Third of antimalarial drugs fake

MORE than a third of malaria drugs examined by scientists in South-East Asia were fake, researchers say after a review.

"These findings are a wake-up call demanding a series of interventions to better define and eliminate both criminal production and poor manufacturing of antimalarial drugs," said Dr Joel Breman of the Fogarty International Center at the US National Institutes of Health (NIH).

Trawling through surveys and published literature, the researchers found that in seven South-East Asian countries, 36% of 1437 samples, from five categories of drugs, were counterfeit.

Thirty per cent of the samples failed a test of their pharmaceutical ingredients.

In 21 sub-Saharan countries, 20% of more than 2500 samples tested in six drug classes turned out to be falsified, and 35% were below pharmaceutical norms.

Sub-standard medications are a major problem in the fight against malaria, a disease which killed 655,000 people in 2010, according to the UN's World Health Organisation (WHO).

Many of the drugs that are being faked or poorly manufactured are artemisinin derivatives, the study said.

This is a special worry because artemisinins are the frontline treatment for malaria, replacing drugs to which the malaria parasite has become resistant.

The study says there are many causes for the problem, ranging from widespread self-prescription of drugs to shoddy control over drug quality and failure to prosecute counterfeiters.

"Poor-quality antimalarial drugs are very likely to jeopardise the unprecedented progress and investments in control and elimination of malaria made in the past decade," Dr Breman said.

Last month, the Institute of Health Metrics and Evaluation at the University of Washington in Seattle reported that artemisinin-resistant malaria which was first spotted in Cambodia in 2006 has since surged 800km westward to the Thailand-Myanmar border.

Lancet Infect Dis 2012;12:488-96