WHO steps up action against substandard and counterfeit medicines

The World Health Organization (WHO) has launched an action plan against substandard and counterfeit medicines with six countries from the Greater Mekong sub-region.

Counterfeit and substandard medicines - particularly antibiotics and drugs used in the treatment of tuberculosis, malaria and HIV/AIDS - are frequently detected in Cambodia, China, the Lao People's Democratic Republic, Myanmar, Thailand and Viet Nam and the problem seems to be increasing, the WHO claims.

Substandard medicines are thought to account for 8.5% of medicines on the market in Thailand, while 8% of randomly collected samples in Viet Nam and 16% in Myanmar failed laboratory testing for quality assessment. From these batches, TB drug rifampicin showed the highest failure rate at 26% followed by the antibiotic cotrimoxazole at 24%. In 2001 it was esti-mated there were 2,800 illegal medicine sellers in Cambodia and 1,000 unregistered medicines on the market. In the Lao People's Democratic Republic 2,100 illegal drug sellers are said to exist.

The six countries will undertake joint activities to combat counterfeiting of medicines in the region, to promote advocacy activities directed at key decision-makers, health professionals and the general public and to strengthen inspection and post-marketing surveillance. 'Combating low quality or illegal medicines is now more important than ever,' said Dr Lee Jong-wook, WHO director-general. ' Expanding access to safe, effective treatment for AIDS and other illnesses is no longer an option, it is an imperative.'

The plan follows similar initiatives begun in Africa, where a recent WHO survey of the quality of antimalarials in seven African countries revealed that between 20% and 90% of the products failed quality testing. The reason why many of the antimalarials tested were substandard stems from pervasive pov-erty, the WHO suggests. Poorly equipped laboratories, under-funded regulatory authorities, poor handling and manufacturing practices mostly contributed to the results of the tests.

'Many tools exist to improve quality control and supply systems,' explains Dr Vladimir Lepakhin, head of health technology and pharmaceuticals at WHO. 'The problem is one of resources. Most of the countries with the lowest quality pharmaceuticals are also the ones with the highest disease burden and the poorest economies.'