Assume I have no conscience or any morals. Assume I have a legitimately registered company or CC with hefty overdraft facilities. Here I am in South Africa just ready to make a buck from those most gullible of consumers — the worried (but wealthy) well, the health and wellness neurotics, the painted, dyed and cosmetic-dependent clientele of “natural” medicine.

The illiterate and physiology-information-deprived usually don’t have much spare disposable income, so any diffusion of their resources into my pockets would simply be an added bonus.

I’ve found an overseas manufacturer of a sure-fire best-seller in SA — “Taller-brand” height-increase pills. (Read: “weight-loss remedies”; “hair-growth enhancers”; “bust-enlargement medications”; “penis-enlargement tablets”; “improved sexual-performance capsules”; “immune boosters”; etc.) I just need to import the product, start marketing it, sit back and wait for the rands to roll in.

I would, however, have some red-tape hurdles to jump through. (These minor obstacles could possibly be helped along with a few “tokens of appreciation”.)

  • 1. I would state that the product is a natural “nutritional [or dietary] supplement” on all official documentation, especially customs, and thereby hopefully avoid any need to interact with the inspectors of the Medicines Regulatory Affairs (MRA) Cluster of the Department of Health (DoH). However, as Director General of Health Thami Mseleku has stated to Parliament’s health portfolio committee, there is a lack of capacity in inspections — so the chances are I’d get away with it anyway.
  • 2. I would then submit an abbreviated application to the Medicines Control Council (MCC) for registration of my product as part of the 2002 Complementary Medicines “call-up”. This simple procedure would add my product to the over 20 000 applications said to have already been received by the MCC as of September 2006. Even though the call-up was for six months only, the applications have continued unabated — partly in order to obtain a NAPPI code (see below). A simple acknowledgement of receipt with an allocated application number, would enable me, albeit falsely, to advertise my product as being “registered with the MCC”.
  • 3. I would apply for a NAPPI (National Pharmaceutical Product/Pricing Index) code — so that your medical aid will pay for the product or at least make part of the payment. Fortunately NAPPI codes are free: you just fill in the forms, show proof of registration of your company, show that you have the correct licences or registration from the MCC/Pharmacy Council (not too difficult to obtain);,and send along a copy of the label showing the ingredients. (The person/computer allocating the NAPPI code will probably not check the label for prohibited or scheduled substances, and would possibly not even be qualified to do so.) I would have little concern about how the purchase of my product and/or similar products would affect medical aid tariffs in general
  • .

  • 4. I would find a tame/shady pharmacist or medic friend who would agree to substantiate that the product works [doctors were amazed at how much taller I became within a few weeks of taking “Taller-brand” pills!], just in case anyone submits a complaint to the Advertising Standards Authority (ASA).
  • 5. I would advertise widely using obfuscatory phrases such as “helps to”, “improves”, “alleviates”, “supports”, or “assists the body with”. No specific or definitive claim such as cures short stature, or treats the vertically challenged etc. As none of the print or electronic media seem to have any ethical problems about accepting advertisements of this genre, I would have free reign until or unless someone complained to the ASA. Even then, my substantiation would probably be accepted by the ASA (provided my tame/shady pharmacist/medic’s credentials are accepted — usually not a problem). As the ASA does not have anyone in its own structures who can assess medical or health-related claims [no, really!], if my expert says it’s so, this “substantiation” must, according to the advertising code, be accepted as correct (no matter how absurd the claim). After that, a long, drawn out process of appeals, allegations of breaches of the code, and/or arbitration would ensure that I could cover legal fees and continue selling and profiting for months or even years — while the media continue to accept my advertising.
  • 6. For my website, I would find a research article in any obscure journal that shows that the product (or just one ingredient) makes use of previously unused or unknown technology, which technology may have been endorsed by a Nobel Prize winner or person of similar stature. Molecular-structure hypotheses, laboratory tests and animal studies, rather than clinical trials with humans, would of course be emphasised. Extrapolations to living human beings can always be fudged. Besides which, none of the target market are likely to question “science”.
  • 7. I would find a salesperson oozing with charm, and in possession of a degree or diploma of some sort. This person could intercalate doses of scientific-sounding verbiage with common sense, and smoothly spout these, making the product appear highly credible. For example:

    The Earth we grow our food in is now so deficient in nutrients — especially vitamins, minerals and antioxidants — that the produce of that soil (or an animal that eats food growing in it) is similarly deficient. And this is why people are no longer growing as tall (retaining their hair, developing as large breasts or penises, enjoying sex, living as long) as they could. But science is here to help! Researchers have found a completely safe and natural revolutionary new product that has been shown to increase a person’s height (lose weight, grow hair, enlarge breasts or penises, improve sex, counteract ageing) within weeks.

    If the product cannot make claims of being revolutionary, it can easily be legitimised through claims of “traditional” use (even if this vague term applies to but one of multiple ingredients in a newly formulated product): e.g. contains an indigenous herb, found only in a remote/secret area (of an exotic island), traditionally used for hundreds or even thousands of years as part of religious ceremonies. No one will notice that the concentration of the herb may have been so highly diluted (for cost-saving measures) that any possible purported efficacy is completely nullified.

