- In November 2020, two people were arrested after a consignment of falsified COVID vaccines were discovered in a warehouse in Germiston.
- The World Health Organisation says the global market for substandard or falsified medicines could be worth up to 15% of the total pharmaceutical market.
- Weak medicine regulators in Africa mean the continent is vulnerable to falsified COVID vaccines being circulated.
- Sources at international anti-crime agencies argue that Africa’s strong trade routes with China and India are going to allow criminals to introduce shipments of falsified vaccines into supply chains.
On Friday, 6 March 2020, a day after South Africa recorded its first-confirmed case of COVID-19, and a few weeks after Egypt had on 14 February become the first African country to register an infection, Ugandan police arrested a traditional healer and his daughter in a village 120km east of Kampala.
Police spokesperson, Fred Enanga, told Uganda’s New Vision newspaper: “They visited a number of families … telling them that they had discovered a vaccine for the coronavirus disease … The unknowing subjects purchased the said vaccine at a fee that was negotiated with the seller before it would be administered.”
On 19 November a far more sinister incident unfolded in a warehouse in Germiston, according to Mlungisi Wondo, acting manager of the South African Health Products Regulatory Authority’s (Sahpra) regulatory compliance unit.
The police, he says, tracked “suspicious freight” from the OR Tambo airport to the building east of Johannesburg. After opening a “lot of boxes”, an officer called Sahpra for assistance.
“Our inspectors got there and then they saw prefilled syringes, and they [had labels that] were written in Chinese … The two people who were at the site, the owner of the warehouse and the Chinese owner of the consignment were arrested,” says Wondo.
“There were clear indications that the contents of the boxes were going to be sold as genuine COVID-19 vaccines.”
According to Interpol, the “vaccines” had been advertised for sale on a Chinese social media app, WeChat, and had been imported from Singapore as “cosmetic injections”.
Wondo says the police, in cooperation with Sahpra, are “still trying to trace if there were units released into the country. The risk now is, if people are injected with those [fake] vaccines; we don’t know what is in them because we are still doing the tests at the National Control Laboratory in Bloemfontein.”
On 15 January, Nigeria’s National Agency for Food and Drug Administration and Control (Nafdac) said it was aware of fake vaccines circulating in the country. The agency’s director-general, Mojisola Adeyeye, told a press conference: “Nafdac is pleading with the public to beware. No COVID vaccines have been approved by Nafdac. Fake vaccines … could kill.”
And on 31 January, a “Dr H. Losho from Lagos”, who also advertises sex toys, clothes and shoes, posted the following tweet: “If you’re interested in 2 shots of Covid Vaccine at 50k each, contact @ad_de_moles. AstraZeneca. Arrives in 2 weeks. You get a card.”
These cases show that Africa is fertile ground for distribution of falsified and stolen vaccines. And with the emergence of new SARS-CoV-2 (the virus that causes COVID-19) variants, such as the 501Y.V2 variant that was first identified in South Africa, COVID vaccines will become an even more sought-after commodity — because, at least so far, those variants have proven to be more infectious than the original form of the virus. Some are also able to escape the immunity that current vaccines induce, leading to more fear — and desperation — to be protected from such variants by adjusted, newly developed vaccines specific to those variants.
The statistics also show the continent is extremely vulnerable to vaccine crime: A report by the World Health Organisation (WHO) in 2018 said between 2013 and 2017, almost half of all substandard and falsified medicines found were in sub-Saharan Africa, where regulations are weak, borders porous and the distribution of fake pharmaceutical products is often not considered a crime, despite the harm they do.
“We’ve found very toxic substances in falsified medicines. First, you are not cured, and then you have seen cases of people who are dying because of the product they were taking,” says Cyntia Genolet, the associate director of Africa engagement at the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA). The organisation represents the world’s major pharmaceutical firms, including most of those making COVID-19 vaccines.
The WHO report says fake malaria drugs alone cause up to 158 000 deaths every year in sub-Saharan Africa, and that the global market for substandard or falsified medicines could be worth $200bn (about R3-trillion), or 10-15% of the total pharmaceutical market.
Most African countries are unprepared for the potential onslaught of vaccine theft and falsification
In South Africa, one of the African countries worst-affected by the pandemic, the health department says at least 67% of the population of about 60-million must be vaccinated to achieve the herd immunity that would effectively end its epidemic.
South Africa’s vaccine roll-out, that would have started with the AstraZeneca vaccine, was temporarily suspended this week, after new, early data showed that the jab only provides 10% protection against mild to severe COVID-19 caused by the new 501Y.V2 variant.
The health department announced that the country will now, instead, launch an implementation study that will compare how well three jabs — Johnson & Johnson, Pfizer and possibly AstraZeneca — protect against severe COVID-19 disease caused by the new variant. Severe COVID leads to hospitalisations and death and protection against it is therefore an important function of vaccines during pandemics.
