Commentary: Substandard medicines are the priority for neglected tropical diseases

• Published in: BMJ (Online) Vol. 345; no. 7884; p. 27
• Main Authors: Dorlo, Thomas P C, Ravinetto, Raffaella M, Beijnen, Jos H, Boelaert, Marleen
• Format: Journal Article
• Language: English
• Published: England British Medical Journal Publishing Group 14.11.2012; BMJ Publishing Group; BMJ Publishing Group LTD
• Subjects: ANALYSIS; Counterfeit Drugs; Disease prevention; Drug regulation; Drugs; Fraud - prevention & control; Government regulation; International Cooperation; Manufacturers; Manufacturing; Manufacturing processes; Medicine; Parasitic diseases; Pharmaceutical preparations; Public sector; Quality control; Tropical diseases; Tropical medicine; Visceral leishmaniasis; Bangladesh
• ISSN: 0959-8138; 1756-1833; 1756-1833
• DOI: 10.1136/bmj.e7518

Attaran and colleagues propose new definitions for the quality of medicines and plead for a global treaty tackling both substandard production and falsification. 1 We support this, as the international community tends to concentrate its efforts on falsified medicines, whereas substandard drugs are just as much a threat. 2 Moreover, in practice the distinction can be difficult. According to the proposed definitions, this medicine is substandard. For visceral leishmaniasis at least three other incidents with poor quality medicines have been described, from India, Nepal, and Sudan. 7 8 9 All came to light only because of abnormally high failure rates or life threatening toxicities, though the poor manufacturing practices could have been detected in advance by regulatory inspections.