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Fake Malaria Drugs Could 'Put Millions At Risk   
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An international research has shown that Ghana together with 10 other African countries risk putting the lives of millions of its people in danger due to the influx of fake malarial drugs on the market.

The research showed that fake and poor quality anti-malarial drugs were threatening efforts to control the disease in Tanzania, Liberia, Sierra Leone, Nigeria, Kenya, Cameroon and other countries including China.

Undertaken by the Wellcome Trust-Mahosot Hospital in collaboration with the Oxford University Tropical Medicine Research, the research showed that counterfeit medicines could harm patients and promote drug resistance among malaria parasites.

According to the World Health Organisation (WHO), around 655,000 people died from malaria in 2010, with over 90 per cent of the deaths occurring in Africa with almost nine out of 10 malaria victims in 2010 being children under five.

Plasmodium falciparum malaria remains a major public health problem and according to the WHO, a vital component of malaria control rested on the availability of good quality artemisinin derivative-based combination therapy (ACT) at the correct dose. However, there were increasing reports of poor quality anti-malarial drugs in Africa.

The research, which was conducted between 2002 and 2010, showed that some of the fake tablets originated from China when seven collections of artemisinin derivative monotherapies, ACT and halofantrine antimalarials of suspicious quality were collected
in 11 African countries and in Asia en route to Africa.

According to the lead researcher, Dr Paul Newton, failure to take action will put at risk the lives of millions of people, particularly children and pregnant women, as malaria is believed to kill about 800,000 people a year.

In Ghana, the research found that the Food and Drugs Board (FDB), in 2009, via INTERPOL, found that two packets of Coartem stated to be co-formulated artemether-lumefantrine with eight tablets/blister and manufactured by Beijing Novartis Pharma Ltd upon testing contained no detectable artemether or lumefantrine.

Also another ACT sampled in Ghana, which was expected to contain Artesunate+amodiaquine, and analysed was found to contain less than the reference range for artesunate and amodiaquine and might be counterfeit, substandard or degraded.

The research discovered that some counterfeits contained a mixture of the wrong pharmaceutical ingredients which would initially alleviate the symptoms of malaria but would not cure it.

The study found that some of the ingredients in the tablets could cause potentially serious side effects, especially if they were mixed with other drugs a patient might be taking, like anti-retrovirals to treat HIV.

According to the research, the malaria parasite can, after a period of time, develop resistance to the drugs being used to treat it as it happened in the past with medicines such as chloroquine, which therefore necessitated the change to using monotherapies such as the ACTs.

The researchers warn that the fake drugs could make artemisinin, one of the most effective drugs now being used to treat malaria, ineffective as small quantities of artemisinin derivatives are being put in some of the counterfeit products to ensure that they pass authenticity tests.

The research warns that although these drugs are unlikely to rid the body of malaria parasites, they could enable them to build up resistance to artemisinin and the lead researcher, Dr Newton, has called for urgent measures from African governments to tackle counterfeit anti-malarial drugs, saying, "The enormous investment in the development, evaluation and deployment of anti-malarials is wasted if the medicines that patients actually take are, due to criminality or carelessness, of poor quality and do not cure."

Speaking to the National Co-ordinator of the Affordable Medicine Facility for malaria (AMFm), Ms Vivian Aubyn, she said Ghana had put in place measures to ensure that fake ACTs were not imported into the country.

According to her, the AMFm, which is being sponsored by the Global Fund, has helped reduce the cost of quality ACTs on the market thereby making it affordable for all.

Also, she said together with the National Malaria Control Programme (NMCP), the Ministry of Health (MoH) and the Food and Drugs Board (FDB), various programmes had been evolved which aimed at checking importation of ACTs into the country and ensuring the genuineness of ACTs on the market through continuous surveillance.

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