Poor-quality medicines - including counterfeits and those with the incorrect dosage - are a “real and urgent threat” to public health, according to a collection of 17 research papers published in a prominent medical journal.
So-called “fake drugs” include expired medicines, those with manufacturing defects, and bogus tablets designed to look like the real thing.
“We know that this is an epidemic occurring over a very wide area, crossing international boundaries, and now affecting an extremely large number of people,” said Public health expert Guarvike Nayyar of the drug-standards organization USP, the U.S. Pharmacopeial Convention.
Nayyar is is co-editor of a special report on fake medicines in The American Journal of Tropical Medicine and Hygiene.
The report collects 17 research papers highlighting the problem. In one, a decade-long analysis of drug samples found about 11 percent of the drugs in Africa and 3.5 percent in Asia were either counterfeit or substandard.
Counterfeits, which can sometimes be hard to tell from the genuine product, get a lot of headlines, but if there’s a problem with the drug, it’s more likely that it just won’t have the prescribed amount the active ingredient.
Patricia Tabernero of the University of Oxford studied the quality of anti-malaria drugs in Laos. She and her colleagues found no fakes, a big improvement from a previous study a decade earlier. But they did find lots of the medicine was substandard.
“Patients are still exposed to poorly-manufactured drugs or ineffective drugs, such as chloroquine, because 25 percent of the samples, they either contained lower quantities of the drug or higher quantities,” she told reporters in a briefing.
That’s a particular problem with malaria medicines, because giving the patient too little can often promote drug-resistant forms of the malaria parasite.
Many scientists say there is a need for better ways to test drug potency in the field. And Amir Attaran of the University of Ottawa says a better legal framework is essential, pointing out that’s how the world deals with problems like this that cross international boundaries.
“There’s been an international treaty against counterfeit money since 1929,” he said. “If we’re serious about solving this problem with medicine, we need to get to where we were in 1929 with money.”
