WATCH OUT! One in 10 malaria drugs are substandard —Study

Stakeholders in the health sector have been told to worry more about substandard drugs than counterfeits. This is the outcome of a new study by a team of researchers from the University of Nigeria, Enugu; and the London School of Hygiene and Tropical Medicine.

According to the study, which analysed more than 3,000 anti-malarial drugs purchased in Enugu, Enugu State, there are more substandard medicines in Nigeria than fakes.

With 48 million cases and 180,000 deaths per year, the World Health Organisation estimates that Nigeria is the single most heavily malaria-burdened country in the world.

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The researchers discovered that substandard or degraded drugs were more prevalent than falsified ones in Enugu. Poor quality drugs were also reportedly found in patent medicine stores and not in pharmacies.

A drug quality team of the Artemisinin-based Combination Therapy Consortium analysed 3,024 anti-malarials containing artemisinin, the component that makes malaria treatment effective.

While researchers found 1.2 per cent of the samples to be falsified and 1.3 per cent to be degraded, they insisted that what should raise bigger concerns is the 6.8 per cent substandard products which leave patients at risk of not receiving the correct treatment dose and potentially contributing to the development of resistance to the main drug used to treat malaria.

According to the Lead Investigator, Dr. Harparkash Kaur, “Although these results raise concerns, they are reassuring in comparison with previous reports that found that more than 35 per cent of antimalarials in sub-Saharan Africa failed chemical content analysis – in other words, were poor quality. This may be because those reports predominantly used a “convenience” approach to select samples for analysis, which may not be representative of the places where patients buy their medicines.”

The report of the study, published in Public Library of Science, a scientific journal, said samples were analysed in three independent laboratories in the United Kingdom and United States of America and classified as acceptable quality, falsified (fake drugs which do not contain the stated active pharmaceutical ingredient or API), substandard (which contain inadequate amounts of the active ingredients), or degraded (decomposition of the API by poor storage conditions, such as heat and humidity).

Falsified samples contained chemicals other than the stated API, such as chlorzoxazone (a muscle relaxant), ciprofloxacin (an antibiotic) or acetaminophen (a commonly used painkiller).

Speaking on the study, study co-author, Prof. Obinna Onwujekwe from the University of Nigeria, Enugu charged stakeholders in the health sector to be more vigilant.

“The results show that the health system actors should be eternally vigilant in Nigeria and in other countries to ensure that sub-standard drugs do not impede or erode gains made in malaria treatment. Drug regulatory authorities and their partners should intensify drug quality monitoring activities with appropriate sanctions for defaulters,” she said.

-Punch

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