WHO Fears Growing Malaria Drug Resistance May Be Spreading

WHO officials say counterfeit drugs and poor storage are to blame.

Ron Corben in the November 28th issue of the Voice of America News, reports on a story from the World Health Organization regarding the growing issue of malaria drug resistance in Asia primarily caused by adulterated, fraudulent, sub-standard and counterfeit medications.

Highlights from the Voice of America News article include:

• World Health Organization officials say there are signs of growing drug resistance to mosquito-borne malaria, raising concern millions of people in Asia may be at risk.

• The Asia region accounts for more than 60 per cent of the global population at risk of the parasite with the main focus on India, Burma, Bangladesh, Indonesia and Papua New Guinea.

• But World Health Organization officials point to troubling signs a current drug combination based on artemisinin, originally drawn from a Chinese herb, is losing its potency against the malaria parasite.

• Artemisinin is largely given to patients in combination with other drugs rather than by itself in a bid to preserve the drug's long term effective strength.

• "The place where we are really concerned is on the Cambodian-Thai border," said Eva Marie Christophel a World Health Organization official in the Phillipines. "It would be disastrous if that spread because there's hardly anything in terms of new drugs in the pipeline for malaria or what is in the pipeline will take years, so we're really very much relying on arthemisinin based combination therapy."

• The World Health Organization is concerned that drug resistance could spread from the Cambodian-Thailand border region to Africa, following a similar pattern with anti-malaria drugs such as cloroquine and sulfadoxine-pyrimethamine in the 1960s and 1970s.

• In February 2009, WHO confirmed anti-malarial resistance at the Cambodian-Thailand border. But recent WHO studies found up to 20 per cent of patients at the Burma-Thailand border also showed signs of malarial parasites in the blood after the normal artemisinin combination therapy.

• "We noticed years ago that the disappearance time for parasites to disappear from the blood is increasing. Usually they disappear in two days or less," said Dr. Charles Delacollette, coordinator of the Bangkok-based WHO Mekong Malaria Program. "And we observe that there are an increasing proportion of patients showing parasites, still parasites in their blood after two days of artemisinin treatment, which was not the case before."

• Dr. Delacollette says the growing drug resistance is in part due to the sale of substandard and counterfeit drugs. In recent years, authorities cracked down against illegal factories in China. Meanwhile, counterfeit producers have been found elsewhere, including Cambodia and Burma.

• "Drugs are not quality, the quality of the drugs sold in private sector is selling any kind of drugs which are stored in very bad conditions, so they becoming substandard and also you have sellers which are selling counterfeit - purposely made counterfeit," said Dr. Delacollette.

The crime of adulterated, fraudulent, sub-standard and counterfeit drugs is a dangerous threat to populations around the globe.

To think that unscrupulous organized gangs can impact the health and well being of populations around the globe, especially for diseases and maladies that have long since been conquered by the advances in medical science is unconscionable.

Unfortunately the issue with malarial drugs is just the beginning of a much larger issue of drug resistant strains of diseases around the world. Drug resistant diseases know no borders and impact all societies, rich and poor.

The global supply chain must take proactive measures to protect their inventories from this insidious crime by deploying solutions to track and authenticate their inventories.

To read the entire Voice of America News story, visit: http://www.voanews.com/english/news/WHO-fears-growing-malaria-drug-resistance-may-be-spreading---110934814.htmlmalaria-drug-resistance-may-be-spreading---110934814.html

To learn more about anti-counterfeiting technologies for pharmaceuticals, visit: http://www.xstreamsystems.net/

WHO: Fake Drugs Major Factor in New Malaria Strain

The World Health Organization (WHO) raised the alarm about a new strain of drug resistant malaria in South East Asia.

According to SafeMedicines, a newly published report on antimalarial drug efficacy and resistance, scientists believe that fake and substandard malarial medications are a major factor in the development of new drug-resistant strains of malaria.

According to SafeMedicines:

• Resistance to artemisinin has emerged along the border of Cambodia and Thailand, and WHO is putting together a global panel of stakeholders to work to contain this new strain before it spreads to Africa, as other strains did in the 1960s and 1970s. Scientists believe that once a new strain occurs through spontaneous change in the parasite, its ability to survive is promoted by substandard medications.

• Current containment activities involve long-lasting insecticide-treated mosquito nets, recruitment and training of village health workers equipped with rapid diagnostic tests, and most importantly free malaria treatment and follow-up. Free treatment is key to the success of the containment effort because “free treatment and care helps to undermine the sale of counterfeit and substandard antimalarial drugs,” states WHO in the “Global Report on Antimalarial Drug Efficacy And Drug Resistance: 2000-2010.

