Reuters has reported on a unique collaboration between police and scientists to stem the tide of fake antimalarial drugs, particularly artemisinin based medicines in southeast Asia. Details of the investigative process form the basis of an article in PLoS Medicine.
The problem has been know for ten years. Reuters commented that, “An investigation coordinated by Interpol, with input from international researchers, found as many as half of the malaria tablets sampled in Vietnam, Cambodia, Laos, Myanmar and on the Thai/Myanmar border were counterfeit.” This is a huge concern, in part because some tablets contained no active ingredients, older antimalarials, or inappropriate drugs and would therefore not provide a cure and also because some contained less than the required amount of active ingredients and would therefore contribute toward aretemisinin resistance, threatening the main drug used around the world to save lives.
Sophisticated scientific techniques for tracing the culprits even ranged to analysis of pollen found in the blister packs. A variety of holographic logos were also found. Specialists were able to spot many fakes simply by examining the packets, the one doubts that the average consumer would be so skilled.
The WHO prequalification process and bulk ordering through GFATM may help some countries avoid fakes, but this does not guarantee safety in the private sector. It also points out the need for speedier efforts to add more antimalarial drugs to the prequalification list. Finally, capacity building is also needed for Food and Drug Agencies in malaria endemic countries to enable timely detection of fakes before they reach clinics and stores.