LONDON: Doctors have called for an urgent international effort to combat a “pandemic of bad drugs” that is thought to kill hundreds of thousands of people globally every year, the Guardian reported on Tuesday.
A surge in counterfeit and poor quality medicines means that 250,000 children a year are thought to die after receiving shoddy or outright fake drugs intended to treat malaria and pneumonia alone, the doctors warned.
More are thought to die from poor or counterfeit vaccines and antibiotics used to treat or prevent acute infections and diseases such as hepatitis, yellow fever and meningitis. Most of the deaths are in countries where a high demand for drugs combines with poor surveillance, quality control and regulations to make it easy for criminal gangs and cartels to infiltrate the market. Often they face only fines or minor sentences if caught.
“The penalties are a slap on the hand, but we are talking about murder by fake medicine here,” said Joel Breman, a senior scientist emeritus at the US National Institutes of Health in Maryland.
Tests on drugs in the field have identified fake and ineffective copies of a vast range of drugs including antimalarials, antibiotics and cardiovascular and cancer medicines. Many fakes originate in India and China and have been found to contain everything from printer ink and paint to arsenic. Lifestyle drugs, such as Viagra, dominate the market for counterfeit medicines.
Beyond the fakes that are made and sold by criminal gangs are poor-quality medicines that lack sufficient active ingredients to work properly, or fail to dissolve correctly when taken. Sloppy manufacturing is often to blame, but others are sold past their shelf life or have degraded in poor storage conditions.
Writing in the American Journal of Tropical Medicine and Hygiene, doctors from the US government, universities and hospitals warn that the rise in “falsified and substandard medicines” has become a “public health emergency”. On top of the direct harm they cause, bad drugs are a major driver of antimicrobial resistance, which fuels the rise of superbugs. “This is an urgent public health issue and we need to take action,” Breman said.
Up to 10% of drugs in low and middle income countries are poor quality or outright fakes, costing local economies between $10bn and $200bn a year, the report states, and the problem is getting worse. In 2018, a multinational drug manufacturer identified 95 fake products in 113 countries, up from 29 fakes in 75 countries in 2008.
In a raft of recommendations, the doctors call for greater support for the World Health Organization’s (WHO) drug surveillance programme and an update to the UN’s sustainable development goals in which governments would ensure at least 90% of the medicines in their countries were of high quality. Registers of fake drugs found in the field should also be made open to the public, the doctors say.