UN joins with Asian countries to combat substandard, counterfeit medicines

In a bid to combat an apparent rise in substandard and counterfeit medicines such as antibiotics and treatments for tuberculosis, malaria and HIV/AIDS, the United Nations World Health Organization (WHO) is this week launching an action plan in conjunction with six countries from the Greater Mekong sub-region in Asia.

"Combating low quality or illegal medicines is now more important than ever,” WHO Director-General Lee Jong-wook says of the plan being launched at a meeting from 11-13 November in Hanoi, Viet Nam. “Expanding access to safe, effective treatment for AIDS and other illnesses is no longer an option, it is an imperative."

Counterfeit and substandard medicines are frequently detected in Cambodia, China, Laos, Myanmar, Thailand and Viet Nam, and the problem seems to be increasing, WHO said in a news release. The plan follows similar initiatives begun in Africa and will continue to expand in response to countries' increasing calls for assistance to improve the quality of their medicines.

Measures planned include the promotion of advocacy activities directed at key decision-makers, health professionals and the general public and the strengthening of inspection and post-marketing surveillance.

Substandard medicines are thought to account for 8.5 per cent of medicines on the market in Thailand. Eight per cent of randomly collected samples in Viet Nam and 16 per cent in Myanmar failed laboratory testing for quality assessment. From these batches, Rifampicin, used to treat tuberculosis, showed the highest failure rate at 26 per cent followed by Cotrimoxazole, an antibiotic used mostly for children, at 24 per cent.

With more complex combination medicines now being recommended for drug-resistant malaria, there is a strong possibility that more substandard and counterfeit medicines will enter the market in malaria-endemic countries, WHO said. Even in terms of older, more traditional antimalarials, the quality of the medicines is often poor.

A recent WHO survey of antimalarials in seven African countries revealed that between 20 and 90 per cent of products failed quality testing. The medicines were a mixture of locally produced and imported products. Samples were submitted by Gabon, Ghana, Kenya, Mali, Mozambique, Sudan, and Zimbabwe. The reason why many tested substandard seems to stem from pervasive poverty. Poorly equipped laboratories, under-funded regulatory authorities, poor handling and manufacturing practices mostly contributed to the results of the tests.