From the archive, originally posted by: [ spectre ]


“This is the untold story of how the global racket in fake drugs turned an easily curable disease into Africa’s biggest child killer. According to leading scientists, millions of children could have been saved if the pharmaceutical industry and World Health Organisation had collaborated to address the problem. Now, signs are emerging that malaria is developing resistance to the one effective drug which can still treat it. It’s a development which threatens patients all over the world. But – after decades of silence – has the WHO left it too late to act?

“The fake drugs racket is one of the greatest atrocities of our times. It is mass murder”, states Dr Dora Akunyili, director of Nigeria’s food and drug’s regulatory body. Thirty years ago, malaria was no more dangerous than a dose of the flu. “It was when the fake drugs racket broke out that people started dying like rats”, states Dr Akunyili. Even Prof Nick White, one of the world’s top malaria scientists admits: “fifty years ago, malaria was in retreat. Now, it is getting worse.” Many believe that fake and substandard drugs are the main cause of the devastating resurgence in malaria. In the hours lost giving a child a useless fake, malaria turns into a killer. “Getting the treatment right in the first instance is crucial”, explains Dr Meremikwu, who runs the children’s emergency unit. “You don’t have time to wait.”

The worst type of fakes are those which contain a small portion of active ingredient. “Counterfeit drugs with little active ingredient drive drug resistance”, explains Prof White. “Everyone in the malaria field accepts they’re a major threat.” There is now only one effective drug which treats malaria. “If we lose this drug to resistance, it will be an absolute disaster,” starts White. “All our modern treatments depend on it.” But despite this, the WHO has yet to acknowledge the link between fake drugs and malaria resistance.”

Drug giants accused of ignoring fake medicines that kill millions
by Saeed Shah  /  13 April 2007

The world’s major drug companies have been accused of turning a blind
eye to the multibillion-dollar trade in fake medicine that has
resulted in an explosion of child malaria deaths in developing

Governments have not tackled the problem and pharmaceutical companies
are burying the issue, afraid that any publicity given to their
medicines being faked will lead to a fall in the sale of the genuine
product, according to a documentary.

The problem has been particularly acute with the treatment of malaria
in Africa, with anti-malaria drugs faked on an industrial scale.
Professor Nick White, of Oxford University, one of the world’s leading
experts on malaria, said: “We estimate that there are more than one
million deaths each year – which is the equivalent of seven jumbo jets
going down every day. And 90 per cent of those deaths are in

Professor White said that counterfeit medicine was a major reason why
malaria had become, over the past 30 years, Africa’s biggest child
killer, from an illness that used to be easily treated with medicines.

Some of the fake drugs contain no medicine at all, but others have
tiny traces of the real ingredients – which leads to another,
potentially bigger problem: it allows the malaria parasite to build up
resistance to the drug.

Nigeria’s campaigning drugs regulator, Dora Akunyili, described
counterfeiting as “mass murder”. She told the documentary, which will
be aired today on The Business Channel, a satellite station: “The fake
drug racket and the silence associated with it have led to the
resurgence of malaria… The companies kept quiet. The regulators were
paid off and everybody was helpless. Drug counterfeiters operated in
this country and in most developing countries for almost three
decades, unchallenged.”

There is now just one family of drugs left that malaria has not built
up resistance to, Artemisinins – which are also being faked. Professor
White said: “Resistance to the Artemisinins would be an absolute
catastrophe for our current attempts to try to control malaria.”

It is estimated that the global fake drug racket is worth $40bn
(£20bn) a year, and between 50 and 90 per cent of medicine in some
African and Asian countries is counterfeit. Graham Satchwell, the
former head of security at GlaxoSmithKline, the British-based global
pharmaceutical giant, told The Independent: “Each therapy area is
highly competitive, so if one person’s drug is undermined, their
market share will suffer. It takes a brave company to say they have a

Mr Satchwell said that the “majority of the industry are sitting on
their hands”, rather than tackling the problem – for instance through
radio tracking of their products. He also pointed out that the figures
from the industry’s own organisation, the Pharmaceutical Security
Institute, showed many cases of counterfeiting in the US, but hardly
any in China or Africa – despite firm evidence from other sources that
tens of thousands die each year in China and Africa as a result of
fake medicines each year.

Dr Akunyili said: “If the companies had risen up to their
responsibilities early enough, the issue of the preponderance of fake
drugs would not have gotten to the level it got in Nigeria. It is this
silence that is actually largely encouraging drug counterfeiting”

Dr Martin Meremikwu, of Calabar University Hospital, in southern
Nigeria, said that he had seen child malaria deaths soar. He said
that, by the time children who had been treated with fake drugs got to
the hospitals, it was often too late to save them.

“Malaria should not kill people. It’s a curable disease. But if the
patient uses the wrong drug – either because they are fake or they are
ineffective because of higher resistance – then they are lying here
with complications.

“And in children, young children, the time between a mild disease and
a severe disease can be as little as eight hours, or 24 hours or 12
hours. So time is of the huge essence here. You really cannot afford
to try some other drug before trying a good one. You can’t. Because
you don’t have that time.”

The drugs don’t work

* Counterfeit medicines are swamping unregulated markets in developing
nations with unknown and sometimes fatal results. Not only are
thousands dying needlessly, but patients are also becoming immune to
the effects of the real thing. Counterfeit drugs occasionally contain
small doses of the active ingredient – enough to induce resistance

* The UN World Health Organisation estimates the incidence of
counterfeit medicines is about 10 per cent in developing countries,
with prevalence higher where regulatory control is weakest. But in
many parts of Africa, according to the WHO, as well as in some
countries in Latin America and South Asia, prevalence sits at around
30 per cent. The patients hit are the sickest and the poorest.

* WHO estimates that 200,000 of the one million malaria deaths every
year would be prevented if all the drugs taken were genuine. The
popularity of combination malaria drugs – which are more expensive
than other treatments – has seen counterfeit peddlers cash in on the
opportunity to boost sales. In Cambodia, Tanzania and Cameroon, up to
90 per cent of such drugs on sale in local markets are believed to
contain nothing but chalk or maize flour.

* As recently as 2001, about 68 per cent of medicines in circulation
in Nigeria were unregistered, and as much as 41 per cent were believed
to be fake.

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