Why Medical Education Must Catch Up

In a video interview with Pharma Commerce, Sean O’Hearen, founder and principal consultant at 1st Line Partners, discusses the critical issue of substandard and falsified (SF) medicines and the lack of awareness among healthcare professionals (HCPs). Despite SF drugs posing a growing global health risk, only 2% of HCPs are trained to detect them, and over 80% don’t consider them a serious threat. The Johns Hopkins Bloomberg School of Public Health has recently started focusing on this issue, holding its second symposium on the topic with support from Pfizer. Their work is encouraging, signaling that academic institutions are beginning to address these systemic educational gaps.

O’Hearen notes he’s not an expert in medical or pharmacy education but emphasizes that the BESAFE report—referenced in the interview—offers actionable recommendations. These include integrating SF medicine awareness into undergraduate curricula for healthcare students, establishing dedicated modules in medical schools, and expanding continuing education for practicing professionals. In his experience, frontline education, especially at infusion centers administering life-saving treatments like oncology drugs, plays a critical role in identifying and preventing counterfeit drug use. Nurses and healthcare workers trained to detect signs of falsification are a vital line of defense.

Efforts are underway globally, with the World Health Organization and the International Pharmaceutical Federation leading collaborative projects with African universities in countries like Nigeria, Uganda, and Tanzania. These efforts aim to establish standardized, research-backed curricula to address the growing threat of SF medicines, especially in regions more vulnerable to drug fraud.

While progress is being made, O’Hearen believes the issue is still in its early stages of recognition and response. With more academic and clinical institutions like Johns Hopkins stepping up, the hope is to eventually embed SF medicine detection and awareness into formalized education systems worldwide—closing critical gaps in the healthcare supply chain and improving patient safety.

He also comments on how the private sector should support and scale these efforts to ensure that HCPs globally receive standardized training; the communication strategies stakeholders should adopt to alert without alarming, ensuring patients stay confident in genuine pharmaceuticals, while also remaining vigilant against counterfeit threats; and much more.

A transcript of his conversation with PC can be found below.

PC: Your article highlights that only 2% of HCPs are trained to identify substandard and falsified (SF) medicines, and over 80% don’t view SF drugs as a serious issue. What systemic gaps in medical and pharmacy education need to be addressed, and how can academic and clinical institutions accelerate awareness training?

O’Hearen: Clearly, as the Johns Hopkins research indicates, it's a significant issue. The first thing I would say is that I think the industry is very pleased that the school with the resources of Johns Hopkins and their public health team recognize excellence, and the public health arena are getting behind this issue, and it's only been a couple of years. The report that I was referring to in the article was their second symposium, so they're just recently getting behind it, with sponsorship from Pfizer. Great to see that push.

One thing I should say is that I'm not an expert on medical and pharmacy education, number one. You can access that report through the BESAFE references, but that report you'll give some very specific recommendations, as far as what can be done to address the education gap that that they're seeing.

They're talking about all levels of education. It’s starting with undergrad curricula for healthcare professionals, pharmacists, folks who are interested in medical degrees. Of course, medical school having dedicated curricula around that, and continuing education related to that. I think there's also a component that pharmaceutical manufacturers and industry associations are doing today, and that is providing education to healthcare professionals, either in cases where they're reacting to an incident and a known issue, and then that education of those frontline workers becomes part of the solution.

I've been involved in many cases where we're trying to solve, and that's a significant part of the solution is educating those healthcare practitioners. Just as an example that's been at infusion centers: one of the trends we’re seeing is life-saving type of treatments—like oncology treatments—in certain parts of the world where counterfeits are turning up. It's enabling those nurses, who are working with the products and patients to help them understand how to identify counterfeit medicine.

The issue that the report highlights is that there are few standardized curricula. There's the International Pharmaceutical Federation, which, I think, at least based on what I've seen—I haven't done extensive research on this—but that's kind of the first of its type of a really, thoroughly researched and an organized effort. Notably, that was sponsored and put together by with the help of the World Health Organization and International Pharmaceutical Federation. The universities involved were in Africa. There were five countries in Africa, Nigeria, Uganda, Tanzania, and some others, so obviously, they're trying. The World Health Organization in particular is trying to focus on those parts of the world where this issue is even more significant than it is in other parts of the world. In terms of the big picture, I think we're in early stages on addressing the issue. Johns Hopkins isn't the only university that's getting behind this issue, but as more and more universities recognize it, I think that the goal would be to try to get this education into standardized curriculum.