Increasing prevalence of counterfeit malaria drugs
53 percent of the antimalarial artesunate drugs sold in Southeast Asia in 2004 contained no active ingredient at all, according to researchers led by Paul Newton and Nicholas White of the University of Oxford. For example, the scientists were able to use their analyzes to clarify the death of a 23-year-old in Myanmar who had died of an acute attack of malaria, although he had been given an otherwise highly effective artesunate drug: the tablets were obviously counterfeit imitations with only a fifth of the normal amount of active substance [1]. It is therefore at least negligent homicide, if not murder, according to the authors.
Researchers fear that counterfeit medicines will increasingly claim lives in Africa, where combination therapy with artesunates is one of the few remaining treatment alternatives. Since the demand for the very expensive preparations is high, there is a huge market for counterfeiters. It is therefore urgently necessary to reduce costs through state subsidies and thus minimize the incentive for counterfeiting. Ineffective knockoffs have already been spotted in Cameroon and Tanzania.
In order to fool doctors and scientists, the pills often contain not only small amounts of active ingredient, but also antibiotics or fever reducers to simulate the desired effect, the researchers continue to report. This makes it particularly difficult to uncover the dangerous imitations.
Newton and his colleagues also warn that the spread of counterfeit medicines can lead to increased resistance: due to the lower active ingredient content, not all pathogens are killed, and resistant forms develop that can no longer be treated.
Meanwhile, co-author Facundo Fernandez and his colleagues at the Georgia Institute of Technology have succeeded in optimizing detection methods for counterfeit drugs [2]. With the help of a charged water-alcohol-alkylamine mixture or helium atoms, they ionize the surfaces of the samples and analyze the components released as a result for their active ingredient content. They are now working on linking the apparatus to an ion mobility spectrometer instead of a mass spectrometer, which is used, for example, in airports to search for explosives. In this way, the previously very time-consuming verification could be carried out on site within seconds.
