Fake anti-malarials: start with the facts.

Area of Science:

• Global Health
• Pharmaceutical Sciences
• Medicinal Chemistry

Background:

• Antimalarial drug quality is a significant public health concern, particularly in malaria-endemic regions.
• The Artemisinin Combination Therapy (ACT) Consortium's drug quality programme investigated the prevalence of substandard and falsified antimalarials.
• Previous efforts by the World Health Organization (WHO) to curb the sale of oral monotherapies have had limited success.

Purpose of the Study:

• To disseminate the findings of the ACT Consortium's drug quality programme.
• To discuss the public health impact of falsified and substandard antimalarial drugs.
• To review strategies for improving drug quality surveillance and health system capacity.

Main Methods:

• Purchased over 10,000 antimalarial samples using representative sampling in six malaria-endemic countries.
• Conducted laboratory analyses to assess the quality of purchased antimalarial samples.
• Reviewed data on the prevalence of falsified and substandard antimalarials and monotherapies.

Main Results:

• Substandard artemisinin-based combinations were detected in all six countries studied.
• Falsified antimalarials were identified in two of the six countries (<8% prevalence).
• Antimalarial monotherapy tablets were still found to be available in some regions.

Conclusions:

• Substandard antimalarials pose a widespread threat to malaria treatment efficacy across multiple countries.
• The continued availability of falsified and substandard antimalarials necessitates strengthened regulatory and surveillance systems.
• Addressing the challenge requires a multi-faceted approach involving quality control, health system strengthening, and regulatory action.