  • 8. I would organise advertorial interviews on radio talk shows, and perhaps even on SABC3’s 3 Talk with “gifts” for those who call in. (The presenter’s unique ability to somewhat gushingly endorse rather dubious products and their accompanying smooth and rather dubious sales personae, especially those from the UK, is legendary.)
  • 9. I would arrange that only “leading pharmacies” stock the product. All non-leading pharmacies would not be able to stock it — but any so-called “health shop” could carry it.
  • 10. I would start a distribution network locally (with a view to an international network, of course) whereby ordinary citizens are brainwashed into an uncritical belief in the product and, in line with the government’s encouragement of small businesses, are encouraged to find their own customers and create their own micro-distribution networks. (This is not a pyramid scheme!) With “trickle-up” economics, I would benefit every time a new customer is found.

Any concerns a person may have about the quality of my product will most likely remain unanswered for many long years. The magic number of 20 000 complementary medicines, which the spokesperson for the DoH cited again in July 2007, means my product’s application will wait its turn to be assessed. Since 2002, 14 000 products have been “assessed” according to the spokesperson. (In the ten months between the spokesperson’s two virtually identical statements, it would appear that no significant progress was made in assessing these products.)

Contradicting the MCC’s own website that the Medicines Act applies to all medicines, including complementary medicines, the director general stated to the health portfolio committee that complementary medicines do not need to be registered. The Democratic Alliance’s Mike Waters, however, seems to have inside knowledge that my product would be checked for “content, source of origin and presence of heavy metals, dangerous substances and banned substances” by the MRA.

Thank goodness this is not true. If it were, my product would be a non-starter. My own sources indicate that the “assessment” referred to by the DoH spokesperson involves nothing more than the listing of a few administrative details about each product in a database. Earlier this year, I found numerous products containing prohibited (“banned”/”illegal”) substances being advertised on South African websites, that had not been detected by the MRA in its assessment process. It is perhaps not surprising that the majority of these products were sexual-enhancement products.

Considering it’s taken more than five years to “assess” 14 000 products and assuming that the total number has increased (some say there are now over 60 000 products on the market), and because there’s no capacity according to the DG, it’s surely going to take many, many years before any official ever gets to take even a glance at the “labelled” (not necessarily actual) ingredients of my product. It could well contain nothing more than finely ground silica dioxide( sand) bound with starch. There’s nothing quite as natural as plain sand! But by then it wouldn’t matter — I’d have made my money several times over.

When aircraft cannot produce documentation to show they’ve been correctly maintained, they are grounded. There’s an independent body — the Civil Aviation Authority — checking on aircraft.

When condoms are found to be defective, they are recalled. There’s an independent body — the South African Bureau of Standards — checking on condoms.

When defects or new risks related to registered (orthodox, Western, allopathic) medicines are found, they are recalled, withdrawn or have their registration cancelled. The MCC is the independent body that checks on (registered) medicines. The self-monitoring of a product, once registered, is only possible because of the rigorous requirements of registration — and because registration (and therefore profits) can be cancelled.

No independent body is checking the quality of complementary and alternative medicines in South Africa.

The producers and sellers of complementary and alternative medicines in South Africa are certainly not voluntarily submitting information on the quality of their products to any independent body.

This means that none of the (unregistered) complementary or alternative medicines available on the shelves of your leading (and non-leading) pharmacies, health shops or supermarkets have been independently assessed in terms of their contents (what’s on the label is in the product), possible contaminants (bacterial or toxic heavy metals), spiked substances (e.g. Viagra), prohibited substances (e.g. dangerous herbal products) or scheduled substances(e.g. dehydroepiandrosterone — DHEA). [Sorry to disillusion you, Mike.]

If it is not known exactly what’s in every batch of a medicine/product, logically you can’t know whether it’s safe or effective. And if the original medicine/product has not initially been rigorously and independently assessed for quality (and safety and efficacy), self-monitoring has no validity or reliability.

So, please, should you be feeling a little short (fat, bald, small, libido-deficient, aged), don’t hesitate to buy my product(s). You and your healthcare professionals will be astounded at the results. I will make a fortune, and will have joined a cohort of unscrupulous, predatory, and soulless sellers of scam products in South Africa.

Disclaimer: Please note that any resemblance between “Taller-brand” and “HeightoMAX” , or any other globally available commercial height increase product, is purely coincidental.

Author

  • Roy Jobson is a specialist medical doctor in clinical pharmacology. He is employed as a specialist clinical pharmacologist at the Dr George Mukhari Academic Hospital / Associate Professor of Pharmacology at the Sefako Makgatho Health Sciences University. He is a Council member of the Allied Health Professions Council of South Africa. In his non-medical life, he is a vicarious observer of South African society through his association with the Khulumani Support Group, where his wife is the director. He has done extensive research in the last few years on the advertising and marketing of medicines in South Africa - with an emphasis on complementary medicines.

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Roy Jobson

Roy Jobson is a specialist medical doctor in clinical pharmacology. He is employed as a specialist clinical pharmacologist at the Dr George Mukhari Academic Hospital / Associate Professor of Pharmacology...

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