Kenya: Dodgy drugs hamper fight against malaria

American Red Cross | 13 Jun 2008
IRIN News
The presence of large quantities of ineffective or counterfeit anti-malarial drugs on the Kenyan market is hampering efforts to fight the disease, according to health officials.

"Some of the counterfeit drugs are substandard and usually do not have the active ingredients required to treat malaria," Dorothy Otieno, an officer in the Ministry of Medical Services' malarial control division, told IRIN.

She said patients using counterfeit drugs were at great risk.

"Can you imagine giving someone who is sick those drugs? Sometimes it's just chalk, they could die," she said.

Officials from the Pharmacy and Poisons Board, a government regulatory body under the Medical Services Ministry, recently confiscated thousands of counterfeit Artemisinin-based malaria drugs in a shop in Nairobi. The company that manufactured the drugs was ordered to recall the entire batch.

Study

The results of a study of anti-malarials on sale in six African countries found that 16 of 42 tested drugs (some 38 percent) on the Kenyan market were ineffective in treating the disease.

According to the study, published in May 2008 and funded by Africa Fighting Malaria, a non-governmental organisation (NGO) based in South Africa and the USA, "the public health impact of this crisis... must be staggering."

"Artemisinin monotherapy, which the World Health Organization rejects as inherently substandard treatment even when its dosage is correct, remains common in Africa," it reported.

As is the case in most of Africa, Kenyan health authorities recommend the use of artemisinin-based combination therapy (ACT) to treat malaria, since mono-therapy drugs have been found to be ineffective and to increase the resistance of the malaria-causing parasite to treatment.

A study by the Kenyan government also found many substandard anti-malarial drugs on the market, but it put the proportion at a much lower 16 percent.

Speaking of the authors of the Africa Fighting Malaria Study, Joseph Yano, the legal officer at the Pharmacy and Poisons Board, told IRIN. "I do not know what parameters they used and what motivation they had, since they did not involve us."

He said the study was not extensive enough for its findings to be conclusive.

"Our [government] study was much wider, we went to all eight provinces in Kenya, and took samples from all public, mission [religious] and private hospitals," he said.

Nevertheless, he added, the presence of ineffective drugs "undermines the confidence in our public health sector".

Porous borders

Yano attributed the proliferation of such drugs to the country's porous borders. "One can bring them [in] as personal effects, which is common, or through the ports," he said, adding that the board had only 40 inspectors to cover the whole country.

He said the Kenyan legal system was not supportive enough. "The courts treat the offences very lightly, and we need to sensitise our courts on stringent punishment guidelines."

An estimated 1.5 million people die of malaria worldwide out of 500 million cases recorded each year, according to the African Medical and Research Foundation. At least 80 percent of the cases were in sub-Saharan Africa.

The government procures 17 million doses of ACT at a cost of 1.5 billion shillings (US $24 million) every year, according to an assistant minister of medical services, Danson Mungatana.

Other efforts targeting malaria control have also been spearheaded by the government and donors, including the nationwide distribution of insecticide-treated bed nets in malaria-endemic areas of Coast, Nyanza, Western and parts of Rift Valley provinces.

This has reduced the number of children under five who were dying annually from over 34,000 to 16,000 in 2007, Otieno said.

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