Criminals threaten malaria fight

Hopes of controlling malaria in Africa could be wrecked by criminals circulating counterfeit and sub-standard drugs, threatening millions of lives, scientists warn.

They are calling for public health authorities to take urgent action to preserve the efficacy of the anti-malarials now being used in the worst-hit areas of the continent.

There has been growing hope of putting an end to malaria, with the United Nations and donor countries having contributed to a massive effort to get modern technological tools to endemic areas, including insecticide-impregnated bed nets and new drugs derived from artemisinin plants. But large parts of Africa are threatened by the distribution of fake and poor quality anti-malarials made illicitly in China.

Malaria kills nearly a million people each year, mainly young children and pregnant women. It is caused by parasites injected into the bloodstream by mosquitoes.

Some of the fake drugs contain artemisinin, but not enough to kill all the parasites in a child’s body.
Not only will the child struggle to recover, the parasites that survive may become resistant to the drug and spread a form of the disease that artemisinin combination therapy will no longer cure.

In a study in the Malaria Journal, Dr Paul Newton from the Wellcome Trust-Mahosot Hospital-Oxford University Tropical Medicine Research Collaboration in Laos and a team of colleagues report on the make-up of some of the fake anti-malarials on sale in Africa, as well as some that are equally useless and dangerous because they are of poor quality. They looked at samples of suspect drugs from 11 countries collected between 2002 and 2010.

Analysis showed some counterfeits contained a mixture of the wrong active pharmaceutical ingredients, some of which may initially alleviate malaria symptoms, but will not cure malaria.

Worse still, these unexpected ingredients could cause potentially serious side effects, particularly if they interact with other medication people are taking, such as antiretroviral therapies for HIV.—

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