Proliferation of Non-Conforming Herbal Medicines in the Ghanaian market: A case of Ashanti Region, Ghana, 2021

Background
Although over 70% of Ghanaians utilize herbal medicines for their healthcare needs, not all herbal medicines (HM) on the open market are licensed. Market surveillance (MS) activities are conducted by the FDA to inspect medicines and their sales points for non-compliance to regulatory measures. Expired, improperly labelled, improperly stored and non-FDA licensed herbal medicines displayed in the open market are seized during MS. We conducted this study in the Ashanti region, Ghana, to determine the prevalence of non-compliant herbal medicines, reasons and trends in seizures from herbal medicine MS.

Methods
We conducted secondary data analysis of herbal medicine activities from 2017 to 2020. Variables extracted from the database of the FDA included, type of herbal medicines seized, reasons for seizure and location. We analyzed quantitative data to generate frequencies and proportions.

Results
From 2017-2020, a total of 1,783 market surveillance activities were conducted with 7.9% (140/1,783) of herbal medicines seized from the open market. Mixtures made up the highest 46.4% (65/140) proportion of non-compliant HM, while powders made up the lowest 7.9% (11/140). About 62.1% (87/140) seizures were from hawkers and lowest 4.3% (6/140) from pharmacy shops. Unregistered herbal medicines accounted for 66.4% (93/140) while least, 6.4% (9/140) nonconformity were due to poor storage. There was an observed decreasing trend in the number of herbal medicines seized from 2017 to 2020 (64, 45, 23, 8 respectively). Centralized herbal registration in the capital poses a challenge for manufacturers in the Ashanti Region.

Conclusion
Non-conforming herbal medicines were being sold on the open market, with non-registration being the reason for most seizures. There was a decreasing number of drug seizures over the period. We recommend decentralizing registration of herbal medicines to other regions in the country. Intensifying public education and sensitization on use of safe herbal medicines are key to protecting public health.

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