Low-quality and fake anti-malarial drugs flooding into markets in Asia and Africa are driving drug resistance and threatening gains made in the fight against the disease in the past decade, according to a study by global health experts.
The study found that about 36 percent of anti-malarial drugs analyzed in Southeast Asia were fake, while a third of samples in sub-Saharan Africa failed chemical testing because they contained either too much or not enough of the active ingredient.
The researchers said the problem might be even bigger.
The emergence of resistance to artemisinin drugs — currently the most effective treatment for malaria — along the Thailand-Cambodia border has already been documented.
“Despite a dramatic rise in reports of poor-quality anti-malarial drugs over the past decade, the issue is much greater than it seems,” Gaurvika Nayyar, of the Fogarty International Center at the US National Institutes of Health, said in a study in the Lancet Infectious Disease journal.
“Most cases are probably unreported, reported to the wrong agencies, or kept confidential by pharmaceutical companies,” Nayyar wrote.
More than 3 billion people worldwide are at risk of malaria, a mosquito-borne parasitic disease that kills about 650,000 people a year, most of them babies and children in Africa.
Nayyar said many of the deaths caused by the disease could be avoided “if drugs available to patients were efficacious, high quality, and used correctly.”
The WHO estimates that while less than 1 percent of medicines available in developed countries are likely to be counterfeit, the figure is about 10 percent globally.
The UN agency estimates that as much as a third of all medicines in some developing countries is fake.
As well as putting patients at risk, counterfeit drugs are a constant bane for companies like GlaxoSmithkline, Sanofi and other international drugmakers.
Nayyar’s team analyzed data from both published and unpublished studies that looked at chemical analyses and the packaging of malaria medicines in sub-Saharan Africa and Southeast Asia, where the malaria risk is highest.
Data from seven countries in Southeast Asia — including from analysis of 1,437 samples of seven different malaria drugs — showed that more than a third of them failed chemical testing, nearly half were wrongly packaged and about a third were bogus.
Analysis of data from 21 countries in sub-Saharan Africa that included more than 2,500 drug samples showed similar results, with more than a third failing chemical testing and about one-fifth turning out to be fake.