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The issue

In low- and middle-income countries (LMICs), substandard and falsified medicines are estimated to account for 1 in 10 medicines costing LMICs US$30.5 billion. Quality issues observed include low or absent drug content, contamination with impurities, lack of sterility and inappropriate packaging and labelling.

The health impacts are huge with studies indicating that poor quality antibiotics cause the deaths of up to 170,000 children under five from pneumonia, while substandard and falsified antimalarials cost up to 115,000 lives in sub-Saharan Africa alone.

For some categories of medicines, such as those used in maternal health, the situation is particularly alarming. Post-marketing surveillance studies of the most common medicines used to prevent and treat postpartum haemorrhage (the single greatest cause of maternal mortality) have been found to have a prevalence of poor quality of between 40-75%.