Quantitative and qualitative analysis of anabolic androgenic steroids found on the black market – A protocol for a systematic review

Review question / Objective: With this systematic literature review we aim to assess published data on the quality and quantity of anabolic androgenic steroids (AAS) found on the black market to further determine the proportions of original, substandard, and counterfeit drugs. To our knowledge this is the first systematic literature review analyzing the quality and quantity of blackmarked anabolic steroids within the published literature. Condition being studied: AAS are synthetic, or human-made, variations of the male sex hormone testosterone that are widely abused by athletes for its anabolic effect on the muscle, thus are a convenient and easy method to improve body image and sport performance goals. Fake AAS, commonly acquired from the black market, pose a significant risk to individual and public health.

Assessment of Consumers' Awareness and Proposed Measures Against the Prevalence of Counterfeit Drugs in Developing Countries

Background: Counterfeit drugs have been reported as the primary cause of increased morbidity and drug resistance in developing countries. However, consumers' awareness of the prevalence of fake drugs in developing countries remains unknown.Objectives: To assess consumers' awareness and the principal contributors of counterfeit drugs, propose measures to curb this menace in developing countries.Method: Data were collected using a questionnaire with 24 questions bordering on consumer awareness and measures taken by health professionals in combating the prevalence of counterfeit drugs. All the questions were fully completed by participants and submitted online. The data were analyzed using both deductive and inductive approaches. Results: It was observed that the level of awareness of counterfeit drugs among consumers varies across different countries. A high level of awareness was reported in countries with improved technology for combating substandard drugs, comparable to countries with lesser technology. The results show that pharmacy retailers and pharmaceutical industries are the major contributors to the prevalence of counterfeit medicines in developing countries. It was observed that consumers are exploring brand awareness and the physical appearance of drugs in the fight against counterfeit drugs.Conclusion: This study assessed consumers' awareness of counterfeit drugs in selected developing countries and proposed measures that the government can implement in the fight against counterfeit drugs. These measures and findings may be appropriate in designing awareness programs and developing a framework for monitoring pharmaceutical production companies and supply chains.

Problems of false medicines' distribution and prospects of combat: survey of specialists and consumers results

The aim: comparative analysis of the results of a questionnaire survey of pharmaceutical and medical professionals and consumers, conducted by the authors during 2019-2021 to identify opinions on which there are coincidences and differences, as well as an assessment of the problem of drug counterfeiting in Ukraine to develop approaches to prevent their spread. Materials and methods. The study used scientific publications, as well as the results of a survey of specialists of the State Service of Ukraine for Medicines and Drug Control (State Medical Service) and its territorial bodies, pharmaceutical and medical professionals of health care institutions and consumers on the fight against drug falsification. The research was conducted using the methods of questionnaires, systematization and generalization. Results. According to the results of a comprehensive questionnaire during 2019-2021, it was found that the share of CM in the Ukrainian pharmaceutical market is estimated at 5 % by a majority of respondents on average 58.5 %, including 59.7 % of experts of the State Medical Service, 42.3 % of pharmacy specialists, 11.4 % by doctors and 73.5 % by consumers. Respondents' answers about the signs of drug falsification differ significantly, so most experts believe that this is a change in the usual signs (taste, smell, color), while pharmacy specialists - labelling in a foreign language, doctors - no therapeutic effect, for consumers it is a change in packaging design (labels) and a significantly lower price. The main sales channels of CM for experts and pharmacy specialists are e-commerce (68.7 % and 75.7 %, respectively), while the majority of consumers could not determine. Many experts and pharmacy specialists pointed to the need to introduce special security features of packaging in the form of 2d barcodes as the main method for protection and detection of CM (79.1 % and 39.6 %, respectively). Most of the surveyed pharmacy workers and consumers believe that the risk of purchasing counterfeit drugs is higher in the pharmacies of individual entrepreneurs or small pharmacy chains.The main problem that hinders the effective fight against drug counterfeiting was the imperfect legislation (68.7 %). Regarding effective tools in the fight against counterfeit drugs, experts called a significant strengthening of the powers of the regulatory body - following the example of the FDA (70.1 %). Conclusions. It is established that the most important priorities of the state policy for combating CM in Ukraine are the improvement of the system of state control and quality assurance of medicines, in particular 2d coding, as well as the need to strengthen the responsibility for drug falsification. The results of research on the problem of drug falsification indicate the feasibility of introducing a systematic survey for a wider range of respondents - professionals and consumers

