2012柳叶刀东南亚和撒哈拉以南非洲抗疟药质量堪忧

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Poor-quality antimalarial drugs in southeast Asia and sub-Saharan Africa

Gaurvika M L Nayyar, Joel G Breman, Paul N Newton, James Herrington
Poor-quality antimalarial drugs lead to drug resistance and inadequate treatment, which pose an urgent threat to
vulnerable populations and jeopardise progress and investments in combating malaria. Emergence of artemisinin
resistance or tolerance in Plasmodium falciparum on the Thailand–Cambodia border makes protection of the
eff ectiveness of the drug supply imperative. We reviewed published and unpublished studies reporting chemical
analyses and assessments of packaging of antimalarial drugs. Of 1437 samples of drugs in fi ve classes from seven
countries in southeast Asia, 497 (35%) failed chemical analysis, 423 (46%) of 919 failed packaging analysis, and
450 (36%) of 1260 were classifi ed as falsifi ed. In 21 surveys of drugs from six classes from 21 countries in sub-Saharan
Africa, 796 (35%) of 2297 failed chemical analysis, 28 (36%) of 77 failed packaging analysis, and 79 (20%) of 389 were
classifi ed as falsifi ed. Data were insuffi cient to identify the frequency of substandard (products resulting from poor
manufacturing) antimalarial drugs, and packaging analysis data were scarce. Concurrent interventions and a
multifaceted approach are needed to defi ne and eliminate criminal production, distribution, and poor manufacturing
of antimalarial drugs. Empowering of national medicine regulatory authorities to protect the global drug supply is
more important than ever.

Lancet Infect Dis 2012;
12: 488–96
This online publication
has been corrected.
The corrected version fi rst
appeared at thelancet.com/
infection on May 22, 2012
Fogarty International Center
(G M L Nayyar BS, J G Breman MD,
J Herrington PhD), National
Institutes of Health,
Bethesda, MD, USA; Wellcome
Trust-Mahosot Hospital-Oxford
University Tropical Medicine
Research Collaboration,
Microbiology Laboratory,
Mahosot Hospital, Vientiane,
Laos (P N Newton MRCP); and
Centre for Clinical Vaccinology
and Tropical Medicine, Churchill
Hospital, Oxford University,
Oxford, UK (P N Newton)

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