Counterfeit drugs: a WMD for malaria

Malaria parasites in a mosquito midgut

This Sunday is World Malaria Day 2010. The disease remains one of the world’s biggest health burdens and a growing reason for this unwanted status is the rise of drug resistance. For example, last year researchers found that parasite strains in Cambodia are developing resistance to the current front-line treatment, therapies based on the drug artemisinin.

One of the contributing factors to drug resistance is the huge market in counterfeit medicines, particularly from Asia. These fake drugs are extremely dangerous.

Firstly, because there is no telling what is in the fakes, the ingredients could kill a patient through toxicity. Secondly, even those fakes containing a small amount of the real, active ingredient are a major problem because they could merely weaken rather than completely eliminate the malaria parasites in a person’s body. This can lead to selection for those strains that develop resistance against the active ingredient.

As well as putting the person taking the counterfeit medicine at risk, this means that those who are not on fake medicines could also become infected by the resistant strains. Consequently, the illicit trade in counterfeit medicines has the potential to impact on us all, and people in developing countries in particular where Malaria is endemic, not just the unfortunate users of the fakes.

The Wellcome Trust is a supporter of the campaign against counterfeit medicines. Last year, together with the American Pharmaceutical Group, we convened the first major conference on the issue, bringing together researchers, industry leaders and law enforcement officers from all over the world and you can learn more about the event here.

However, to help put the scale of the problem into perspective, some estimated statistics based on figures from WHO, Health International and other organisations were reported in an article last year by Andreas Seiter of the World Bank. These estimates are for a typical malaria endemic African country of 20 million people:

• Of the 4 million anti-malarial treatments used per year, about 800, 000 of them will be ineffective
• An estimated 0.5 days per average worker is needed to pay for these ineffective drugs which imposes an economic burden on the country of 3.2 million working days wasted
• Their use will lead to 4,000 child deaths.

Click to see Aline Plançon of INTERPOL talking about counterfeit medicines

Counterfeit anti-malarials are not the only fake drugs and the April issue of Nature Medicine features a series of articles that focus on the breadth and scale of this problem in relation to the other commonly counterfeited drugs.

The series includes an interview with Aline Plançon of INTERPOL and you can watch our own film of Aline speaking about her experience of tackling counterfeit medicines, along with films of Paul Newton, Head of the Laos arm of the Trust’s Major Overseas Programmes in South-east Asia, discussing his research, and Roger Bate from the American Enterprise Institute for Public Policy Research.

Image credit: Hilary Hurd and Wellcome Images