Unfolding the COVID-19 second wave in India

Early efforts to vaccinate the Indian population were started on 16th January 2021. With this, a ray of hope came as people again starting their livelihoods, roads looked busy again, playgrounds were again full of children. Everything seems back to normal, while the Government was allowing all other activities with the option to follow the COVID appropriate behavior (CAB) keeping a blind eye to whether or not someone follows it. The immediate consequence of this laxity was that people were not following the CAB in particular, and by the end of January 2021, the situation was back to normal, as if there were no pandemics anywhere. While the rate of vaccination was slowly taking pace, the majority population believed that the vaccination may be necessary later, leading to the vaccine hesitancy. The second wave which started in the last quarter of March 2021 and spreader much faster than the first wave, is believed to be fueled by the additional strains of the coronavirus, as stated by many health experts. New coronavirus strains are thought to be more infectious home ground variants found in 61% of samples of genomes sequenced in many states in India. Even such news was reported by media rapidly, the laxity in the CAB and preventive measures, coupled with the presence of new variants, has resulted in a nationwide crisis. What caught the attention of the globe was despite the ongoing pandemic, the Indian Government allowed State assembly elections in the Eastern part of the country, which could have been delayed at this point. The prime Minster led Government faced this Critic from the opposition while the “Maha Kumbh Mela” organized at Haridwar attended by lacs of devotees who believed to bathe in a ritual river to pure themselves for their mistakes of past was also allowed by the Government. It was reported by media that about 7 million devotees attended the event and 1700 tested positive for covid-19 over 5 days period because no such social distancing measures or masks were used during the Maha Kumbh Mela by the attendees. Most of the public health agencies tried their best to dispel the myths and supported the campaigns associated with covid-19 vaccines but turned a blind eye and acted as a muted spectator for the election rallies and Maha Kumbh Mela. Following COB during election rallies and Maha Kumbh Mela will never go easy hand in hand, so the best is to follow the no man’s rule. What we believe the public health professionals of the country followed in deep agony and pressure. As India is engulfed in the second wave of covid-19, the current situation is deteriorated by the presence of counterfeit drugs, lack of human resources, medical supplies, and equipment. There are unique scientific, technical, and logistic challenges which we face in covid-19, we need to take definite steps for fights against this pandemic.

Contribution to the Detection of Poor Quality Sildenafil Drugs in Burkina Faso Using High-Performance Thin-Layer Chromatography

In substandard drugs enforcement, there is a need to develop reliable, fast, and inexpensive analytical methods. Due to its very characteristics, HPTLC offers opportunities for the development of methods that meet these requirements. This technique was used to develop and validate a method for the determination of sildenafil in pharmaceutical formulations from the licit and illicit supply chain in Burkina Faso. Taking into account optimization parameters such as measurement wavelength and mobile phase composition, the best elution quality is found at the maximum signals of spots on silica plates at 305 nm, using a mixture of dichloromethane-methanol mixture 9 : 1 (v/v) proportions. The method developed under these conditions was validated using the accuracy profile as a decision tool. The establishment of the response function curves allowed the choice of the polynomial function applied to the peak areas. This mathematical model provides a validity range between 0.4 and 0.6 mg/mL. The application of the developed and validated method to collected samples allowed the detection of two substandard drugs and confirmed the poor quality of drugs in the illicit market. More data using this approach in a variety of drug molecules could lead to the establishment of databases of counterfeit drugs in Burkina Faso.

A Study On Application Of Blockchain Technology To Control Counterfeit Drugs, Enhance Data Privacy and Improve Distribution In Online Pharmacy

Technology has always emerged to embolden the existing working process. On the one hand, it encourages transparency, accessibility and robustness in the system and on the other hand, it begets mitigation of the risks and allows us to detect, evaluate and eliminate vulnerability in the system. The most prominent technologies in todays’ world like Artificial Intelligence, Virtual/Augmented Reality, Automation, Cloud Computing are thriving to solve society’s problems and ensure the expedition in the process from its previous generation. Blockchain technology is no exception in providing the solution to eliminate the counterfeit markets across the globe and building trust among parties to do business without the fear of indulging or facing any unscrupulous business. Blockchain technology can ensure data privacy while improving supply chain transparency and reducing fraud. It can provide all stakeholders within a certain supply chain with access to the same information, potentially reducing errors. A decentralised application can pave the way to promulgate online pharmaceutical business where health information and each stakeholders’ data is not compromised. Against this backdrop the research conducted throws light on the challenges in the online medical drug and devices’ distribution and proposes a solution, an architectural design for blockchain technology in an online pharmaceutical platform to mitigate the counterfeit market while bringing efficiency to the ecosystem.

