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Are we doing enough to prevent poorquality antimalarial medicines in the developing world?

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Walker, EJ, Peterson, GM ORCID: 0000-0002-6764-3882, Grech, J, Paragalli, E and Thomas, J 2018 , 'Are we doing enough to prevent poorquality antimalarial medicines in the developing world?' , BMC Public Health, vol. 18, no. 1 , pp. 1-6 , doi: 10.1186/s12889-018-5521-7.

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Abstract

Background: Malaria is a deadly parasitic disease that affects more than 3 billion people worldwide, in predominantlyresource-poor countries. Despite malaria being preventable and treatable, a large number of adults and children,mostly in Africa, die from this disease each year. One contributor to needless morbidity and mortality is the productionand distribution of poor-quality antimalarial medicines; indeed, it is estimated that over 122,000 deaths of childrenunder 5 years of age in sub-Saharan countries were caused by poor-quality antimalarial medicines, in 2013 alone.Discussion: Poor-quality medicines include those that are deliberately falsified for monetary gain and may containincorrect amounts or even no active ingredients at all, as well as products that are inadequate due to poor complianceto conventional quality standards and medicines that have degraded over time. Across a number of studies it has beenreported that 4-92% of antimalarials tested are poor quality. This represents a massive risk to the population subjectedto the use of these medicines, in the form of more severe and prolonged illness, additional costs to individuals whoalready have very little money, and lack of confidence in treatments. The continuing circulation of poor-qualitymedicines results from a number of factors, including insufficient regulatory capacity in susceptible countries,inadequate funding to perform regulatory functions, poor coordination between regulatory authorities, andinefficient import/export control systems.To combat the distribution of poor-quality medicines a number of organisations have developed guidelines for theprocurement of antimalarials, and programs to educate consumers about the risks of poor-quality medicines andincentivise retailers to identify and report falsified medicines. The development of new technologies to quickly identifypoor-quality medicines in the field is also essential, and some significant advances have been made.Conclusion: There has been considerable improvement in the delivery of high-quality antimalarials to those who needthem; however, there is still an urgent need for a collective response by the international community, political leaders,regulatory bodies, and pharmaceutical companies. This should include political commitment for enhanced researchand development funding, such as for new innovative track-and-trace field devices, and international efforts tostrengthen and harmonise drug regulation practices.

Item Type: Article
Authors/Creators:Walker, EJ and Peterson, GM and Grech, J and Paragalli, E and Thomas, J
Keywords: antimalarial, counterfeit, malaria, poor-quality, substandard, drugs
Journal or Publication Title: BMC Public Health
Publisher: Biomed Central Ltd
ISSN: 1471-2458
DOI / ID Number: 10.1186/s12889-018-5521-7
Copyright Information:

Copyright 2018 The Authors. Licensed under Creative Commons Attribution 4.0 International (CC BY 4.0) https://creativecommons.org/licenses/by/4.0/

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