Fake drugs kill over 700,000 people every year - new report

Fake tuberculosis and malaria drugs alone are estimated to kill 700,000 people a year. That’s equivalent to four fully laden jumbo jets crashing every day.

The report lays bare the ballooning problem of counterfeit and substandard drugs, which can constitute one third of the drug supply in certain African countries. These dodgy drugs result in unnecessary death and increased levels of drug resistance.

The report highlights more shocking evidence, such as:
• Nearly half the drugs sold in Angola, Burundi, and the Congo are substandard
• About two thirds of artesunate (anti-malaria) drugs in Laos, Myanmar Cambodia and Vietnam contain insufficient active ingredient
• Most fake drugs originate from China and India

Current attempts to deal with the problem through tougher regulation and criminal penalties do not address the root causes of counterfeiting. Worse, many countries have corrupt regulatory and legal systems that are easily exploited by criminal counterfeiters, so additional rules will only increase corruption.

Governments also exacerbate the problem by making legitimate drugs more expensive through taxes and tariffs.

The report stresses that what is needed are effective mechanisms to enable purchasers of drugs to be assured that what they are buying is the real thing. Identity preservation systems using unique codes verifiable through a simple text message are one possible solution. More effective trademark systems would also help.

Report author Julian Harris said: “Many poor countries have weak or nonexistent trademark laws, so it’s no surprise that counterfeits are rife. A free press, free courts, and free trade would actually increase the quality of medicines.”

Ends

Link: www.policynetwork.net/health/publication/keeping-it-real-protecting-worlds-poor-fake-drugs

Contacts
• For more information contact Julian Harris, +44 20 3393 8415 or jharris //at// policynetwork.net

Notes on statistics:

Malaria:

The WHO has previously estimated that 200,000 deaths per annum would be preventable if drugs used were not fakes. They calculated this from statistics in two papers: the Africa Malaria Study 2003, and The Quality of Antimalarials - A Study in Selected African Countries. The calculations assumed that there were 1 million annual deaths from malaria, with only half of these victims being diagnosed and receiving any treatment at all. Of these, a fifth were estimated to have been resistant to chloroquine and sulfadoxine-pyrimethamine, leaving 400,000 lives capable of being saved through treatment (given existing levels of coverage). The study asserted that, according to the research in The Quality of Antimalarials - A Study in Selected African Countries, up to half of antimalarial drugs in some areas were substandard, and therefore up to half the 400,000 preventable deaths were due to substandard products.

This figure may be conservative. Since then artemisinin use has become far more widespread, meaning that the 100,000 deaths removed from the equation now arguably should not be. This, by their methodology, would increase their figure to 250,000 deaths. Furthermore neither their figures (nor our tuberculosis figures below) account for fake drugs causing resistance. In parts of Asia fake antimalarials account for as much as 68% of the market, and drug resistant malaria is growing as a consequence. Fakes are at the very least partially culpable for deaths from drug resistant disease.

Tuberculosis:

According to the World Health Organization, there were 9.3m new cases (in 2007).
Coverage of DOTS (Directly observed treatment, short course) is said to be 94% worldwide, with half of untreated sufferers expected to die.

Data on levels of fake TB drugs is scarce, yet one reliable study (Laserson, 2001) across six countries found the level to be 10%.

This leaves approximately 900, 000 people suffering from TB and receiving treatment with fake drugs. The chances of dying from TB if not treated correctly are 50%, so we can assume this situation could lead to approximately 450,000 deaths.

Malaria and TB deaths caused by fakes, combined, therefore equals at least 450,000 + 250,000 = 700,000.