12 July 2012

AEI Raises Issue of Fake Malaria Drugs in Africa

It turns out that a significant amount of malaria drugs in Africa are either fake or poor quality finds a new study from the American Enterprise Institute. Not often that you see a conservative think tank with this kind of study, but it is quite interesting. The GlobalPost reports on the study:
This has the potential to render entire classes of medicines useless, making malaria or TB untreatable with currently available medicines,” Bate wrote in an opinion piece published today in Business Day, a South African newspaper. 
More than a million people, most of them young African children, die from malaria every year. 
In one of the studies, 2,652 samples of antimalarials, antibiotics and tuberculosis drugs were purchased in 11 African cities, three cities in India and five middle-income cities, including Beijing and Bangkok. 
Up to 15 percent of the all the drugs bought in Africa failed basic quality testing. Of the drugs that had received approval from the World Health Organization (WHO), 7 percent failed the quality tests. 
The investigation found that 18 percent of the made-in-China medicines approved by the WHO failed quality tests – a far worse result than with the non-approved Chinese products. 
Some of the medicines were counterfeit, while others were of substandard or degraded quality, containing too little of the active ingredient for the patient to recover. This can lead to parasites or bacteria surviving treatment and mutating into stronger strains. 
The second study found that nearly 8 percent of antimalarial drugs approved by the WHO or another “stringent” regulatory authority, and sold in Accra, Ghana and Lagos, Nigeria, failed quality tests because they contained too little of the active ingredient.
In treating malaria, artemisinin-based drugs are now the only effective treatment that is widely available. But a spike in global prices of sweet wormwood, the main natural source of artemisinin, may be contributing to the quality problems. 
The most important part is the potential for growing resistance.
A separate study published in May by the US National Institutes of Health said that poor-quality antimalarial drugs are leading to drug resistance in Southeast Asia and sub-Saharan Africa, posing an “urgent threat” to at-risk populations and jeopardizing gains made in fighting malaria in the past decade. 
In that study, researchers found that 20 to 42 percent of malaria drugs available in those regions are either of bad quality or fake. 
The WHO, in an apparent response to the new studies, said that every year millions of people receive life-saving drugs through international health agencies because of the 
WHO's medicine pre-qualification program, intended to reassure these agencies that they are buying good-quality drugs.
The issue along the Thai-Cambodia border is one that the UN is paying close attention to these days.

Thomas Teuscher, executive director of the United Nations-backed Roll Back Malaria Partnership explains to VOA, "Right now we need to intensify our attention and action in a way to keep the world safe from malaria epidemics in the future by making sure the medicines we use at present remain useful for as long as possible - so the topic of containing the spread of drug resistance in the Great Mekong Region."

The hope is to contain the strain in the region. This is certainly a story to keep an eye on in the context of counterfeit drugs in Africa. With the relative high rate of malaria, it is likely that further instances of resistance will crop up against current treatments.