidized)
 Flexible and scalable
 Upgradable and Replaceable

Role of the State
 Centralized solutions may be the best option
 Europe, USA, China, Brazil etc.
 Not all states will cope with serialization
 Heavy subsidy and technical help needed
 Scalable approaches to aid phased uptake
 Supportive, non-punitive environment

But…
Share of Public Health Spending

How About the Pharmacist?
 The last professional to touch the pack
 Trained and trainable (in anti-counterfeiting systems)
 Ubiquitous in every community?

Unequal Share of Pharmacists

Publicly-funded Healthcare and
Private Pharmacists
Mostly
private-sector
pharmacists
Pharmacists
Public funding

Pharmacy-Based Drug Security
 Relatively simple, logical approach
 May not work everywhere
 Not all pharmacists are equivalent
 Sometimes they are the problem not the solution

How About the Consumer?
 Ubiquitous
 Least trained element of the supply chain
 Most to lose if product security fails:
 We invest, but they ingest
 Very effective if given the right systems
 Communication is vital:
 Education, education, education
 Should only be the “sentinel of last resort” against fake
drugs

How to get the message across to consumers?

Share of Literacy

Share of Personal Computers

Share of Languages

Consequences
 Low literacy levels and high language diversity need to
be dealt with and planned for
 Don’t assume that the message transmitted is the
message received
 Adapt materials and channels to local requirements
 Culture, language, taboos etc
 Use verbal communication when necessary:
 Radio, local networks, village meetings
 Reinforce the message repeatedly and frequently

Clue: They don’t care about anti-counterfeiting technologies…

Patients Want Safe Medicines
 Supply chain security is vital
 Customer is a useful last link for security
 Many people are too poor to have choices
 Choice of fake or real may actually be drug or no drug
 Distinctions are often blurred
 Traditional medicine versus western drugs
 Expensive versus cheap
 Genuine versus fake

Why Don’t Drug Companies Just Concentrate on
Keeping Developed Markets Safe?
 Serialize (code) everything but only check a subset
 Developed countries, Major urban centres
 Protect (paying) patients’ health, share price, revenues
 Eliminate the costs and complexity of a global system!
“Devil’s Advocate” question!

Here’s why: Share of Malaria
Answer!

Or Share of Tuberculosis…

“Fake tuberculosis and malaria drugs alone are estimated
to kill 700,000 people a year. That’s equivalent to four
fully laden jumbo jets crashing every day.”
Julian Harris, International Policy Network, 2009
www.policynetwork.net/health/publication/keeping-it-
real-protecting-worlds-poor-fake-drugs

The World is Small, Disease Travels and Everyone is Connected

Send me an email if you want to know more about
global anti-counterfeiting issues.
Photo on title slide by John Steven Fernandez www.flickr.com/photos/stevenfernandez/2069638117/
Maps are from Worldmapper.org and Buckminster Fuller Institute
Any man's death diminishes me,
For I am involved in mankind.
And therefore never send to know
For whom the bell tolls;
It tolls for thee.
(John Donne)

Global Anti-Counterfeiting Challenges

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