Reciprocal Innovation – Pharmaceutical Quality in Malawi2020-12-03T13:54:49-05:00

Pharmaceutical Quality in Malawi

Principal Investigator Dr. Marya Lieberman
International Collaborator(s) Mr. Ibrahim Chikowe
Project Title Pharmaceutical Quality in Malawi
Priority Area Access to healthcare; medication quality
The Intervention We developed a paper test card to quickly detect falsified pharmaceuticals in field settings in Malawi. The card contains twelve chemical color tests that react with the test substance to create a color bar code.The color bar code shows what functional groups and materials are present, so it can detect falsified medicines. It can also detect a range of illicit substances and cutting agents commonly found in street drugs. This intervention can be applied within Indiana by assisting first responders (police, firemen, EMT, etc.) and harm reduction organizations (safe injection sites) in identifying drugs and unknown substances.
Key Facilitators Intervention transfer is being facilitated by the CTSI programs in Indiana and Illinios. We are working with Chicago Recovery Alliance and University of Chicago COIP sites. In Indiana, we have a separate project working with the Chief Deputy Coroner, Alfie Ballew, to evaluate drugs and drug paraphernalia found at the scenes of overdose deaths.
Target Population The intervention targets Malawain citizens and in the US, people who use illegal drugs. Both are vulnerable populations who are exposed to harm from the products they are using.
Process to Implementation A test card was optimized for detection of illicit drug components. We worked with the Berrien County forensic lab to validate the card against real street drugs. Next we trained counselors to collect street drug samples at CRA and COIP sites. We found different cutting agents in use at these sites and had to retune the test card. The next step will be training drug counselors to run the test and advise drug users on how to modify their use to reduce risk of harm.
Key Stakeholders Stakeholders include the police, EMTs, firefighters (first responders). Drug counselors and other staff at CRA and COIP. People who use drugs. People who sell drugs. Other drug checking organizations. We anticipate in transferring to the US that there would need to be similar stakeholders that would need to be engaged within the health systems and regulatory agents.
Scaled or Transferred? We are using the idPAD card to test drugs in Indiana.
Type of Research Development of the idPAD required basic research; getting it into clinical/harm reduction settings required both basic research (to characterize the cutting agents and “products” in this “market”) and also implementation research. For our implementation process, we evaluated the main causes of overdose deaths through our collaboration with the Deputy Coroner in Indianapolis. Then we redesigned the idPAD so it could detect the main risk elements (fentanyl, other opioids, meth, and benzos). We are now working with the drug counselors and people who use drugs to see what information they need to support choices for safer use behavior.
Published Materials Mss in review: idPAD: Paper analytical device for presumptive identification of illicit drugs, Tracy-Lynn E. Lockwood, Tammy Leong, Sarah L. Bliese, Alec Helmke, Alex Richard, Getahun Merga, John Rorabeck, and Marya Lieberman
Year Funded 2016

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