And, once the country’s roll-out finally takes off, it will be massive and fraught with challenges.
“This roll-out will be unprecedented in scale, importance and complexity. Will there be crime around that? Probably. But I think we have bigger problems, like how are we going to get the vaccine into the arms of millions of people?” says Salim Abdool Karim, an epidemiologist and co-chair of South Africa’s scientific ministerial advisory committee on COVID-19.
Abdool Karim, who also heads up the HIV research organisation, the Centre for the Aids Programme of Research, Caprisa, adds: “The system that’s going to regulate the vaccines seems pretty strong; they say security around the vaccines will be strong.”
But nowhere close to as strong as in Europe and the United States, where almost every entity involved in distributing the jabs, from airports to transport firms to manufacturers, has formed task teams to keep them safe.
Companies have done background checks on staff; GPS trackers are inside every box of vaccines, which are being stored in secret locations; some vials contain black light verification technology (markings that are only visible using equipment that emits ultraviolet rays) to prevent falsification; some firms are using bogus shipments to throw criminals off-track.
But most African authorities, entangled in negotiations to secure vaccines and preparing for the logistical nightmare of getting them to people across vast territories where transport routes are poor and sometimes non-existent, are nowhere near ready to safeguard the vaccines, according to numerous sources interviewed by Bhekisisa, including law enforcement, crime intelligence, customs and border officials, government representatives and crime analysts.
Africa has almost 1.4-billion inhabitants, according to the latest Worldometers population recording mechanism.
In an analysis in late November last year, the WHO warned that “Africa is far from ready for what will be the continent’s largest ever immunisation drive”.
The analysis found that, based on self-reports by all countries, Africa had an average score of 33% readiness for a COVID-19 vaccine roll-out, far below the WHO’s desired benchmark of 80%.
The organisation said less than half of Africa had identified “priority populations” for vaccination and had plans in place to reach them, and only 44% had “coordination structures” in place.
According to the WHO report, only 24% had “adequate plans for resources and funding”, a mere 17% had data collection and monitoring tools ready, and just 12% had plans to communicate with communities “to build trust and drive demand for immunisation.”
Maurice Ogbonnaya, a crime analyst and former security analyst at the National Institute for Legislative and Democratic Studies in Nigeria’s National Assembly in Abuja, says it’s precisely such inadequacies, “gaps” and disorganisation that could allow organised crime groups (OCGs) to insert falsified vaccines into supply chains, and to steal vaccines.
Why is Africa ripe for a COVID vaccine black market?
Inspired by a sister addicted to illegally trafficked codeine in Nigeria, Ruona Meyer spent more than a year infiltrating gangs dealing in illicit pharmaceuticals in West Africa.
She went undercover as a buyer, her contribution to a Grammy Award-winning documentary in 2018, Sweet Codeine, resulting in several arrests and convictions, including that of a pharmaceutical company executive.
[WATCH] Sweet Codeine
“In Africa, you have all the elements necessary to allow a black market in vaccines to flourish,” says Meyer. “Lack of resources, logistics and technical capacity means it’s going to take incredibly long for the roll-outs to happen. That gives organised crime the time and space needed to strategise, adapt to security measures and to insert their products into supply chains. The poverty and official corruption that’s unfortunately prevalent throughout Africa makes their job much easier.”
In its July 2020 research brief analysing the impact of the COVID-19 pandemic on organised crime infiltration in the legal economy and illegal governance, the United Nations Office on Drugs and Crimes (UNODC) says: “Although no country is completely immune from fraud, countries with a high level of corruption are at a much greater risk of being affected.”
Meyer adds: “It also doesn’t help that healthcare workers in Africa, many who are going to be in charge of vaccine supplies, are very poorly paid … Of course criminals will take advantage of this.”
Interpol East Africa crime intelligence analyst, John-Patrick Broome, says OCGs are “ideally placed”, having “well-developed networks and methodologies” to smuggle falsified, substandard and stolen vaccines.
“Illicit medications are primarily entering the market in eastern Africa through three key areas. There’s the avoidance of regulations, there’s violence-based criminality and there’s corruption … at a number of different levels,” explains the former British Isles border policing officer.
“The organisations in eastern Africa that have responsibility for regulating the legislation and enforcement activities around this form of criminality have been seen to lack some of the autonomy and powers that they require to deal with the illegal trade.”
Meyer says rising infections and deaths and third and even fourth waves of COVID-19, could cause increasing fear, thus driving demand for vaccines up even further.
“At certain stages supplies will be low. This is the gap that the criminals will fill. We’ve seen it happen already with personal protective equipment (PPE) and chloroquine, when the crime groups got their fakes into global supply chains quite easily.”
Demand for chloroquine, a medication used to treat rheumatoid arthritis, the autoimmune disease lupus erythematosus, and also malaria, rocketed after a French microbiologist claimed in March 2020 it was “efficient” at combating COVID-19.
