KARACHI, Pakistan – The government of Pakistan is tapping into mobile technology to protect its pharmaceutical supply chain and prevent abuse. As part of an ongoing effort to deal with an overabundance of fake and counterfeit medicines, Pakistan has introduced a mobile app that allows for instant access to the country’s National Essential Medicines List (NEML) while giving patients access to drug information and the ability to lodge complaints with regulators.

The mobile app contains a searchable list of products included in the NEML developed by the National Department of Health of Pakistan. Patients can scan barcodes on medicine packages to ensure they are both real and approved. A spokesman for the Drug Regulatory Authority of Pakistan (DRAP) said the NEML mobile app has been standardized in line with the World Health Organization’s (WHO) Model List of Essential Medicines.

The application can help monitor drug prices and identify counterfeit or fake medicines. The NEML application gives users the option to lodge complaints against particular drugs or pharmaceutical companies. Authorities are expected to address these complaints within 48 hours.

Essential medicines on the list also can be filtered based on their availability, service levels, links to other medicines and links to specific health programs like malaria or tuberculosis control programs.

Growing themes

Telehealth and mobile health are growing themes in Pakistan. The widespread use of the NEML app has been made possible by the more common use of smartphones and rapidly spreading mobile network coverage. Pakistan’s telecommunications authority said there are 164 million mobile phone users in the country of 220 million people, and more than 74 million of them have access to 3G and 4G networks. The NEML mobile app taps into this growing network.

“[From] my perspective, the NEML mobile application will not only make people aware about fake medicines, but also get information about the actual price of the medicines,” said Khawar Rizvi, a university lecturer and the former general manager at Getz Pharmaceutical.

One of the key goals of the NEML app is to minimize or even eliminate counterfeit medicines while providing more information about real and safe drugs.

The NEML itself has had an impact by identifying safe, quality, efficacious and affordable medicines, said Zafar Mirza, who is part of the Ministry of National Health Services, Regulation, and Coordination.

For its part, WHO estimates that as many as a million people die every year globally from counterfeit medications.

In one high-profile incident in 2012, 120 people died after taking counterfeit heart medicines in Lahore, Pakistan’s second largest city.

In another incident in November 2019, Pakistan’s Customs Authority carried out a raid and came upon a group of people packaging fake medicines in Islamabad. A Customs Authority spokesman said that

“during the raid, vitamins bottles were being stuffed with the same green tablets by the unscrupulous persons running this operation.” The fake products were later found in pharmacies across the city.

Problems with drugs have led to widespread recalls across Pakistan, said a spokesman from the DRAP. The agency instructed nine pharmaceutical firms in November 2019 to recall medicines for high blood pressure after finding they were made with contaminated raw materials.

According to a national task force report, the DRAP carried out 51,194 inspections between January and November 2019 and found 587 cases of unregistered medicines and 1,710 sales of medicines without warranties or false warranties, along with other problems.

Rizvi said part of the problem is a set of incentives that link pharmaceutical companies, doctors and pharmacists. Doctors play a role in the spread of poor-quality medicines due to the marketing incentives used by pharmaceutical companies. Unfortunately, patients often lack the knowledge or ability to gauge the quality of medicines. The NEML app may help bridge this knowledge gap.

However, an app may not be enough. Pakistan also may need to strengthen its regulatory environment.

The Additional Director of Health for Karachi Nadeem Shiekh said Pakistan’s pharmaceutical industry has been operating with spotty regulatory oversight since the National Ministry of Health was abolished in June 2011 and its power devolved to the provinces. Following the 2012 Lahore incident, the government established DRAP.