Hopes of controlling malaria in Africa could be wrecked by criminals who are circulating counterfeit and substandard drugs, threatening millions of lives, scientists have warned.
They are calling for public health authorities to take urgent action to preserve the efficacy of the anti-malarials now being used in the worst-hit areas of the continent.
There has been growing hope of an end to malaria, with UN and donor countries having contributed to a massive effort to get modern technological tools to endemic areas, including -insecticide--impregnated mosquito nets and new drugs -derived from artemisinin plants. However, large parts of Africa are threatened by the distribution of fake and poor quality anti-malarials made illicitly in China.
Malaria kills nearly 1 million people each year, mainly young children and pregnant women. It is caused by parasites injected into the bloodstream by mosquitoes.
Some of the fake drugs contain artemisinin, but not enough to kill all the parasites in a child’s body. Not only will the child struggle to recover, but the parasites that survive may become resistant to the drug and spread a form of the disease that artemisinin combination therapy will no longer cure.
In a study in the Malaria Journal, Paul Newton from the Wellcome Trust-Mahosot -Hospital-Oxford University Tropical Medicine Research Collaboration in Laos and a team of colleagues reported on the make-up of some of the fake anti-malarials on sale in Africa, as well as some that are equally useless and dangerous because they are of poor quality. They looked at samples of suspect drugs from 11 countries collected between 2002 and 2010.
Analysis showed some counterfeits contained a mixture of incorrect active pharmaceutical ingredients, some of which may initially alleviate malaria symptoms but would not cure malaria. Worse still, these unexpected ingredients could cause potentially serious side effects, particularly if they were to interact with other medication that the patient was taking, such as anti-retroviral therapies for HIV.
It is impossible to say how widely counterfeit and substandard drugs are being distributed, but, Newton said something needed to be done.
“The enormous investment in the development, evaluation and deployment of anti-malarials is wasted if the medicines that patients actually take are, due to criminality or carelessness, of poor quality and do not cure,” he said.
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