Tuesday December 25, 2012, 8:17 pm

Counterfeit medicine from Asia threatens lives in Africa

Malaria is one of the diseases affected by unscrupulous traders in fake and substandard drugs

Kathleen E McLaughlin
The Guardian, Sunday 23 December 2012 11.33 EST

Malaria
A Ugandan woman watches over her child who is suffering from malaria. Photograph: Yannick Tylle/ Corbis

International health experts are warning of a mounting health crisis in parts of Africa because of an influx of counterfeit medicine from Asia that is playing havoc with the treatment of diseases such as malaria. Porous borders in Africa coupled with indifferent oversight in China are combining to turn the continent and its pressing health problems into a free-for-all for maverick manufacturers, some of whom are producing pills with no active ingredients at all.

Precise data is hard to track down because of the informal nature of African health systems. But several recent studies warn that as many as one-third of malaria drugs in Uganda and Tanzania are fake or substandard, with most believed to originate in China or India.

Apart from the lives lost, there are additional concerns about drug resistance building in east Africa, experts say. "It's a crisis any time someone dies," Nick White, who chairs the Wellcome Trust's south-east Asia major overseas programmes and the WorldWide Antimalarial Resistance Network (Wwarn). "It's a massive problem that people have simply ignored. It's not like a boil that's beginning to burst because it's been a problem for a long time. What has happened is we are beginning to recognise it more."

Laurie Garett, senior fellow for global health at the US Council on Foreign Relations, said: "Nobody has a head count – or a body count – on numbers of Africans that have died as a result. But China's role certainly has been dreadful."

David Nahamya, chief drug inspector for the Ugandan national drug authority, said: "What we are told is this, if someone wants to counterfeit a drug, they just take the package to China and they can make it in thousands. You have seen how they make it there. They can copy anything."

An increasing list of studies and surveys about fake, counterfeit and substandard drugs has emerged in recent years, but because of deeply entrenched interests from all sides – governments, NGOs and pharmaceutical companies – there has been great reluctance to call the scourge of killer medications in Africa and elsewhere a crisis.

This is despite the fact that everything from life-saving Aids medication to emergency contraception are being copied, faked and made with shoddy components on a huge scale.

Patrick Lukulay, vice president of the US Pharmacopeial Convention's global health impact programmes, said it was no secret that the majority of dangerous medications came from China and India, as those countries had the world's largest production bases for both active ingredients and finished drugs.

While India has stepped up oversight, "China is only now just catching on", he added.

Though it may seem like an immense amount of trouble to counterfeit a £3 packet of malaria pills, Lulukay noted that the global trade was estimated at £46bn a year. Counterfeiters know their markets well and target medications accordingly. Efforts to combat the activity are in their infancy.

"If you want to be efficient in fighting it, you have to have a very strong regulatory authority, very strong collaborations, very good distribution networks and good co-operation between governments," said Sabine Kopp, who manages the anti-counterfeiting and medicines quality assurance programmes at the World Health Organisation.

As yet, none of those components are in place and counterfeiters, apparently unconcerned with harming sick people in developing countries, continue making huge profits.

It is a loss to global aid organisations, as well, said Dr Nick White. "Think of the hundreds of millions, if not billions, you spend on pills to help people in poor countries," he said. "It's bonkers not to make sure they're authentic and instead people are ending up with shoddy pills from China."

This work was funded in part by a grant from the Pulitzer Center on Crisis Reporting

Thursday December 27, 2012, 11:42 am
China isn't the first or the last to get in on this type of scam. I suspect many of the early drugs for the various diseases were either actual placebos or useless. Pfizer and all the others have made a tidy profit.

Thursday December 27, 2012, 12:32 pm
Thanks J.L. A.

This problem has beeen known about for years; possibly if it occurred more often in "developed countries" people might do more about it.

Thursday December 27, 2012, 3:39 pm
noted

Thursday December 27, 2012, 7:58 pm
You cannot currently send a star to Michael because you have done so within the last week.
Good point Mary; you are welcome. You cannot currently send a star to Mary because you have done so within the last week.

Friday December 28, 2012, 2:54 am
so true Mary D

Friday December 28, 2012, 3:06 am
Really unfortunate.Noted,thanks J.L

Friday December 28, 2012, 6:31 am
You cannot currently send a star to Rose because you have done so within the last week.
You cannot currently send a star to Samir because you have done so within the last week.

Friday December 28, 2012, 6:37 am
Don't trust the asians when it comes to anything that you put in your or your pet's mouth or use in food preparation. They know what they export is poison and they don't care. The rest of the world is stupid enough to keep buying it.

Friday December 28, 2012, 3:15 pm
I cannot prove anything neither can the medical profession unless they took my meds & checked to see if they were any good or not. I was hospitalized a couple times when I got my b/p meds via mail order in the USA. I did some research & found most all b/p meds are made in Pakistan, India or China. I changed drug stores and thereby manufacturers and haven't had a problem since with palpatations, skyrocketing b/p for no reason. So--I suggest if any med you are taking isn't working or disagrees with you....change the pharmacy---make sure the manufacturer is "different".
What I believe happened is that people complained about the cost of drugs so---pharma started importing them from countries that pay only 38 cents an hour !! We are getting what we paid for---and it's scary.

Friday December 28, 2012, 3:21 pm

It is possible for even generic medication to be ordered from the company that holds the original patents, just ask your pharmacist to do so. But how would any one know if their medication is counterfeit without having random batches screened for potency?

Friday December 28, 2012, 3:27 pm
Many products are supposed to get random checking at the border when imported--sounds as if this is one more area for beefed up monitoring Kit. You cannot currently send a star to Kit because you have done so within the last week.

Friday December 28, 2012, 3:53 pm
Virtually all of our medicines here in the USA are made in China. This is horrifying and I do not understand why we, as a nation, put up with the product tampering that goes on in Chinese factories.

Friday December 28, 2012, 10:06 pm
wowwww

Saturday December 29, 2012, 6:27 am

Noted....

Saturday December 29, 2012, 12:14 pm
noted

Saturday December 29, 2012, 5:29 pm
Noted

Saturday December 29, 2012, 11:49 pm
noted

Sunday December 30, 2012, 8:27 am
Unfortunately since no one can be bothered to keep a body count, I wonder just how much worse the death and misery caused by using the poor in Africa for drug testing trials is. The fact is nearly all or all of the drug manufacturers in the world use the poor in Africa for human trials for new drugs to determine efficacy, side effects and mortality rates, where it is not the fact that the drugs are counterfeit but that no one actually knows just exactly what the drugs do long or short term nor where the line between beneficial and harmful/fatal dosage is.

Sunday December 30, 2012, 8:38 am
You cannot currently send a star to LLOYD because you have done so within the last week.

Sunday December 30, 2012, 10:36 am
Wow

Sunday December 30, 2012, 1:17 pm
I don't trust China; they don't care much about "foreigners", they care for profit. The poor in countries like Africa have to pay a high price, medication is tested on people, it's outrageous. Who defends them ?

Sunday December 30, 2012, 8:54 pm
You cannot currently send a star to monka because you have done so within the last week.