17 scientific studies reveal a global pandemic related to falsified and poor quality medicines

On April 20, 2015, the American Journal of Tropical Medicine and Hygiene (AJTMH) published a supplement entitled “The Global Pandemic of Falsified Medicines: Laboratory and Field Innovations and Policy perspectives” with 17 articles on detection technologies and methods, field surveillance data, multisectoral perspectives and policy interventions and recommendations needed to create a coordinated and effective response to curb the pandemic of poor quality and falsified drugs.

An alert is launched to scientists, public health authorities and governments to the problem of substandard and counterfeit drugs to take emergency measures and curb this growing danger.

The aggravating consequence of these counterfeit medicines or substandard is the emergence of resistance to treatments including those against HIV-AIDS, tuberculosis and malaria. 41% of 17,000 samples collected and tested failed to meet the “quality” standards. Among the studies, the discovery of substandard treatments against malaria would have caused the death of 122,350 African children under 5 years old in 2013. This represents 4% of deaths in this age group. Other studies show the poor quality of antibiotics endangering patients health and increasing antibiotic resistance.

Seven studies conducted in different countries have analyzed the quality of medications: 16,800 samples of antimalarials, antituberculosis, antibiotics and treatments against leishmaniasis were collected and analyzed.

In Tanzania, a study was conducted on the antimalarial treatment artemisinin and shows that 4.1% of the 1,737 boxes purchased from vendors were under-dosed. In Cambodia, using the same method, 31% of 291 samples of artemisinin were substandard.

The drug supply chain is also in danger due to the globalization. Monitoring should now be strengthened globally.

They also rely on new promising technologies in the detection of counterfeit medicines. Additional monitoring and detection are essential.

Scientists unanimously are calling for a common international framework to fight against this international pandemic related to falsified and poor quality medicines.

Some data to remember – 16,800 samples collected and tested. – Analysis of treatment against malaria, tuberculosis, HIV-AIDS, leishmaniasis and antibiotics. – 9-41% of the samples failed the “quality” standards.

– Analysis of treatment against malaria, tuberculosis, HIV-AIDS, leishmaniasis and antibiotics.

– 9-41% of the samples failed the “quality” standards.

List of 17 articles freely available on the website of the American Journal of Tropical Medicine and Hygiene (AJTMH):

