The latest issue of Pathogens and Global Health highlights the current debate surrounding the under-investigated, and politically sensitive, issue of counterfeit medicine. Issue 106.2 includes an interview with Dr Paul Newton, Head of the Laos arm of the Wellcome Trust's Major Overseas Programmes, and a number of articles highlighting the technological innovations and field initiatives that are challenging this threat to global health.
According to the World Health Organisation (WHO), 10% of prescription drugs sold worldwide are counterfeit; the packaging may be almost identical but the ingredients within the product are often absent or at lower dose than stated, or the product has been contaminated with other dangerous ingredients such as arsenic, heavy metals, pesticide, ink, and leaded paints.
In his interview, Dr Newton explains the important differences between substandard and falsified (or counterfeit) medicines, and how controversy over the definition of these terms is slowing down progress in combating them. These terms are important as accurate reporting enables an understanding of the epidemiology of medicine quality and guides interventions. After two years of debate a WHO Member State mechanism has been formed to try to tackle these issues.
Dr Newton states in his interview "Whether the new WHO Member State mechanism will be able to improve the current situation remains to be seen. It will need to take rapid action if the public health of vulnerable patients is to be protected."
He then goes on to comment on the consequences of falsified medicines being used in developing countries, including increased morbidity, increased health expenditure, and loss of confidence in health systems and pharmaceuticals. Additionally, anti-infective medicines containing inadequate amounts of the stated active ingredient will engender drug resistance. The WHO reports that 30% of countries have no drug regulation, or a capacity that hardly functions. Dr Newton states that more investment in Medicine Regulatory Authorities (MRAs) is required to reduce the number of errors occurring during the production of pharmaceutical products, and to allow essential medicines to be analysed within the poorer countries themselves.