MPedigree: Combating Counterfeit Drugs

Interview: Bright Simons, mPedigree

Alarmed by growing rates of pharmaceutical fraud, Bright Simons and a small team launched the effort that culminated in the mPedigree platform, a mobile initiative in Ghana that empowers consumers with the ability to verify the authenticity of the drugs they purchase. In the following interview, Bright shares the origins of mPedigree, its public-private sector partnership approach, and plans for the future.

What is your background?

I have a background in social marketing and social enterprise and was working as a journalist when the idea for mPedigree came about. I was writing African stories from a global perspective and looking at how the newly developed nations of East Asia were expanding their economic interests in Africa, and particularly at the growing relationship between China and Africa. I was intrigued by many things. First was the transformation of once agrarian backyards into economically confident states that some were beginning to ascribe colonial motives to. Next were ruthless shifts in ideology that was seeing business rapidly subsume all forms of politics in this part of the world. And last was the question of whether Africa could learn about its own underdevelopment and innovation lag by looking at the East-Asian experience.

I was also interested in the details of this seismic transformation – the little-known facts that could make this intimidating reality easier to approach and understand. For instance, I developed a keen interest in how overseas outsourcing was linked to abuses in the global supply chain generally. For example, through what has come to be called the “third shift,” contract manufacturers choose to run an additional batch of an outsourced item for better-paying crooks.

Then I learned about a study in 2001 in which an estimated 190,000 Chinese people died from various pharmaceutical abuses in that year alone. I wondered if these fake and substandard drugs were making their way to China’s trading partners in Africa. More and more, the evidence suggested that a lot of the counterfeit drugs in West Africa originated in China, the Far East, and South Asia.

A number of my colleagues who were involved in technology abroad were also interested in the subject and in doing something to contribute to the life of ordinary citizens in Ghana. Eventually myself and my Dartmouth colleague made the leap of relocating to Ghana, from our Diasporan perches, to do something with our passion for social innovation. In 2007, we started mPedigree with seed capital provided by the National Collegiate Innovators and Inventors Alliance (NCIIA) in the U.S, and strong support in kind from the Thayer School of Engineering and the Dartmouth Entrepreneurship Network.

What prompted you to name the initiative mPedigree?

The term pedigree refers to a lineage of superior quality. It’s somewhat of a ‘gold seal’ that enables you to trust where something comes from, its origins. We’re asking that drug manufacturers ensure the efficacy and authenticity of the products they produce. M is for mobile.

How does a consumer use mPedigree?

When the consumer buys a product, they see a scratch panel. When they scratch it off, a series of eight numbers (this may vary in minor details in the future) is revealed. He or she then sends the eight numbers via SMS to a four digit short code (presently 1393), which works across every telecom network in Ghana. All the telecom providers have agreed to this uniform code and process. The consumer then receives a message telling them if the product is genuine. Other messages of relevance to consumer safety and satisfaction may also be relayed through the same two-way mechanism.

On the backend, we have built a good relationship with the Pharmaceutical Society of Ghana, in order to ensure that the majority of trained pharmacists will join in the effort of educating the consumer. The manufacturers of the medicines obviously constitute one of the most crucial stakeholders. The codes are applied either at their packing plant or on the packaging side, at their printers. In the implemented pilot however, code application happened strictly at the packing/labeling plant. By the time the product is in the shop the code will already be embossed, with pharmacists and other key actors in the supply chain informed. The SMS is free to the consumer and is paid for by the manufacturer. Indeed this is one of the foremost innovations in the process. Prior to our arrival in Ghana, there was no mobile-based application that was free to the end-user and paid for by the application developer. The telecom operators have been extraordinarily far-sighted and public-spirited not only to have agreed to this “reverse-charging” scenario, but to have agreed on rates below the commercial level.

Currently 65% of drugs in Ghana come from overseas with 35% are manufactured locally. We’re only actively courting local producers at present. To get foreign manufacturers involved would entail longer due diligence processes. They will have to become better versed in the West African context. What is clear is that multinationals are observing the model and, given the greater complexity of their supply chains, will sign on in due course once robustness has been demonstrated.

