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Malaria

Many drugs being used to treat Malaria in disease ridden areas could be substitutes, or could even be fake.

The Lancet Infectious Disease Journal reported that up to 42% of the Malaria drugs used in Southeast Asia or Sub-Saharan Africa could be ineffective, being either counterfeit medication, a substitute medication or just a placebo.

The governments of the countries where these ineffective drugs were discovered are being urged to regulate drug production more strictly.

People along the borders of Thailand and Myanmar have been found to carry a Malarial parasite that is immune to the best anti-Malarial drugs available, called artemisinin combination therapy, or ACT.  In Cambodia, drug resistant Malarial parasites were also discovered.  These new cases showing up along the borders of Thailand and Myanmar are different in the fact that it is a different parasite these patients are carrying.

“Anti-malarial control efforts are vitally dependent on artemisinin combination treatments,” says  Anne-Catrin Uhlemann and David Fidock of Columbia University.  “Should these regimens fail, no other drugs are ready for deployment, and drug development efforts are not expected to yield new antimalarials until the end of this decade.”

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Illegal drug developers are exploiting one of the world’s most prevalent diseases by distributing fake anti-malaria drugs in the Asia-Pacific region. Malaria, a disease caused by parasites, transferred usually by the Anopheles mosquito causes high fever and eventually death, has no vaccine. Therefore, the treatments provided by drugs are pertinent to making sure the disease does not escalate.

When administered to a child one possible side effect of the fake drugs is death. Long term effects include distrust in the use of drugs and development of resistance to the active ingredient, artemisinin, which fights malaria, but in its minor dosage in the fake drug can be potentially harmful. Fake drug developers are staying one step ahead of enforcement agencies as they manufacture the drugs with this small amount of artemisinin in order to pass tests as though the drug were real (safe and effective). The poorly developed drugs may also have traces of carcinogens as well. Ric Price, Professor of Global Health at Darwin’s Menzies School of Health Research states that  “about 20%-60% of the drugs sold across the counter in Asia in many parts are usually fake.” Developing countries are falling into this trap because their limited budget to purchase medicines means that cheaper drugs are entering the country without a quality check and while countries like China have made some success at shutting down the illegal factories, other black markets are spreading in New Delhi and even Nigeria.

The problem is even more concerning as the Institute for Health Metrics and Evaluation (IHME) has found that it previously underestimated the number of malaria cases there are worldwide. Today, the number of people affected is approximately 1.2 million. Risk of developing resistance of artemisinin means that the progress made towards fully eradicating the disease can be jeopardized. An IHME study found that 76% of deaths related to malaria are from Asia alone.

 

Doctors Without Borders has put together a useful summary of the ten key stories from 2011 on the struggle to obtain essential medicines in developing countries.  As they describe, one of the critical faultlines is India, a country that produces “the most quality affordable medicines used in the developing world, but which faces attacks by drug companies and wealthy countries who continue to clamp down on generic production.”