Table 1.

Cascaded approach to prevent falsified products

Stakeholder	Roles
International regulatory agencies	Strengthening national and international pharmaceutical governance (agencies such as INTERPOL have intercepted significant falsified products, which should continue)
	Adequate funding for monitoring distribution of falsified products
	Initiation and/or assistance in coordinating the information-sharing process among regulators in different regions and countries
Supply agencies	Ensuring security of supply chains through implementation of good distribution and warehousing practice.
	Adequate and continuous supply of standard drugs can avert the bad ones from filling the vacuum in times where there is a heightened fear and desperation for treatments
	Good procurement practice with an extra focus on quality
Local regulatory agencies	Regulatory agencies are expected to fulfill the Global Benchmarking Tool, which has more than 200 indicators to measure effectiveness of regulatory functions in a country. At this stage, Tanzania is the only country that achieved such a milestone in Africa,17 emphasizing on the need for other African nations to leverage this local experience for implementation in their respective settings
	Have the responsibility to make sure there is a routine inspection on their borders in relation to the entry of new medicines and medical products
	Implementation of legislative changes restricting counterfeit drugs
	Improved investment capital and infrastructure to encourage small- and medium-sized drug manufacturing companies to meeting international standards
	Strong political will to enforce regulations
Health ministries	Creating awareness among citizens regarding medicine quality through their public health section
Technological companies	Implementation of detection technologies to enable easy identification of falsified products, when affordable and appropriate
	Social media platforms should be held accountable for the dissemination of fake health news, with a more proactive identification and removal of fake health news provided by armchair epidemiologists, vendors of bogus cures, and citizen journalists. This requires working closely with consumer protection agencies across the globe and with qualified public health officials to take quick and decisive steps to remove inappropriate and inaccurate content, and to prevent it appearing in the first place
Researchers and health professionals	The hype associated with finding a cure for COVID-19 has changed the way research is communicated to the public, with potentially flawed or premature research findings being hastily released. Researchers and health professionals need to play a greater role in controlling the narrative surrounding COVID-19 research
	Continued engagement with the communities through education, training, and public discourse can reduce harm and save lives
	Health professionals should always be vigilant of newer medicines joining the market, especially those with increased relevance due to the pandemic
Citizens	The pandemic response cannot be effective without active participation of the people. It is important to heed advices by health experts, especially in relation to drugs, and to differentiate between fact-based reporting and nonfactual claims particularly when it comes to medicine-related information.41