Research: Substandard Malaria Drugs Outnumber Fakes

According to new research published in PLOS ONE, an analysis of more than 3,000 anti-malaria medication found nearly 9 out of every 100 to be of poor quality, but another seven in 10 were substandard.The analysis also found that one in 10 of the medicines were falsified or degraded.

Researchers at University of Nigeria, Nsukka found that falsified samples contained chemicals other than malaria-treating artemisinin, including chlorzoxazone (a muscle relaxant), ciprofloxacin (an antibiotic) or paracetamol.

Substandard or degraded drugs were more prevalent than falsified ones in Enugu, according to the research, and poor quality drugs were frequently found in patent medicine vendors, also known as drug shops, which are the main source of treatment for most patients, rather than in pharmacies.

The research raises concern about patients not receiving correct doses for treatment and potentially contributing to the development of resistance to artemisinin, the main drug to treat malaria.

“The results show that the health system actors should be eternally vigilant in Nigeria and in other countries to ensure that sub-standard drugs do not impede or erode gains made in malaria treatment. Drug regulatory authorities and their partners should intensify drug quality monitoring activities with appropriate sanctions for defaulters,” Prof Obinna Onwujekwe of UNN, the study’s co-author said.

Previous surveys have indicated that up to 35% of antimalarials in sub-Saharan Africa were poor quality because they failed chemical content analysis, but  Dr Harparkash Kaur, from the London School of Hygiene & Tropical Medicine, lead investigator of the drug quality programme of the ACT Consortium, said the “convenience” approach to select samples for previous studies may have affected results generated.

A team of the Artemisinin-based Combination Therapy (ACT) Consortium at the London School of Hygiene & Tropical Medicine analysed 3,024 antimalarials containing artemisinin bought from stores in Enugu Metropolis and analysed the sampled at three independent laboratories in the UK and the US.