The international organisation, Medecins sans Frontieres (MSF), announced in an article published on 17th January 2017 in the magazine Lancet Global Health that in 2015 more than 1000 people in an isolated part of the DRC had to be hospitalised after being poisoned by fake or poorly labelled medicines.

The end of 2014 saw the first patients with symptoms such as stiff neck and involuntary muscular contractions arriving at the health centres in the district of Ituri, near the border between the DRC and Uganda. By August 2015, more than 1000 patients had been admitted to the health facilities run by Medecins sans Frontieres and the Ministry of Health.

The nursing staff first suspected meningitis, but detailed tests seemed to indicate the ingestion of a toxic substance. An analysis of samples of medicines frequently prescribed in the region revealed that the toxin came from tablets sold locally as Diazepam but which actually contained Haloperidol, an anti-psychotic used in the treatment of schizophrenia.

Dr. Nicolas Peyraud of MSF explained that Diazepam is used to treat various problems such as anxiety and depression. Its usage is even more widespread in the region of Ituri where patients often request it when suffering from sleep problems or headaches that are put down to malaria.

Haloperidol is known to cause acute involuntary muscular contractions of the face, eyes, tongue, neck and arms. Although rarely dangerous, they cause worry, panic and embarrassment for the patients, according to Dr Peyraud.

MSF quickly alerted the Ministry of Health in the RDC and the World Health Organisation (WHO) who sent out a warning identifying suspect products.

An investigation is taking place to determine how these poorly labelled medicines reached the market. It looks likely to uncover the existence of deliberately faked medicines as well as a more general availability of poor quality medicines. The latter are harmful to both the patient and the health system. The ineffectiveness of mechanisms to regulate drugs, combined with insufficient penalties, corruption and porous borders turn poor communities into easy prey for people who deal in toxic or poor quality medicines.

Dr Peyraud stresses that such drugs undermine all the progress being made in the fields of pharmacology and public health, saying that the increase in cases of serious poisoning due to faked drugs must be a wake-up call for people working in public health at a global level to ensure that all patients, especially the most vulnerable, are able to access appropriate medicines of a high standard.

Dr Nicolas Peyraud