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The primacy of public health Considerations in defining poor quality medicines


PLos Medicine

Category: Publications

Author: Paul N. Newton, Abdinasir A. Amin, Chris Bird, Phillip Passmore, Graham Dukes, Go ran Tomson, Bright Simons, Roger Bate, Philippe J. Guerin, Nicholas J. White

Published Date: 06 December 2011


Poor Quality Medicines—A Major Public Health Problem

There is growing, but belated, concern that much of the developing world’s supply of medicines—in particular, its supply of anti-infective drugs—is of poor quality. This constitutes a major public health problem because the high prevalence of poor quality drugs in developing countries results in avoidable morbidity, mortality, and drug resistance [1–7]. Moreover, any efforts to improve public health by developing new medicines or by changing treatment policies will ultimately be pointless if the drugs patients actually take contain insufficient or incorrect ingredients. Unfortunately, efforts to improve the quality of medicines in developing countries are being hampered by confusion over the terms used to describe different types of poor quality medicines. This confusion has arisen because of poor science and because of tension between the defence of commercial interests and the public health importance of enhanced access to good quality medicines in developing countries. Specifically, some commentators have argued that counterfeit medicines are being viewed primarily as intellectual property (IP) rather than public health concerns and that the innovative pharmaceutical industry is using action against counterfeit medicines to impede the trade in competing generics [8– 20]. In this essay, we call for public health concerns to be made the prime consideration in defining and combating counterfeit medicines and argue that recent World Health Organization (WHO) initiatives eschew IP concerns. We also discuss some related but neglected interventions that might help to improve drug quality in developing countries


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