A new report says that as many as one third of the antimalarial drugs sold in south Asian and sub Saharan African countries are counterfeit or of such poor quality as to be ineffective. Experts say this not only jeopardizes the progress made against malaria in the past decade, but also is speeding the emergence of drug resistance in the malaria parasite.
Experts have known for years that fake, poor quality, and improperly-packaged drugs pose a serious public health threat in many developing countries.
Now, a new study has found that many people infected with malaria in sub-Saharan Africa and Southeast Asia are not getting treated because of counterfeit or poor quality antimalarial drugs.
The lead author of the study, researcher Gaurvika Nayyar of the National Institutes of Health, said in a Skype interview the problem is widespread.
“While we have limited information [about] where these drugs are made and how they are produced... we do know that they are rampant in local shops, grocery stores, and even hospitals,” said Nayyar.
Nayyar said the survey discovered that a high percentage of the sampled drugs failed chemical analysis, had fake packaging or improper labeling or were being sold years beyond their expiration dates.
“While poor quality anti-malarial were available in seven south East Asian countries and 21 sub-Saharan African countries - this is just a tip of the iceberg,” said Nayyar.
Malaria kills as many as one million people each year.
Scientists and public health experts say the single most important way to prevent these fatalities, and fatalities from other drug-treatable diseases, would be a regulatory system to protect the integrity of the global drug supply chain.
United States Pharmacopeial Convention [USP] is a nonprofit standard-setting organization that works to ensure the quality of medicines and food ingredients. Patrick Lukulay directs USP's drug-quality program.
“In every country there has to be a system to regulate. Without regulation, everything is at play and everything is possible. So regulators have to be strengthened. They have to be given an enabling environment so that they can really clamp down on illicit trade,” said Lukulay.
He said poor-quality drugs exist not only because the local manufacturers fail to maintain high standards, but also because some drug makers are pursuing quick profits. He said that in either case, these unreliable drugs are a menace to global health efforts.
“I believe that this has really led to the prolongation of neglected diseases in developing countries, whether it's malaria, TB or HIV/AIDS and the problem seems to be growing every day," said Lukulay.
Experts insist that drug makers found to have poor quality-control practices should be prosecuted. And standard-setting groups, such as USP, recommend clearer guidelines for regulators and better technologies for detecting poor drugs and flushing them quickly out of the market.