Malawi, Africa

Alarmingly, a fifth of medicines in Africa could be substandard or fake, revealed a major research project. The research by researchers from Bahir Dar University in Ethiopia has raised significant concerns over a problem that could potentially be contributing to numerous preventable deaths. 

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The researchers reviewed 27 studies and found that out of 7,508 medicine samples, 1,639 failed at least one quality test, which confirms them as substandard or falsified.

Public health concern

Claudia Martínez, the head of research at the Access to Medicine Foundation, an Amsterdam-based non-profit group, described the findings as a major public health concern, reports The Guardian. 

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"If patients are getting medicines that are substandard or outright fake, it can result in their treatment failing or even preventable deaths," she said.

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Last year, the UN Office on Drugs and Crime estimated that falsified and substandard medicines could be responsible for up to 500,000 deaths annually in sub-Saharan Africa. 

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What are substandard medicines?

Substandard medicines are those that do not meet quality standards despite being authorised. Similarly, falsified medicines deliberately falsify their identity, composition, or source.

Citing a World Health Organization (WHO) spokesperson, The Guardian reports that antibiotics and antimalarial products are Africa's most commonly falsified medicines. These substandard or falsified antibiotics can contain incorrect dosages or wrong active ingredients, leading to ineffective treatments and the survival of resistant strains, thus fuelling antimicrobial resistance.

Highest proportion of substandard medicines in Malawi 

The study found that Malawi had the highest proportion of substandard and falsified medicines. 

Martínez pointed out several factors contributing to the problem, including complex, inefficient, and fragmented pharma supply chains. 

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"Pharma supply chains in many low- and middle-income countries are often complex, inefficient, and fragmented; the region relies heavily on a limited number of suppliers for essential medicines, and many countries face significant challenges in procuring products in time and effectively policing the quality of products in the market," she said.

The role of multiple middlemen in distributing products across the continent makes it easier for substandard or falsified medicines to infiltrate the supply chain, she added.

A previous WHO study estimated that one in 10 medical products in developing countries are substandard or falsified, with 42 per cent of such reports coming from Africa.

Martínez called for immediate action from governments, national authorities, regulators, and pharmaceutical companies to address the issue. She emphasised the need to strengthen supply chains by "enhancing infrastructure, improving logistics and implementing better surveillance-monitoring systems."

She said that pharmaceutical companies should promptly report any cases of substandard or falsified medical products to national health authorities and the WHO rapid alert system.

"There is also a lot that pharma companies can do by reporting any cases of substandard or falsified medical products to national health authorities and the WHO rapid alert system promptly and contributing to capacity building."

(With inputs from agencies)