• “Efforts have also been made to stop the sale of counterfeit and substandard drugs, which are a major factor in the development of resistance,” states the report.

• WHO’s report states that the Cambodian government is working closely to monitor malarial medications and educating consumers in workshops and through reading materials on the extensive dangers fake malaria drugs may cause them.

• “History has shown that once resistance to antimalarial treatment emerges it is only a question of time before it spreads. For the first time, the global malaria community has the opportunity to contain resistance before it spreads,” states the report.

• Artemisinin is a plant-based antimalarial medicine, which due its potency very quickly reduces the number of malaria parasites in humans. Artemisinin compounds are combined with other anti-malarial drugs in therapies called artemisinin-based combination therapies (ACTs). Using combination therapies provide multiple possible agents to kill the plasmodium parasites that cause malaria.

Drug resistant diseases know no borders and effect wealthy and the poor.

Counterfeit drugs have become one of the most insidious criminal and health care epidemics of the 21st century.

All members of the global pharmaceutical supply chain (manufacturers, distributors, regulatory agencies, dispensers and consumers) must insist on it members to use all laws, solutions and technologies to fight this lethal crime.

To view the entire SafeMedicines post, visit: http://www.safemedicines.org/2010/11/fake-drugs-major-factor-in-new-malaria-strain-says-who-49.html

To learn more about anti-counterfeiting technologies, visit: http://www.xstreamsystems.net/

WHO: Poor Quality Drugs Used to Treat Malaria

Both the BBC and the Associated Press are reporting on a new World Health Organization study regarding the quality of drugs used to treat malaria in Africa.

The study goes into some depth regarding the findings that up to 40% of the artemisinin drugs used to treat malaria in poor African nations are of such poor quality they are ineffective in treating the disease. In addition because these poor quality drugs contain some of the active ingredient of the drugs, they are now causing drug resistant strains of malaria.

Here are some of the highlights from the BBC story:

• The group, conducting the study for the World Health Organization, said low-grade drugs were being used in both public and private health practices.



• Some 90% of malaria deaths in the world occur in Africa.



• They found 44% of the drugs from Senegal failed the testing, followed by 30% from Madagascar and 26% from Uganda.

To read the entire BBC story, visit: http://news.bbc.co.uk/2/hi/africa/8504137.stm

Some of the highlights of the Associate Press story which was published in the Chicago Tribune include:

• Between 16 percent and 40 percent of artemisinin-based drugs sold in Senegal, Madagascar and Uganda failed quality testing, including having impurities or not containing enough active ingredients, the survey found.


• Artemisinin-based drugs are the only affordable treatment for malaria left in the global medicine cabinet. Other drugs have already lost effectiveness due to resistance, which builds when not enough medicine is taken to kill all of the mosquito-transmitted parasites.



• If artemisinin-based drugs stop working, there is no good replacement and experts worry many people could die.


• "It is worrisome that almost all of the poor-quality data that was obtained was a result of inadequate amounts of active (ingredients) or the presence of impurities in the product," said Patrick Lukulay, director of a nongovernmental U.S. Pharmacopeia program funded by the U.S. government, which conducted the survey. "This is a disturbing trend that came to light."


• The study is the first part of a 10-country examination of anti-malarials in Africa by the U.S. and the World Health Organization. It follows evidence from the Thai-Cambodian border that artemisinin-based drugs there are taking longer to cure malaria patients, the first sign of drug resistance.


• The three-country report also found bad drugs in both the public and private health sectors, meaning governments — some buying medicines with donor funds — are not doing enough to keep poor-quality pills out. All of the drugs tested from the public sector in Uganda, however, passed the quality tests. But 40 percent of the artemisinin-based drugs in Senegal failed.


• "There are countries where donated medicines are not subjected to quality controls, they're just accepted," said Lukulay. "There are countries in Africa where Chinese products have been donated and found to be unacceptable later in the public sector."

To read the entire Associated Press story, visit: http://www.chicagotribune.com/health/sns-ap-med-africa-malaria-drugs,0,1354782.story.

This issue of counterfeit, fraudulent and adulterated medications, which is causing a deadly healthcare crisis around the globe, energizes the need for material screening of products within the supply chain, from raw materials to dispensing, to properly protect consumers everywhere.

To learn more about material authentication solutions, visit: www.xstreamsystems.net.

