A potential one in ten medications circulating in India could be fake, claims a recent news release by the World Health Organization (WHO).
The report states that, in low and low to middle income countries (L-LMICs), there is an abundance of medications that are either deemed to be substandard — containing far less of the active ingredients than is noted on the packaging — or fake. Most common amongst these are antibiotics and antimalarials.
Investigations by the University of Edinburgh estimate that 72,000 to 169,000 children may be dying each year from pneumonia due to substandard and falsified antibiotics. A second study conducted by the London School of Hygiene and Tropical Medicine estimates 116,000 additional deaths from malaria could be caused every year by substandard and falsified antimalarials in sub-Saharan Africa.
The medicines will either be only partially effective or, if the medication is a fraud, completely ineffective. The WHO believes that, depending on the chemicals used as a substitute in the fake medicines, the fake substanced could have even contributed to a number of deaths.
Many individuals may have been paying often large sums of money for medicines that are having no impact. This also translates to a national level, where government-subsidised or freely provided medicines are purchased despite being ineffective.
In India — where out of pocket expenditure accounts for two thirds of healthcare spending — this implies that many people, often from poor economic backgrounds have placed themselves further into poverty to no avail, receiving a medication that not only has no benefit, but may even be potentially dangerous.
WHO Director-General Dr Tedros Adhanom Ghebreyesus acknowledges this potential, saying that “Substandard and falsified medicines particularly affect the most vulnerable communities…Imagine a mother who gives up food or other basic needs to pay for her child’s treatment, unaware that the medicines are substandard or falsified, and then that treatment causes her child to die.”
The figure of 10 percent may be a conservative estimate. Prior to 2013 there was no global scheme in place to monitor substandard and fake medications. As a result, there is no means of accurately assessing how long this kind of malpractice has taken place. Therefore the overall impact that fake medicines have had could stretch back for decades, and potentially claimed many lives.
The evidence is drawn from 100 published research papers across 88 low to middle income countries that assess the prevalence of fake and substandard medicines. The WHO news release notes that this is just a sample of what could potentially be a more far reaching problem, citing the need for more research into the matter.