Poor quality of private sector antimalarials

Bate et al. tested antimalarial quality for several drugs in 6 countries across sub-Saharan Africa and found an alarming 35% were substandard as gauged by thin layer chromatography or dissolution tests. The authors did not attempt to assess whether counterfeit or not as the outcome would remain the same – i.e. the drugs are substandard and will fail to cure many cases.

In addition the widespread availability of artemisinin monotherapies, near 80% were manufactured after WHO’s intense efforts to convince manufacturers to end production, is particularly worrisome. In many of these areas the bulk of medicines are obtained through private sector channels. Thus, widespread substandard drugs (whether counterfeit or legitimate) will promote clinical failures. These treatment failures have grave implications for increased health burden and increased drug pressure selecting for parasite resistance.

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