Fake Malaria Drugs Spread, Breed Resistance to Lethal Parasite

In an October 9th story written by Simeon Bennett which appeared on Bloomberg.com, fake malaria drugs from China are breeding resistance to life-saving medications in Cambodia and threatening to derail global efforts to eradicate the disease, a study funded by the Bill and Melinda Gates Foundation found.

The following are some interesting facts from Mr. Bennett’s story about the study:

• Among more than 700 packets of pills sold at private drugstores in Cambodia and Thailand, 60 percent were found to be substandard or counterfeit around the border, compared with less than 5 percent in other areas in Thailand. Previous studies have suggested about one-third of malaria drugs in western Cambodia are fake.


• Substandard treatments are contributing to growing resistance to genuine medicines in the area, he said. That threatens to unravel progress made against the disease in Africa, which has 90 percent of the world’s malaria cases, if the resistant strain spreads there, researchers have warned.


• The pills tested in the $350,000 Gates-funded study were mostly from China and touted to contain artesunate, part of a family of drugs called artemisinins that are the most potent weapons against malaria… the study completed last week found that some had no active ingredient, while others contained small amounts, which fuel resistance by favoring the survival of the hardiest parasites, he said.


• Treatments derived from artemisinin are taking almost twice as long to clear the parasites in patients in western Cambodia than in northwestern Thailand, showing the drugs are losing their potency against the disease, a study published in July in the New England Journal of Medicine showed.


• “This is a very, very large problem potentially for the whole world,” said Nick White, director of the Bangkok-based Mahidol Oxford Tropical Medicine Research Unit, which is studying drug-resistant malaria in the areas around the Thai- Cambodia border. “The scale and the speed of the response have been unfortunately too small,” he said.

The worldwide epidemic of counterfeit drugs continues to grow and impact the healthcare of people around the world.

XStream Systems’ revolutionary technology allows for those within the supply chain to screen and verify medications inside their unit-of-sale container without degrading or destroying the material. This type of verification is a vital solution to the proliferation of counterfeit, adulterated and fraudulent drugs and it impact to the healthcare of populations around the world.

To read the story, follow this link: www.bloomberg.com.

Weekend News Highlights International Epidemic of Counterfeit Medications

XStream Systems found an op-ed article in the New York Times regarding the health epidemic in the third world regarding poor quality and counterfeit medications and a story reported by Bloomberg News about the seizure of millions in counterfeit malaria, HIV and tuberculosis drugs in SE Asia.

The phenomenon of counterfeit, adulterated and contaminated pharmaceuticals continues to grow and flourish as our global economy declines.

Until technology solutions such as XStream’s XT250 become ubiquitous, this malady will continue to proliferate and impact those beyond the third world.

Op-ed: More needs to be done to ensure safety, quality of drugs in the developing world.

In an op-ed in the New York Times (11/15, A21), Roger Bate, author, director of the health advocacy group Africa Fighting Malaria, and resident fellow at the American Enterprise Institute, wrote that, "if aid organizations are serious about combating the spread of deadly diseases in the developing world, they must do more to ensure the safety and quality of drugs."

According to Bate, the importations of counterfeit medicines "are only part of the problem." Bate explained that in order "deal with the scarcity of drugs, many poor governments have turned to local production." Still, "local producers often make low-quality" medicines. "Many poor countries," he wrote, "lack the regulatory structure needed to monitor safety and effectiveness. Some do not even have laws against selling substandard drugs, and none have sophisticated agencies like the" Food and Drug Administration (FDA).

Bate concluded that aid organizations must first "give technical and financial support to governments' sincere efforts to maintain strict drug inspection standards." Second, they should "always refuse to subsidize any low-quality drugs." And finally, organizations need to "insist that only brand-name and generic products approved by stringent drug agencies like the FDA be distributed."


Interpol seizes more than $6.65 million of counterfeit medicines in Southeast Asia.

Bloomberg News (11/17, Bennett) reports, "Interpol seized more than $6.65 million of counterfeit medicines against malaria, HIV, and tuberculosis in Southeast Asia and made 27 arrests, disrupting the region's fake drug trade for the second time in three years."

According to Aline Plancon, an officer involved in the "five-month investigation called Operation Storm," officials "seized more than 16 million pills, including fake antibiotics for pneumonia and child-related illnesses." Operation Storm "involved almost 200 raids" conducted across "Cambodia, China, Laos, Myanmar, Singapore, Thailand, and Vietnam."

Health officials were particularly concerned by "copies of a class of malaria drugs called artemisinins." Fake "artemisinin-based treatments containing small amounts of the medicine are helping the parasite responsible for malaria to evade authentic drugs in patients near Cambodia's border with Thailand, a recent study showed."