One in ten drugs in developing countries are fake or substandard, leading to the deaths of tens of thousands, namely children with pneumonia and malaria, the World Health Organization (WHO) said on Tuesday. A first major review of the problem highlighted bogus drugs as a growing threat, with increased pharmaceutical trade opening the door to dangerous products. According to WHO, counterfeit drugs include products that failed to meet quality standards, have not been approved by regulators, or deliberately misrepresent an ingredient.
It is difficult to precisely quantify the scale of the problem, but an analysis of 100 studies between 2007 and 2016 which covered over 48,000 samples revealed that 10.5% of drugs in low and middle-income countries were fake or substandard. Drugs for treating bacterial infections and malaria accounted for nearly 65% of the counterfeit medicines. Pharmaceutical sales in these lower income countries run at nearly $300 billion annually, making this trade in fake medicine a $30 billion business.
A study undertaken by a team at the University of Edinburgh that was commissioned by the WHO revealed concerning statistics revealing the high human costs of these counterfeit drugs. It was predicted that between 72,000 and 169,000 children may be dying from pneumonia each year as a result of having taken bad drugs. It was also found that these fake medications may also be responsible for an additional 116,000 deaths from malaria. Fake drugs also add to the risk of antibiotic resistance, threatening to undermine the ability of life-saving medicines in the future.
WHO’s Director-General said the problem is primarily evident in poor countries. Particularly in many African countries, there is limited public awareness, inability to afford costly authentic medications, and poor drug procurement practices. Furthermore, many pharmacists in Africa are often compelled to purchase from the cheapest rather than the safest suppliers to compete with street traders. However, counterfeit drugs are not only an issue in developing countries, and there are increasing numbers of fake drugs being sold widely on the internet. There is a clear need for a more active response by the international community in order to overcome and avoid further destruction by these products.
In 2013, WHO established a global monitoring system for fake and low-quality drugs. Since then, it has received reports of approximately 1,500 problematic medicines and fake vaccines. Reports widely extended from cancer drugs to contraceptive pills. More action must be taken. Firstly, the points of entry need to be tightened by establishing more effective surveillance and greater collaboration between the directorates of inspection and authorities at the ports of entry. An underestimated strategy is the use of public awareness campaigns in lower income countries. Through education of the public, potential victims will be more likely to avoid fake medicines. Furthermore, nations with a serious counterfeiting problem can begin resolving it by establishing effective regulation, stronger institutions, and working courts, with the help and role modelling of the wider international community. It is paramount that the international community takes action to prevent the escalation of this problem and avoid further loss of human life.