Former US President Donald Trump also began touting a form of chloroquine, hydroxychloroquine, as a potential cure, even though there was no evidence to prove that the drug could either treat or prevent COVID-19.
[WATCH] Should doctors prescribe chloroquine to COVID-19 patients?
In the months that followed, Voice of America reports, authorities throughout West and Central Africa seized large quantities of falsified and substandard chloroquine. Many of the tablets were compressed chalk. Police in Cameroon raided and shut down several pharmaceutical manufacturers who were producing fake chloroquine. There’s currently also immense international demand for the anti-parasitic drug, Ivermectin, which is being promoted by some in the medical community as prevention of and treatment for COVID-19, although there is no credible evidence to substantiate these claims. Nevertheless, seizures of illicit Ivermectin are occurring around the world, including in South Africa.
Mafia groups are moving illicit vaccines throughout Europe — and cooperate with criminal enterprises in Africa
Lawyers Marius Schneider and Nora Ho Tu Nam, who advise some of the world’s major pharmaceutical companies on intellectual property issues, warned of the probability of the distribution of fake COVID-19 vaccines on the continent in a report published in the Journal of Intellectual Property Law & Practice in May 2020.
“Why are we going to have an issue with the vaccines? Well, it’s very easy: Because the demand will be high, access will be limited, everybody will want to have his shot, and in that kind of situation this vaccine is liquid gold, as it has been called by some, for these criminal syndicates. They will exploit the situation by either stealing the vaccine, or by counterfeiting it,” argues Schneider, a former chairman of the anti-counterfeiting committee of the European Community Trademark Association.
The advocate, originally from Belgium, founded the IPVocate Africa law firm in Mauritius in 2012 to focus on the “severely neglected” areas of protection, management and enforcement of intellectual property rights in Africa.
Schneider’s practice sometimes coordinates anti-counterfeiting raids with law enforcement agencies and represents pharmaceutical multinationals in legal cases.
“We have seen instances where non-governmental organisations (NGOs) have been engaged in the distribution of these [falsified] vaccines. These NGOs had as a mission to distribute real vaccines to the people. Employees on the ground in African countries were implicated in vaccine trafficking,” he says.
The IQVIA Institute for Human Data Science calculates global spending on pharmaceuticals in 2019 at $1.25-trillion (almost R18.7-trillion). It projects that the global pharmaceutical market will exceed $1.5-trillion (almost R22.4-trillion) by 2023.
Big money equals big crime, says Ho Tu Nam.
In September 2015, a UK court jailed two former United Nations (UN) consultants for rigging a contract for life-saving drugs between a Danish pharmaceutical firm and government officials in the Democratic Republic of Congo. Guido Bakker and Sijbrandus Scheffer took a bribe of £650 000 (about R13.2-million) to secure a £66-million (about R1.3-billion) tender.
“OCGs have always been interested in pharmaceuticals because of the high profit margins and low risks involved,” says Mark Micallef, North Africa and the Sahel Observatory director of the Global Initiative against Transnational Organised Crime. “They move wherever the greatest profits are to be made at a specific time, therefore it is quite obvious they will get involved in whatever ways they can in the vaccine supply.”
Much of Schneider’s career has focused on organised crime. He participated in the famous “Gomorra” investigation in the 2000s that exposed the sale of counterfeit power tools in Europe, which resulted in the downfall of several figures in the Naples-based Camorra mafia.
“The Camorra had set up production of the tools in China,” Schneider recalls.
The UN estimates in a 2019 report that 75% of falsified and substandard medicines in the world originate from China, Africa’s biggest trade partner, and India, with which the continent also has close relations. The world’s largest vaccine producer, the Serum Institute of India, is already manufacturing COVID vaccines for the drug company AstraZeneca and China has at least three vaccine candidates, two of which are already in distribution.
The UNODC says Italian and Sicilian mafia have for decades trafficked in falsified, substandard and stolen pharmaceutical products, mostly sourced in Asia.
A senior police investigator in the UK, who asked not to be named because he’s not authorised to give information to the media, told Bhekisisa in early December: “The mafia are moving illicit vaccines in locations throughout Europe.”
He confirmed links had been established between these mafia groups and “criminal gangs in Nigeria, Morocco, Egypt and Ivory Coast”. The Camorra mafia, for example, have also been active in South Africa. In 2014, five Italian nationals linked to it were arrested near Port Elizabeth and charged with trying to sell counterfeit power tools worth millions of rands, IOL reports.
Well-established Tramadol routes are “waiting to be fuelled” with fake vaccines
Sources at international anti-crime agencies argue that Africa’s strong trade routes with China and India are going to allow criminals to introduce shipments of falsified vaccines into supply chains.
The 1-million AstraZeneca vaccines that arrived in South Africa on 1 February, came via India from the country’s Serum Institute.
