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Vital Signs

A high-tech solution to drug counterfeiting

By Matthew C. Wiencke

Dartmouth graduate student Ashifi Gogo has developed a system that allows consumers to detect counterfeit drugs—a huge problem in some parts of the world—using a cell phone.

Imagine picking up some teething syrup at the pharmacy, giving it to your toddler, and then discovering it had been laced with a toxic chemical normally used in antifreeze. The parents of 84 Nigerian children who died last year don't have to imagine that nightmare. But if Dartmouth graduate student Ashifi Gogo has his way, it won't ever happen again.

Horrific: Such problems arise when drug counterfeiters use cheap but often toxic fillers to extend their profits. In the case of the teething syrup, the toxic chemical was diethylene glycol, which looks, tastes, and smells like glycerin, a common component of such syrups. It's just one of thousands of horrific examples of counterfeit drugs sold in Nigeria and Ghana—including fake antibiotics and antiretrovirals. The World Health Organization estimates that more than a million people die of malaria every year and that 200,000 of those deaths could be prevented if all counterfeit antimalarials could be eliminated.

Gogo, a native of Ghana and a Ph.D. student at Dartmouth's Thayer School of Engineering, has developed a way to circumvent the massive fake drug industry and protect people from its harms. It's based on ordinary cell phones, which are very common in Nigeria and Ghana.

As part of Thayer's Ph.D. innovation program, Gogo founded his own company, Sproxil, which uses cell phone technology to verify if a drug is real or fake. The concept is simple: before distributing the drugs, the pharmaceutical company applies to the package a scratch-off label with a unique ID number. The consumer texts the ID to a phone number. The ID is then sent to a central drug data depository in the U.S. A text message comes back automatically, telling the consumer if the drug is real or fake and its correct name, manufacturer, and dosage. The message also includes advertising discounts from the manufacturer, offsetting the cost of the text message. The technology works anyplace that has cell phone coverage.

Gogo tested the concept by distributing a survey about Sproxil, with a sample drug and scratch-off panel, to 1,000 people in Accra, the capital of Ghana. Just 413 of the survey respondents were aware of fake drugs in Ghana, and only 152 suspected they had ever bought a fake drug.

Trial: Next Gogo undertook a major trial in three large cities in Nigeria, by coding "one million units of the nation's most popular diabetic drug," he explains. "This is the largest trial of scratch-off technology that I'm aware of."

Fortunately for Gogo, Nigeria's National Agency for Drug and Food Administration has been cracking down on counterfeit drugs since 2001. And the agency is quite supportive of the Sproxil technology, since it works well alongside the agency's other strategies, which include stricter importation regulations and training courses for pharmacists.

By 2010, sales of fake drugs could reach $75 billion worldwide.

Most counterfeiters, says Gogo, are former narcotic dealers who turn to counterfeiting because the profits are huge and the penalties lenient compared to those for dealing narcotics. The U.S.-based Center for Medicines in the Public Interest estimates that by 2010, sales of fake drugs could reach $75 billion worldwide. "For every dollar you put into fake meds," says Gogo, "counterfeiters get between $25 and $250 back. So it's incredibly profitable without the long jail-term risk of narcotics."

Gogo's concept is attracting kudos from high places. It received an Outstanding Commitment Award, with $10,000 of seed funding, from the Clinton Global Initiative. It won first prize in the U.S. and second prize worldwide in the 2009 Global Social Venture Competition. And Sproxil was named Technology Pioneer for 2009 by the World Economic Forum.

Extend: Gogo hopes to eventually extend the concept to all of West Africa as well as to India, where many of Nigeria's counterfeit drugs originate. Meanwhile, two recent Dartmouth College graduates who interned with Sproxil are also helping to spread the idea. Taylor Thompson, DC '08, and Nathan Sigworth, DC '07, launched a similar start-up, PharmaSecure, using cell phones to tackle counterfeit drugs in India.

The trickiest part for Gogo is not the technology, but getting pharmaceutical officials and government regulators to work together. "Industry is always trying to get easier regulation . . . [and] regulators are always . . . saying, 'Hey, we can shut you down,' " says Gogo. But, "it turns out that in this case, everybody realizes that the one who loses the most, the one who could die, is the consumer. . . . We're all here to keep the public safe."

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