Poor quality drugs, whether substandard or counterfeit, have far reaching consequences. Patients can suffer prolonged sickness, treatment failure, side effects, loss of income, increased healthcare costs and even death. In addition, societies lose confidence in otherwise effective medicines, in healthcare systems and suffer major economic losses. Of particular relevance, counterfeit or substandard antimalarials containing sub-therapeutic amounts of artesunate or only one of the two active ingredients in Artemisinin Combination Therapy (ACTs) can contribute to emerging antimalarial drug resistance.
The Antimalarial Quality Module aims to collate information and stimulate discussion on the epidemiology of poor quality antimalarials, improving both sampling and analytical methodology, and advocating for more investment in this vital aspect of public health. A better understanding of the prevalence and consequent public health burden of poor quality antimalarials is necessary to impede their distribution, stimulate a global response and reduce their impact on the spread of drug resistance. WWARN is actively seeking funding for the Antimalarial Quality Module. If you're interested in supporting the activities of the Antimalarial Quality Module, please contact us at info@wwarn.org.
What we do
The Antimalarial Quality database
Working in partnership with key stakeholders, we aim to develop a database that unifies reports of antimalarial quality with summary data for individual surveys, and links to individual drug samples. The database will compile these data, aiming to map reports of both acceptable and poor quality drugs in relation to other indicators of antimalarial effectiveness and efficacy, pharmacokinetic data, molecular marker frequency and in vitro susceptibility. An ongoing pilot study, led by Module Head Paul Newton, is mapping poor quality artesunate using data from the Wellcome Trust-Oxford Southeast Asia Tropical Medicine Research Programme.
Packaging provides important clues that distinguish genuine and sub-standard medicines from counterfeits — the database would include a reference collection of genuine and counterfeit antimalarial packaging.
Research tools
Procedures and related documents will be collated for:
- Formal chemical assays of antimalarial active ingredients.
- Rapid and inexpensive field tests for drug quality — colour tests, refractometry, pH and packaging colour analysis.
- Forensic mass spectrometry and palynology techniques to track the source of counterfeit medicines.
- Evaluation and use of portable, handheld analysis devices including NIR, Raman, XRF, ion-mobility and MS instruments for field use.
In collaboration with the Pharmacology Module and the WWARN QA/QC programme, the Antimalarial Quality Module aims to develop and disseminate reference standards for chemical analysis of antimalarial medicine, helping to increase the availability of such facilities.
For more information, read through our Antimalarial Quality brochure or contact aq@wwarn.org.
