Counterfeit, Substandard Medicines Prevalent in Low- and Middle-Income Countries: Study

August 11, 2018


Fake, low-quality medicines are prevalent in low- and middle-income countries, thereby posing a serious threat to the well-being of the people of such countries, a new study carried out by the researchers at the University of North Carolina at Chapel Hill has found.

In the past, WHO has revealed that it is working with the International Criminal Police Organization (Interpol) to dislodge criminal networks involved in the illegal trade of counterfeit medicines. In 2009, Interpol seized nearly 20 million units of fake medicines across China and seven other Southeast Asian countries neighboring China. Interpol coordinated this operation for nearly five months, and arrested over 30 people involved with the illegal trade. In total, 100 retail stores were closed in these countries during the operation.

While Asia has the largest share of the trade in counterfeit medicines, such cases also from other parts of the world. A report published by the Center for Medicine in the Public Interest in the United States of America estimates that worldwide sales of fake medicines could reach US$ 75 billion in 2017. Counterfeit medicines usually appear identical to legitimate medicine. Their packaging is also done in such a way that it looks like a legitimate medicine from an approved pharmacy. Many people want to purchase medications online, as they do for a variety of other products used in their day-to-day life. People find purchasing medicines online not only convenient, but is also grants anonymity to those who don’t want to disclose their personal health with others. However, in a large number of cases, medicines ordered from websites that hide their physical address have been found to be fake.

According to the UNC study, nearly 13 percent of the essential medicines needed for priority health care of the population in developing countries are fake or substandard. In African countries, the percentage is even higher at 19 percent.

In their study, the team analyzed 96 previous studies comprising 67,839 drug samples. Researchers also carried out a systematic review of 265 studies comprising 400,647 drug samples. The results revealed that antibiotics and antimalarial medicines were most commonly sold in fake or substandard conditions (19.1 percent in case of antimalarials and 12.4 percent in case of antibiotics) in low- and middle-income countries.

“The prevalence of substandard and falsified medicines is a substantial public health problem because these medicines can be ineffective or harmful and can prolong illnesses, cause poisoning or lead to dangerous drug interactions,” said Sachiko Ozawa, an associate professor at the UNC Eshelman School of Pharmacy, and the lead researcher of the study.

James Herrington, a professor in the UNC Gillings School of Global Public Health and a co-author of the study says more international collaboration on this issue. Such cooperation would not only make it easier to implement laws on drug quality but would also boost quality control capacity and improve surveillance and data sharing.

“This can strengthen the global supply chain against poor quality medicines, improve health outcomes by reducing antimicrobial and anti-parasitic resistance and, ultimately, help governments, businesses and patients save money.”

The detailed findings of the study have been published in the journal JAMA Network Open.

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