(MintPress) – A new study published in the Lancet Infectious Diseases Journal concluded that one-third of drugs used to combat malaria in Southeast Asia and sub-Sahara Africa are either fake or of poor quality. With more than three billion people in the world at risk of malaria, researchers expressed grave concern because they felt the instances of reporting ineffective malaria treatments could be drastically underrepresented.
In 2010, malaria killed 655,000 people, with a majority of those instances being babies and children in African countries. MSNBC reported that many of the ineffective drugs contained very little or no malaria-fighting agents, a problem that could result in drug-resistant malaria, rendering all malaria medication on the market useless.
“Of 1,437 samples of drugs in five classes from seven countries in Southeast Asia, 497 (35 percent) failed chemical analysis, 423 (46 percent) of 919 failed packaging analysis, and 450 (36 percent) of 1260 were classified as falsified,” an executive summary of the study said. “In 21 surveys of drugs from six classes from 21 countries in sub-Saharan Africa, 796 (35 percent) of 2297 failed chemical analysis, 28 (36 percent) of 77 failed packaging analysis, and 79 (20 percent) of 389 were classified as falsified.”
Speculation continues over how widespread the problem of ineffective malaria drugs are, and experts point to a host of problems that have to first be solved to understand the prevalence and extent to how counterfeits infiltrate markets.
“Despite a dramatic rise in reports of poor-quality anti-malarial drugs over the past decade, the issue is much greater than it seems,” wrote Gaurvika Nayyar of the Fogarty International Center at the U.S. National Institutes of Health. “Most cases are probably unreported, reported to the wrong agencies, or kept confidential by pharmaceutical companies.”
A market of fraud
Counterfeit medications have become a common practice in Southeast Asia, where the need for treatments extends into the hundreds of thousands. Smithsonian Magazine wrote in 2009 that information and statistics on how common drug fraud is are difficult to come by. This is partly due to the fact that 70 percent of those seeking malaria drugs in many of the Southeast Asian countries come from rural areas and seek treatment at village vendors, and those workers do not have the background to be able to differentiate real medication from counterfeit drugs.
A common counterfeit substance used in place of artemisinin, the active ingredient in leading anti-malarial drugs, is flour, a tactic that was exposed in quality control laboratories. The problem also has deep roots: During an informal random sampling of malaria medications in Southeast Asia in 2003, it was found that 53 percent of the pills collected were counterfeits.
According to the World Health Organization (WHO), approximately 200,000 deaths globally could be prevented per year if there were regulations in place to clamp down on fake malaria drugs.
But the problem has failed to generate a strong cast of those opposed to the practices. Many times, the drugs never come into question because it is assumed the patients died solely from their symptoms and that their condition was not treatable.
The regions of Southeast Asia and sub-Sahara Africa certainly are not the only areas globally that struggle with counterfeit drugs, and the main culprit for crime seems to be money. In 2012, it was estimated that the global trade for counterfeit pharmaceuticals for conditions such as AIDS, malaria and tuberculosis could be as high as $75 billion.
Center for Medicine in the Public Interest said political corruption and weak border control contributes to the funneling of counterfeit drugs into countries. Paul Newton, a physician at Mahosot Hospital in Vientiane, Laos, told Smithsonian Magazine that without proper tracking and enforcement, counterfeit drugs will continue to be a cash cow for those in the trade.
Newton said the business of counterfeit drugs is “a relatively high-profit and risk-free venture” that “very few people are sent to jail” for their participation.
“This is a very, very serious criminal act,” Nicholas White, a malaria expert at Mahidol University in Bangkok, Thailand, said. “You’re killing people. It’s premeditated, cold blooded murder. And yet we don’t think of it like that.”
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