A new research suggests that one of the gravest perils comes in the form of falsified and substandard drugs for treating malaria, pneumonia and other diseases.
Hundreds of thousands of children each year are dying due to a surge of poor-quality or outright fake medicines, the report says.
“We’re talking about 300,000 — at least — children who have died because of murder-by-alleged-medicines distributed by criminals,” said Dr. Joel Breman, a co-author of the report and senior scientific adviser emeritus at the Fogarty International Center of the US National Institutes of Health.
The number of falsified and substandard medical products is on the rise, according to Breman and his co-authors on the report, published Monday in the American Journal of Tropical Medicine and Hygiene.
In 2008, for example, Pfizer Global Security, the drugmaker’s team working to counteract counterfeit drugs,identified 29 of its products in 75 countries as being falsified.
Just 10 years later, Pfizer found 95 fakes in 113 countries.
Breman said the “impact” of falsified and substandard drugs is estimated to be as high as 10% of all medicines, costing up to $200 billion, in low- and middle-income countries.
One of two primary areas of concern in these countries is antimalarials, which may be responsible for the deaths of more than 150,000 children each year.
Antimalarials and artemisinin combination therapy (often called ACT) are the best solution for treating malaria.
The program found 185 manufacturers of non-quality-assured ACTs, compared with just 12 reputable companies making these approved combination therapies.
Beyond children, a new category of falsified and substandard drugs is on the rise: treatments for chronic conditions such as hypertension.
The Pharmaceutical Security Institute, a nonprofit watchdog organization, finds that these account for more than 50% of all fake medicines.
The most common of these fake drugs, often peddled over the Internet and sometimes linked to organized crime and terrorist groups, include medicines for heart disease, erectile dysfunction, cancer and pain (prescription opioids).
High-income countries are similarly not immune to the problem, thanks to the Internet: both online unregistered pharmacies and “smartphone applications which allow you to order medicines without prescriptions and have them delivered by a guy on a motorbike that turns up at your home.
An international treaty may be necessary, the report’s authors say.
Technical issues also need to be addressed: For example, there’s a need to identify “the best bedside method of testing drugs,” Breman said, explaining that high-powered analytic tests exist, but the laboratories where such analysis is done are both distant and expensive.
Distribution of fake drugs means the specter of antimicrobial resistance also looms, he said. Low-quality drugs promote and spread resistance due to their inability to thoroughly kill bacteria as do drugs with no active ingredient, so called, “blanks.”