Inventory of counterfeit drugs, history of antibiotics and presentation of the ministry in charge with four of the largest public health centers in Niger using them in 2016-2017

Context: Counterfeit medicine is a substance capable of curing a living, which is made fraudulently without responding to WHO standards. Today, the population Street increasingly to illicit markets to buy drugs at lower cost to the sellers. So, the sale of counterfeit medicines has first become the problem that tempts the media. Those drug supply have become not only a threat to the health of the population but also to the economy and security of many countries including in Niger. The street drug trade is a very growing activity in Niger. Antibiotic is a drug which treats infectious bacterial diseases. Associated with vaccination, it eliminates or greatly reduces the main epidemic diseases. Evidence: Surveys on the use of drugs and in particular antibiotics have been carried out. The people targeted are those of the Ministry of Public Health, health workers stationed in hospitals and referral health centers; pharmacists and drugstore vendors, street vendors. Results: The presentation of Ministry of Public Health in charge of health belonging to 4 greatest health centers were recorded as being used by the Nigerien population to have the most commonly antibiotics used by them. The βeta-lactam family (Amoxicillin, Ampicillin and Cloxacillin) (60/100); the Fluoro-quinolones family (ciprofloxacin) (20/100); the imidazole family (Metronidazol) (20/100) were the most used species. Conclusion: The review on counterfeit drugs, the history of antibiotics and the presentation of the main health centers involved in Niger provided substantial details on the use of drugs to treat infectious diseases. These complete basic data could certainly encourage some researchers to undertake research on other molecules which could lead to the quality control of these drugs for the treatment of the diseases which concern them and to have notions on the functioning of the services concerned by approaching these latter.

Content analysis of the official documents on the turnover of counterfeit medicines in Ukraine in 2017–2020

The purpose of the work was to conduct a content analysis of the orders of the State Medicines Service on the prohibition of the circulation of counterfeit medicines and the information messages of law enforcement agencies in 2017–2020. The object of the study was the orders of the State Medicines Service on the prohibition of the circulation of counterfeit medicines, information messages of law enforcement agencies to identify the facts of clandestine production and counterfeiting, publications on the problems of it’s distribution. The study used the methods of content analysis, systematization and generalization. Тo prevent the circulation of counterfeit medicines in the countries of the world, various methods of countering counterfeiting are being introduced, however, only in Ukraine was the restriction of measures of state supervision (control) in the pharmaceutical sector introduced as an element of deregulation. In connection with this, it was investigated how such restrictions, which were introduced three times, has influenced the identification and distribution of counterfeit medicines. For the study, a methodology for content analysis of official documents on the circulation of counterfeit medicines in the country for 2017–2020 has been proposed. In most of the orders of the State Medicines Service, revealed signs of drug falsification were introduced, which related to the labeling of packages. The imposition of a moratorium on planned measures of state supervision had a negative impact on the work of quality control bodies of medicines to identify counterfeits. In 2010–2014 (before the introduction of the first moratorium) the State Medicines Service issued 326 orders prohibiting the circulation of counterfeit medicines, but after the introduction of the moratorium, the number of orders for 6 years decreased significantly – to 118. So, in 2020, the State Medicines Service issued only 4 orders to prohibit the circulation of counterfeit drugs (for comparisons in 2017 – 18), although law enforcement officers revealed 6 facts of clandestine production and counterfeit. According to the results of the study, it was established that it was necessary to unify and standardize the management documents of the State Medicines Service on the prohibition of the circulation of counterfeit medicines, and also indicated the feasibility of introducing «field screening» of the often counterfeited medicines, to establish the real part of counterfeit medicines. Information messages from law enforcement agencies should not be limited only to the facts of revealing clandestine proceedings, but also should contain the results of court decisions on these facts. It is advisable to intensify interaction with regulatory authorities in other countries for a more effective exchange of information on detected of counterfeit medicines.

Countering Medicines Trafficking in Russia in the Context of the COVID-19 Pandemic: Key Problems and Ways to Solve Them

The article examines a number of key problems in the fight against illicit medicines trafficking in Russia in the context of the COVID-19 pandemic and the development of a set of organizational and legal measures to increase the effectiveness of such a fight. The author concludes that the scale and severity of the various consequences caused by the COVID-19 pandemic are, to a certain extent, due to imperfect state control over the shadow pharmaceutical sector. In particular, many standard measures of government response to drug trafficking are not effective enough to ensure reliable protection of the population from the negative impact of illegal circulation of counterfeit, substandard, unregistered, counterfeit drugs.The measures proposed by the author are aimed at improving the efficiency of the system for preventing drug trafficking not only in relation to the modern conditions of the COVID-19 pandemic, but also designed to ensure state control over the production and circulation of drugs in any emergency conditions.