• Gaurvika M. L. Nayyar et al. The Global Pandemic of Falsified Medicines: Laboratory and Field Innovations and Policy Perspectives. Am J Trop Med Hyg Published online April 20, 2015; doi:10.4269/ajtmh.15-0221.
• Mustapha Hajjou et al. The Global Pandemic of Falsified Medicines: Laboratory and Field Innovations and Policy Perspectives. Monitoring the Quality of Medicines: Results. Am J Trop Med Hyg Published online April 20, 2015; doi:10.4269/ajtmh.14-0535.
• Tim K. Mackey et al. Counterfeit Drug Penetration into Global Legitimate Medicine Supply Chains: A Global Assessment. Am J Trop Med Hyg Published online April 20, 2015; doi:10.4269/ajtmh.14-0389.
• Gaurvika M. L. Nayyar et al. Responding to the Pandemic of Falsified Medicines. Am J Trop Med Hyg Published online April 20, 2015; doi:10.4269/ajtmh.14-0393.
• Nga T. Ho et al. Rapid and Specific Drug Quality Testing Assay for Artemisinin and Its Derivatives Using a Luminescent Reaction and Novel Microfluidic Technology. Am J Trop Med Hyg Published online April 20, 2015; doi:10.4269/ajtmh.14-0392.
• Patricia Tabernero et al. A Repeat Random Survey of the Prevalence of Falsified and Substandard Antimalarials in the Lao PDR: A Change for the Better. Am J Trop Med Hyg Published online April 20, 2015; doi:10.4269/ajtmh.15-0057.
• Shunmay Yeung et al. Quality of Antimalarials at the Epicenter of Antimalarial Drug Resistance: Results from an Overt and Mystery Client Survey in Cambodia. Am J Trop Med Hyg Published online April 20, 2015; doi:10.4269/ajtmh.14-0391.
• Abigail A. Weaver et al. Paper Test Cards for Presumptive Testing of Very Low Quality Antimalarial Medications. Am J Trop Med Hyg Published online April 20, 2015;doi:10.4269/ajtmh.14-0384.
• ACT Consortium Drug Quality Project Team and the IMPACT2 Study Team. Quality of Artemisinin-Containing Antimalarials in Tanzania’s Private Sector—Results from a Nationally Representative Outlet Survey. Am J Trop Med Hyg Published online April 20, 2015;doi:10.4269/ajtmh.14-0544
• Michael D. Green et al. Integration of Novel Low-Cost Colorimetric, Laser Photometric, and Visual Fluorescent Techniques for Rapid Identification of Falsified Medicines in Resource-Poor Areas: Application to Artemether–Lumefantrine. Am J Trop Med Hyg Published online April 20, 2015;doi:10.4269/ajtmh.14-0832.
• Ifeyinwa Fadeyi et al. Quality of the Antibiotics—Amoxicillin and Co-Trimoxazole from Ghana, Nigeria, and the United Kingdom. Am J Trop Med Hyg Published online April 20, 2015;doi:10.4269/ajtmh.14-0539. Margaret Hamburg. The Global Pandemic of Falsified Medicines: Laboratory and Field Innovations and Policy Implications. Am J Trop Med Hyg Published online April 20, 2015;doi:10.4269/ajtmh.15-0046. John P. Renschler et al. Estimated Under-Five Deaths Associated with Poor-Quality Antimalarials in Sub-Saharan Africa. Am J Trop Med Hyg Published online April 20, 2015;doi:10.4269/ajtmh.14-0725. Yuk Lin Yong et al. Collaborative Health and Enforcement Operations on the Quality of Antimalarials and Antibiotics in Southeast Asia. Am J Trop Med Hyg Published online April 20, 2015;doi:10.4269/ajtmh.14-0574. Mirza Lalani et al. Substandard Antimalarials Available in Afghanistan: A Case for Assessing the Quality of Drugs in Resource Poor Settings. Am J Trop Med Hyg Published online April 20, 2015;doi:10.4269/ajtmh.14-0394. Amir Attaran. Stopping Murder by Medicine: Introducing the Model Law on Medicine Crime. Am J Trop Med Hyg Published online April 20, 2015;doi:10.4269/ajtmh.15-0154. Harparkash Kaur et al. Chemical and Bioassay Techniques to Authenticate Quality of the Anti-Leishmanial Drug Miltefosine. Am J Trop Med Hyg Published online April 20, 2015;doi:10.4269/ajtmh.14-0586.

• Margaret Hamburg. The Global Pandemic of Falsified Medicines: Laboratory and Field Innovations and Policy Implications. Am J Trop Med Hyg Published online April 20, 2015;doi:10.4269/ajtmh.15-0046.
• John P. Renschler et al. Estimated Under-Five Deaths Associated with Poor-Quality Antimalarials in Sub-Saharan Africa. Am J Trop Med Hyg Published online April 20, 2015;doi:10.4269/ajtmh.14-0725.
• Yuk Lin Yong et al. Collaborative Health and Enforcement Operations on the Quality of Antimalarials and Antibiotics in Southeast Asia. Am J Trop Med Hyg Published online April 20, 2015;doi:10.4269/ajtmh.14-0574.
• Mirza Lalani et al. Substandard Antimalarials Available in Afghanistan: A Case for Assessing the Quality of Drugs in Resource Poor Settings. Am J Trop Med Hyg Published online April 20, 2015;doi:10.4269/ajtmh.14-0394.
• Amir Attaran. Stopping Murder by Medicine: Introducing the Model Law on Medicine Crime. Am J Trop Med Hyg Published online April 20, 2015;doi:10.4269/ajtmh.15-0154.
• Harparkash Kaur et al. Chemical and Bioassay Techniques to Authenticate Quality of the Anti-Leishmanial Drug Miltefosine. Am J Trop Med Hyg Published online April 20, 2015;doi:10.4269/ajtmh.14-0586.

http://www.ajtmh.org/content/early/

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