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COUNTERFEIT, substandard drugs risk lives in developing countries, study shows

LONDON (AP) _ A high proportion of medicines available in some developing countries could be fake or substandard and putting lives at risk, new research suggests.

Nearly half the drug samples analyzed from pharmacies in Nigeria contained the wrong dose _ too strong, too weak or lacking the active ingredient. And in a separate study in Cambodia, Laos, Vietnam, Thailand and Myanmar, 38 percent of the antimalarial pills sampled had no trace of the drug they were supposed to contain.

The findings, published this week in The Lancet medical journal, have prompted calls for stricter quality control among drug manufacturers in the developing world and better policing to combat fraud.

There have long been reports of poor-quality drugs in developing countries making it difficult to treat certain diseases. Experts have linked the problem to the counterfeiting of drugs, storage in hot climates and slack quality control among drug manufacturers.

The two new studies examined the contents of drugs for a comprehensive range of medicines.

In Nigeria, a team led by Robert Taylor, a professor of pharmacology at the Robert Gordon University in Aberdeen, Scotland, analyzed 27 drugs _ including medicines to treat malaria and tuberculosis _ found in pharmacies in the cities of Lagos and Abuja. The drugs were made in 12 different countries.

The investigators found problems with 48 percent of the 581 samples analyzed. While some contained no active ingredient, most had slightly too much or too little.

``Preparations that originated from developed countries had similar imprecise contents to those manufactured in less developed countries,'' the study said. ``This unexpected feature suggests that the packaging and stated origin is counterfeit, that there is an issue around the quality control of drugs manufactured and exported from developed countries, or both.''

Substandard drugs not only hamper treatment of killer illnesses in the developing world _ such as respiratory infections, tuberculosis and malaria _ but could also contribute to bacteria, viruses and other microbes becoming increasingly tough to treat, in both rich and poor countries. Many are rapidly developing resistance to even the strongest drugs.

In a separate study, scientists from Oxford University in England and Bangkok's Mahidol University found 38 percent of 104 samples of the key antimalarial drug artesunate bought throughout southeast Asia were counterfeit. They called it a ``murderous trade.''

``The illicit trade in counterfeit antimalarials is a great threat to the lives of patients with malaria,'' the study said. The fakes came in poorly forged packaging, lacking proper holograms and registration numbers _ but lured buyers by being cheaper than the legitimate drug.

Commenting on the studies, Alain Li Wan Po of the Center for Evidence-Based Pharmacotherapy at Aston University in Birmingham, England, urged measures to raise drug standards and combat fraud.

Drug manufacturers, he said, should receive training from international health care organizations and regular independent quality checks should be carried out.

``Offenders should be barred from trading and those responsible brought to the attention of the public and the law,'' said the professor, who was not involved with the study.

``Public-education campaigns to draw attention to fake products should be increased. Drug companies making genuine products can of course also help by considering affordability in their pricing strategies, and so make fraud less profitable,'' he said.

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