How do you work with drug manufacturers, pharmacists, government officials, and others to implement the project?

In fact, this is the beauty of the model. We have coined a term for it: stakeholder interfacing. We are the glue that gels stakeholders of different persuasions together in win-win relationships. You need to prove that it’s in people’s short and long-term interest to support a new way of doing things -- together. Enlightened self-interest is the most effective motivator. Currently our most fundamental relationship is with the telecom providers. It’s their infrastructure that allows consumers to access the system for free, and to do so regardless of geographic niche. How did we put our case to them? In Ghana, SMS is far more popular among the urban populace. The telecoms carriers are eager to have SMS adopted as regular practice by more people.

For the manufacturers, it’s in their best interest to have people buy their product, rather than copies made by counterfeiters. Even if the prevalence rate of counterfeits is 5%, and most experts think it is many times that, it is still a 5% loss in revenue. It is not easy for a business executive to tolerate losses of that volume, especially with profit margins continually coming under pressure from legitimate competitors. We’re also helping them with their reputation and maintaining the integrity of their brand. Put yourself in the shoes of a consumer who buys a container of nasal relief only to experience burning sensations after use. Will the consumer’s first instinct be to blame counterfeiters? Certainly not. They will question the quality of the product and switch to another brand. But manufacturers are business people. They need to hear a business case. Our success in connecting with a sizeable number of manufacturers ready to sign on can be attributed to our growing skill in making the business case that SMS-based brand protection bests alternatives like holograms, RFID, and next-generation barcodes in terms of dependability and cost-effectiveness.

It’s in the government’s interest to protect people. The system is set up to give free intelligence to regulatory inspectors and thus to allow law enforcement officials to crack down on illegal activity wherever fake drugs are found to be prevalent. Indeed, we are strengthening our relationship with the key drugs regulator to ensure that our work measures up to an important criterion: the enhancement of existing institutions.

What has been mPedgree’s ‘evidence of effectiveness’ to date?

It’s still too early to tell. We’re in the process of evaluating data collected over three months. We interviewed more than 2,000 people in Accra and Kumasi who used mPedigree during the proof of concept pilot. Our staff and volunteers assisted them in filling out a three-page survey. The initial evidence is that people are ready to jump on as long as the service is free.

Another valuable byproduct of this work has been increased awareness and media coverage of drug counterfeiting. We conducted a partial analysis of media coverage of counterfeit issues and detected a three-fold increase in the two months after we launched our social marketing effort compared to the three months prior.

It could take years to properly assess a radical initiative of this nature. However, we made a number of interesting observations during the pilot that gave us cause for cautious optimism. Local drug manufacturers have little existing data about their supply chains, making it difficult to establish clear baselines. The good news is that mPedigree was shown to be an effective contributor to what one may call, “data competence”, i.e. the ability of manufacturers and supply chain managers to maintain good, actionable, record-keeping. It illuminated the operations of our manufacturing partner in the pilot to a degree that made it much easier to fashion solutions to most identified bottlenecks.

What are your plans for the future?

We are at the stage of consolidating the third major plank of our three-prong stakeholder structure (the first two prongs being manufacturers/telecoms and consumers/civil society) to ensure a consolidation of our strategy for the post-pilot phase. This third plank is government and regulators. We have begun a series of public meetings under the auspices of the Ministry of Health in Ghana. We hope to conclude a memorandum of understanding in the next few weeks with the Food & Drugs Board, the most relevant specialized agency of government. Once the paperwork is in place to determine the full structure of the mPedigree governance system, a two-month window will be opened to solicit submissions from key stakeholders and the general public. An analysis of this important data will inform the final-status issues of how mPedigree will operate across Ghana, expand to other countries in the region and beyond, and into other product niches if need be. Obviously, funding from appropriate sources will be critical.

For further information, visit: www.mpedigree.org or email BSimons@mPedigree.org