A team of international researchers bought anti-malaria drugs from pharmacies in six cities in Africa's malaria belt, tested the products and despaired. More than a third of the alleged medicines flunked the field tests for clinical efficacy. And 48% of the drugs manufactured in Africa -- the best hope for affordable medicines for the poor -- failed the quality tests. The researchers couldn't determine whether the drugs were counterfeit, or old medicines that had been repackaged with new expiration dates, or legitimate pharmaceuticals that had lost some or all of their effectiveness through age or improper storage. What is now clear, however, is that large numbers of African malaria patients are being victimized by the widespread distribution of bogus or substandard medications. Equally horrifying, the sale of these inappropriate or ineffective drugs is virtually guaranteed to increase the prevalence of drug-resistant malaria, which in turn will make it even harder for Africa to eliminate the scourge.
The research, published by the American Enterprise Institute, should set off alarms around the world. In 1999, at least 30 people died in Cambodia as a result of taking counterfeit drugs to treat malaria, according to the Centers for Disease Control and Prevention. A recent follow-up survey in Asia found that 32% of malaria drugs there failed quality tests. Yet the World Health Organization reports that half of its member countries have weak regulations or none at all to prevent pharmaceutical counterfeiting. India and China have been found to be producers of counterfeit drugs, some of which make their way to Europe and the United States. The Internet has proved a boon for purveyors of fake medicines, and some counterfeits have also found their way into pharmacies here.