Fake drugs are one reason malaria still kills so many

A micrograph of a female Anopheles mosquito, a known malaria carrier. /COURTESY
A micrograph of a female Anopheles mosquito, a known malaria carrier. /COURTESY

Malaria, a mosquito-borne parasitic infection , has become largely a disease of the young and poor.

Due to effective medications like chloroquine and artemisinins, malaria deaths . The .

Still, , the latest data available. Most of them occurred in Nigeria, the Democratic Republic of the Congo, Uganda, Ivory Coast and Mozambique. And of the 445,000 people who died from the infection, about 70 percent were .

If malaria is a curable disease with effective treatment, why does it still kill so many?

The rise of counterfeit drugs

Our research has revealed that one reason for malaria’s continued virulence in the developing world is ineffective medicine. In fact, in some poor African countries, many malaria drugs are actually expired, substandard or fake.

Globally, . Substandard and counterfeit medicines may be responsible for up to 116,000 malaria deaths annually in sub-Saharan Africa alone, according to .

Fraudulent pharmaceuticals are on the rise. , according to a 2014 article in the Malaria Journal.

In 2012, a research team from the U.S. National Institutes of Health found that about one-third of anti-malarial medicines distributed in southeast Asia and sub-Saharan Africa . A few years prior, fully 44 percent of anti-malarial supplies in Senegal .

For as long as effective medicines have existed, . That’s because counterfeiting pharmaceutical drugs is profitable business for manufacturers. This illegal activity is in places with little government oversight and limited access to safe, affordable and high-quality medicines.

Various have found that many fake medicines , followed by China, Hong Kong and Turkey. Some illicit drug manufacturers .

It’s a good racket: Public officials in the developing countries where these medicines are distributed typically struggle to detect and investigate the crime – – due to lack of funding and regulatory restrictions.

Imitating good malaria drugs

Generally, fake malaria drugs imitate one of two types of common antimalarial medicines: quinines and artemisins.

Quinine and its chemical derivatives are derived from the bark of the South American quina-quina tree. Artemisinin is isolated from a variety of wormwood. Both medicines, which cost between US$12 and $150 per course, are affordable to rich-world patients but .

was . Synthetic quinine-based drugs became available in the early 20th century. The most common is .

Artemisinin came about in the 1970s, though it had been used as a . In combination with other anti-malarials, it is now the , largely because it has less severe side effects than quinines.

What is a substandard medicine?

Poor quality medicines – not just for treating malaria but in general – usually fall into one of three categories.

Medicines may be falsified, meaning that the treatment has been deliberately and . Some fake drugs contain no active ingredients at all or . This is generally a scam to earn money illegally.

Anti-malarial drugs distributed in the developing world may also be . Such drugs are produced by legitimate manufacturers but are not compliant with World Health Organization standards. Frequently, they are short on artemisinin, the key active ingredient.

Such medicines, which may be produced deliberately or unintentionally, do not prevent malaria in the individuals who take them. Worse yet, they can lead the malarial parasite to develop drug resistance, a significant danger for everyone who lives in a place affected by malaria.

So far, resistance to drugs derived from artemisinin has only been , but doctors .

Finally, medical literature shows that some anti-malarial drugs found in poor countries have either by exposure to extreme heat.

Fake drugs an expensive fraud

Ineffective malaria treatments – whether fake, substandard or degraded – are also expensive for consumers and national health care systems.

Patients who unwittingly purchase ineffective anti-malarial drugs are out of pocket for medicines that do nothing. Then, they pay for additional treatments when the first course of medicine fails.

According to the World Health Organization, repeated medical treatments due to ineffective drugs is estimated to cost to sub-Saharan African patients and health care providers as a whole about .

The problem of fake and substandard malaria drugs is so widespread that the , and the have all developed guidelines regarding the procurement of malaria medicines.


, Assistant Professor/Senior Lecturer in Pharmacy, ; , Medical Science Research Fellow, ; , Deputy Dean (Research) Faculty of Health, , and , Head of Pharmacy (2013-present),

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