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.

Voice of America Editorial: Warning! Counterfeit Medicines

In the November 18th online edition of Voice of America (VOANews.com), an editorial describing the issue of counterfeit medications in developing countries and USAID new program to combat this issue was posted. The complete editorial appears below:

"Substandard and counterfeit medicines represent a threat to public health worldwide but pose a particular problem in developing countries, where lack of financial, technical and other resources make it difficult to protect the drug supply chains," said United States Agency for International Development, or USAID, Acting Assistant Administrator for Global Health, Gloria Steele.

That is why USAID is launching a new program to combat this menace over the next five years. The USAID program will be conducted jointly with the U.S. Pharmacopeial Convention, or USP, a non-profit, non-governmental scientific organization that sets globally recognized standards for medicines and health care products.

The Promoting the Quality of Medicines, or PQM, Program, a $35 million cooperative agreement, will help improve the quality, safety and efficacy of medicines in countries around the world. These medicines are critical for the treatment of serious disease such as AIDS, tuberculosis, and malaria, and essential to USAID's priority health programs.

"Such medicines undermine decades of investments in public health," said USAID Acting Assistant Administrator Steele. "Without good quality, safe medicines to treat such diseases as malaria and tuberculosis, the impact of other health initiatives is severely weakened if not negated completely. The PQM Program focuses on this critical aspect of combating these diseases."

"The lives of patients are put in serious jeopardy when they take substandard or counterfeit drugs," said Dr. Roger L. William, chief executive officer of USP. He noted that these dangerous substances "contribute to the development of drug-resistant strains of infectious diseases. Such strains are a leading challenge in the fight against malaria, HIV/AIDs and tuberculosis."

Building on a 10-year USAID-USP partnership in this arena that assists health officials and others in 28 countries around the world, the program will increase efforts to address the significant public health challenge posed by substandard or counterfeit medicines.

Specifically, the program will help countries strengthen their medicines regulatory bodies; increase the supply of good-quality medicines; reduce the availability of counterfeit and substandard medicines; and conduct global advocacy to raise awareness of the dangers of substandard and counterfeit drugs.

The PQM Program builds on the work of USAID and USP over the past decade through a predecessor program, the Drug Quality and Information [DQI] Program. The new program will expand on these and other activities in Asia, Eastern Europe, Latin America, and sub-Saharan Africa. The United States is committed to working with its international partners to combat the growing global threat posed by counterfeit and substandard medicines.

XStream Systems endorses USAID’s efforts and recommends the use of technology such as material screening as an efficient and robust solution to this issue.

To view the editorial online visit: www.voanews.com/uspolicy/2009-11-17-voa1.cfm.
To learn more about XStream Systems, visit our website at http://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.

Keeping It Real Report reveals 700,000 Die Each Year from Counterfeit Drugs

Do you think that the counterfeit drugs issue is a small issue? Think again! In poorer countries they can account for as much as half of the supply chain and they claim an estimated 700,000 lives a year. In addition, their very use can undermine the effectiveness of the legitimate drug, thus adding research time and dollars to its list of victims.

A report issued this month from the International policy network gives a good overview of the problem of counterfeits in poorer nations. Below is a some highlights of an article by Franklin Cudjoe from IMANI Health on the report:

Counterfeit drugs kill over 700,000 people every year - new report

A new report from the International Policy Network and sponsored by IMANI Center for Policy & Education details the shocking burden of fake drugs in less developed countries. Fake tuberculosis and malaria drugs alone are estimated to kill 700,000 people a year. That's equivalent to four fully laden jumbo jets crashing every day.

The report lays bare the ballooning problem of counterfeit and substandard drugs, which can constitute one third of the drug supply in certain African countries. These dodgy drugs result in unnecessary death and increased levels of drug resistance.

The report highlights more shocking evidence, such as:

• Nearly half the drugs sold in Ghana, Nigeria, Angola, Burundi, and the Congo are substandard

• About two thirds of artesunate (anti-malaria) drugs in Laos, Myanmar Cambodia and Vietnam contain insufficient active ingredient.

The entire article can be viewed at: www.modernghana.com

May 2009 report can be viewed at: www.africanliberty.org.

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."

Largest European Seizure: Two Million Counterfeit Pills Seized in Brussels Airport

Two million counterfeit pills have been seized in Brussels Airport. The seizure of the drugs which originated in Mumbai, Indian and were bound for West Africa is the largest confiscation of counterfeit medicine in Europe.

The three Indian shipments contained counterfeit pharmaceuticals labeled as Tramal, a painkiller, and Fansidar, an anti-malaria drug.

Africa already has the daunting task of trying to control its malaria outbreaks without further obstacles of fake treatments. Many countries, organizations, and businesses have been aiding Africa to fight malaria and therefore, counterfeit medicine is a real threat to their work. In some countries up to 60% of anti-malaria drugs are fake and are aiding in the drugs resistance to current therapies.

Furthermore, the biggest victims are the children, because according to the Worlds Health Organization (WHO) a majority of malaria deaths are children under the age of five and Fasidar is one of the drugs given to pregnant women for the prevention of malaria.

The scope and intent of this particular case leads us to ask – Is any medication safe? How can we protect our most vulnerable medications? We believe the answer can be found in pharmaceutical authentication which verifies the drug itself. With nothing added and nothing destroyed; the method can be programmed to test various oral medications.

To learn more of this fascinating technology, see XStream Systems website at http://www.xstreamsystems.net/products.html.

WHO Combats Malaria

The World Health Organization has declared tomorrow, April 25, 2008 as World Malaria Day.

A day dedicated to education and understanding this dreaded disease. Malaria is preventable and curable with the right medication. Sadly however, the most common medications are also highly counterfeited, with a rate as high as 85% in some countries, such as Nigeria. Patients are left with what was to be their hope now becoming their downfall.

Even more tragic, those most vulnerable to the disease are young children and pregnant mothers. More than a million die each year.

WHO has declared war and has vowed to eliminate Malaria. Please take a moment to reflect on their accomplishments in this humanitarian effort.