A groundbreaking investigation across four African nations has uncovered a disturbing truth: a significant portion of cancer medications are substandard or counterfeit. This leaves vulnerable patients with treatments that may be ineffective or even harmful.
The study, published in The Lancet Global Health, sheds light on a critical and previously unmeasured gap in pharmaceutical regulation on the continent. It highlights the pressing issue of circulating substandard medications for cancer treatment.
Conducted by a US and pan-African research team, the study covertly collected and tested nearly 200 unique cancer drug products. These were from a dozen hospitals and 25 pharmacies in Ethiopia, Kenya, Malawi, and Cameroon.
The findings were stark: approximately 17% - roughly one in six - contained incorrect levels of active ingredients. For patients battling cancer, receiving an insufficient dose means their tumours could continue to grow and spread. This renders their treatment futile.
A Widespread and Hidden Problem
While previous reports have highlighted similar issues with antibiotics and antimalarial drugs, this is the first systematic study confirming high levels of defective anticancer medicines. Researchers suspect that substandard drugs are being used, and this research provides the first concrete evidence.
The causes are complex, ranging from accidental manufacturing faults and product degradation due to poor storage to the deliberate production of counterfeit medicines.
Spotting these faulty products is incredibly difficult. The study found that simple visual inspections, such as checking labels or the color of pills, identified less than a quarter of the substandard products. Health authorities found the vast majority through rigorous laboratory testing.
The Challenge of Regulation and Surveillance
The core of the problem lies in regulation and the capacity for testing. Many laboratories in sub-Saharan Africa, even those equipped with the latest technology, lack the specialised facilities needed for handling and analysing highly toxic chemotherapy drugs safely.
This stands in sharp contrast to high-income countries, where stringent regulatory systems and secure supply chains protect patients. In many parts of Africa,
Inadequate governance and poor access to affordable medication can drive people towards less-regulated markets. This compounds the risk of encountering substandard drugs for cancer treatment.
Health economist Sachiko Ozawa noted the significant "economic losses in terms of wasted resources" for nations purchasing ineffective medicines. Substandard drugs are contributing notably to these losses.
A Path Forward: Reform and Technology
In response to the findings, the World Health Organisation (WHO) has stated it is "concerned." It is now working with the four affected countries to address the issue of substandard drugs in cancer treatment.
The WHO has long called for nations to strengthen their regulatory frameworks. This is to prevent, detect, and respond to incidents of substandard and falsified medicines.
While authorities aim for regulatory reform as a long-term goal, they are developing more immediate solutions to address pressing issues. Researchers are creating innovative screening technologies. For example, a "paper lab" test that could enable trained professionals to chemically verify a drug's quality before it reaches a patient.
Encouragingly, the study found that the majority of the medications tested were of good quality. This indicates that a smaller number of unreliable suppliers may be respnsible for the serious problem. It offers a clear target for regulatory action against substandard medications.