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  • Promoting Quality Malaria Medications

Promoting Quality Malaria Medications

The malaria community has made great strides in reducing morbidity and mortality in recent years – with World Health Organization reports noting that there has been a 37% global decrease in malaria incidence and a 60% global decrease in malaria deaths between 2000 and 2015.

Improvements in malaria case management – including prompt care-seeking, testing and treating – have contributed to these declines, with health promotion campaigns helping to increase knowledge, attitudes, and behaviors around testing before treating, demanding artemisinin-combination therapy as the first line treatment, and taking the full dose of treatment. However, many still die from malaria. 

Unfortunately, the widespread presence of substandard, spurious, falsified, falsely-labeled, and counterfeit – or SSFFC – malaria medicines threatens this progress. The presence of poor quality medicine not only causes undue harm because it cannot effectively treat malaria, but it also negatively influences consumer behavior, wastes individual and national financial resources, and contributes to artemisinin resistance.

The CDC states that counterfeit (fake) and substandard antimalarial drugs may contain no active ingredients, less than the required amount of active ingredients, or ingredients not described on the package label. Manufacturers of counterfeit drugs tend to copy more expensive brands of drugs and make them look like brand-name drugs. They may also repackage expired products and substitute a later expiration date, or they may package another drug or alternative substance as if it were an active product. Substandard drugs are made by manufacturers trying to avoid costly quality control and good manufacturing practices; these can result from deliberate or unintended lapses in the manufacturing process. These medicines may have too little or too much of the active ingredients and may not be absorbed properly by the body. If they are taken to treat an illness like malaria, they may be incompletely effective or altogether useless. A counterfeit or substandard treatment can prolong illness and increase the risk of severe disease or death. If substandard medicines are widely used, they can also select for drug-resistant parasites.

One of the biggest challenges is the scale of the problem, as it could have serious implications on morbidity and mortality. To give some idea of the range of the problem, it is interesting to note that in June, 2015, Interpol coordinated a crackdown on counterfeit drug merchants during which 20.7 million fake drugs were seized. The British think-tank, International Policy Network, estimates that globally, 700,000 deaths a year are caused by fake malaria and tuberculosis drugs. Most importantly, experts estimate that poor quality malaria medicines may be associated with 122,350 deaths of children under 5 years old in sub-Saharan Africa (according to a study of 2013 data in 39 countries).

While there are a number of stakeholders working on these issues – ranging from regulation, medicine quality assurance and surveillance, and law enforcement – there have been few strategically-designed and evaluated programs that use social and behavior change communication (SBCC) to improve demand for quality malaria medicines and and influence behaviors around medicine buying, selling, and use.

Since no country is left unsusceptible to this problem, it is critical that SBCC practitioners come together with these nontraditional partners to intensify efforts to inform medical professionals, regulators, and the general public about the danger of purchasing SSFFC malaria medication for themselves and their families, and the steps that they can take to protect themselves. The malaria community has come a long way – health practitioners must be thoughtful in the way that they discuss SSFFC malaria medicine, so as not to create alter healthcare-seeking behaviors by creating distrust of the effective medicine. 

This Trending Topic offers some tools and examples to help support program managers and local stakeholders develop effective SBCC strategies that contribute to this effort.

 

Resources

  • Tools
  • Examples

Substandard, Spurious, Falsely labelled, Falsified and Counterfeit (SSFFC) Medical Products

This fact sheet contains:

View Resource

T3: Test. Treat. Track Initiative

The WHO Global Malaria Programme’s T3: Test. Treat. Track.

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Fake Medicines and Malaria

This infographic highlights some key facts about the global prevalence and impact of poor quality medicines, and also features case studies and recommendations for relevant stakeholders. It includes facts, case studies, and recommendations.

View Resource

All You Need to Know about Spurious Medicines in India: A Guidebook

The International Pharmaceutical Federation (FIP), in cooperation with the Indian Pharmaceutical Association, has developed a handbook for healthcare professionals entitled “All you need to know about spurious medicines”, which contains tips on preventing and detecting counterfeit medicines as well as advice on how to minimise the threat and cha

View Resource

Fake Medicines: Training for Action E-Learning Course

This is an open access e-learning platform to illustrate the problem of fake medicines and how this crime is being addressed globally.

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Be Aware: Helping to Fight Counterfeit Medicines, Keeping Patients Safer

This toolkit is designed  to assist dentists, nurses, pharmacists and physicians to tackle counterfeit medicines in their daily practice.

The kit includes:

View Resource

Counterfeit Medicines in Legitimate Supply Chains

This infographic provides background information about the geographic extent of the problem of counterfeit medicines in legitimate supply chains. 

View Resource

SSFFC – Frequently Asked Questions – Advice to Patients and Consumers

This website helps consumers with information about substandard, spurious, falsely labelled, falsified and counterfeit (SSFFC) medications:

View Resource

Selection of Safe and Effective Antimalarial Medicines

This webpage provides links to the two documents that antimalarial medicine procurement should be based on: the WHO guidelines for treatment of malaria and the WHO model list of essential medicines.

It also contains more information on the WHO Prequalification Program, as well as recommended procurement practices.

View Resource

12 Golden Rules to Avoid Fake Medicines Online

This brochure answers the following questions:

  • Is it legal to buy medicines online in my country?
  • Is there a label that authenticates legitimate online pharmacies?
  • When buying medicines on the internet, can I speak with a pharmacist?
View Resource

5 Myths about Fake Medicines

This infographic responds to the following myths:

  • Only branded medicines can be counterfeit
  • Only lifesstyle pills are faked
  • Worst comes to worse, the pills just won't work
  • There are good quality faked medicines
  • Fake medicines are easy to spot
View Resource

Sproxil Defender - SMS-based Counterfeit Drug Detector

Sproxil Defender, a point-of-sale product verification solution, empowers consumers to use their own mobile phone to instantly identify genuine products in the marketplace and grow the trust they have in their favorite brands.

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Watch Out for False Friends!

This animated video, available in English, French, Portuguese and Japanese, explains how counterfeit medications can look exactly like legitimate medication and how the public can easily be fooled in purchcasing medication that will not work and may even harm. or kill, patients.

View Resource

Radio Message about Fake Malaria Medicine - Malawi

Malawi

This radio message by a well-known physician warns consumers about the dangers of purchasing fake medicines for malaria.  It was produced in Malawi in 2014

View Resource
Cori Fordham
Nan Lewicky

This website is made possible by the support of the American People through the United States Agency for International Development (USAID) under the Breakthrough-ACTION Project, supported by USAID’s Office of Population and Reproductive Health, Bureau for Global Health, under Cooperative Agreement #AID-OAA-A-17-00017 with the Johns Hopkins University.

Breakthrough-ACTION is based at the Johns Hopkins Bloomberg School of Public Health’s Center for Communication Programs (JHU∙CCP). The contents of this website are the sole responsibility of JHU∙CCP. The information provided on this website is not official U.S. Government information and does not necessarily represent the views or positions of USAID, the United States Government, or The Johns Hopkins University.

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