MMV appeals for urgent action against counterfeit and unregulated antimalarials
Medicines for Malaria Venture (MMV) is a not-for-profit organization committed to discovering, developing and delivering new affordable and effective antimalarial drugs through public-private partnerships. MMV’s goal is to bring drugs of best quality to the poorest people at the lowest possible cost.
The word, effective, is critical in part because of the well documented and widely recognized issue of evolving parasite resistance under drug pressure.
But evolving parasite resistance is not our only challenge; we know how to mitigate it by design and can ultimately prevail through continuous innovation. Sadly, evolution of drug resistance is not the only challenge we face in scaling up effective affordable treatments for those living in malaria endemic countries. There are today countless examples of low quality and counterfeit drugs that are supplied through the poorly regulated informal drug markets of the developing world. These markets and the drugs that flow through them have until recently been mainly ignored by the global public health community because it has largely focused on the more visible public sector distribution channels that it typically works with. This arguably blinkered approach has exposed a clear “Achilles heel” to the aspiration of universal access to prompt effective treatments.
Malaria is entirely preventable and curable if appropriately treated. However, treating malaria with an ineffective drug, and allowing such drugs to be easily traded, all too often costs lives because the illness has progressed too far to be eventually treated properly. Another very real harm done by low quality drugs is at the population level where these drugs can accelerate the onset of drug resistance, shortening the lives of these life-saving medicines.
The question of who and how it is determined that a drug is effective and appropriate is evidently complex, often politically sensitive and, some may say, wholly outside of the remit of an organization like MMV. However, we believe we cannot succeed in delivering effective new drugs to those at risk unless we and others that support our mission draw attention to the factors that threaten it. MMV is neither a regulator nor a body that gives official policy advice to governments. Regrettably however, it is becoming increasingly apparent that we cannot simply be neutral on this issue. Apart from the major natural challenges we face mentioned above we now also face manmade problems from an assortment of unprincipled companies and from the wholly criminal counterfeiters that thrive when enforcement is absent and populations are not well informed and poor. The plethora of unregulated drugs and counterfeits complicate the drive to scale up effective treatments. Indeed, they make our mission of saving lives and making a health impact that much harder to achieve.
It is imperative that the issue of low-quality and counterfeit drugs be brought urgently to the public policy debate. The World Health Organization is having success in bringing the artemisinin monotherapy concern to the fore and this is just the start of what we hope will be a sustained campaign against behavior that would never be tolerated in the developed world. The mother that buys an antimalarial at a roadside kiosk deserves the same protection as one seeking treatment at the best clinic in the developed world.
We must ensure that the era of “poor drugs for poor people” comes to an end.