Back to Browse Journals » Research and Reports in Tropical Medicine » Volume 1

Antimalarial medicine diversion: stock-outs and other public health problems

Authors Roger Bate, Kimberly Hess, Lorraine Mooney

Published Date September 2010 Volume 2010:1 Pages 19—24

DOI http://dx.doi.org/10.2147/RRTM.S13242

Published 2 September 2010

Roger Bate1,2, Kimberly Hess2, Lorraine Mooney3

1American Enterprise Institute, Washington, D.C., USA; 2Africa Fighting Malaria, Washington, D.C., USA; 3Africa Fighting Malaria, Cambridge, UK

Background: Antimalarial medicine diversion has been seen across numerous African markets and can lead to serious stock-outs in the public sector, which can be dangerous to countries with high burdens of disease. This study discusses the numbers of diverted antimalarial medicines from several samplings in Africa.

Methods:
A total of 894 samples of antimalarial medicines were covertly purchased from private pharmacies in 11 African cities from late 2007 to early 2010. All medicine packages were visually inspected for correctness, in line with the protocol established by the Global Pharma Health Fund e.V. Minilab®, as well as for signs of diversion.

Results:
Overall, 6.5% (58 out of 894) of collected antimalarial medicines were found to be diverted, comprising 2.4% (5/210) of medicines collected in 2007 from six African cities, all of which were artemisinin-based combination therapies (ACTs); 2.3% (3/129) of medicines collected in 2008 in Lagos, Nigeria, two of which were ACTs; and 9% (50/555) of medicines collected in 2010 in 10 African cities, 35 of which were ACTs. ACT was by far the most diverted treatment in this study: 15.6% (5/32) of ACTs collected in 2007, and 30.7% (35/114) of ACTs collected in 2010.

Conclusion:
The number of diverted ACTs over the 33 months covered by this study is probably related to the laudable provision of vast amounts of donated or low-priced ACTs across African nations and the actual increase in diversion of these medicines into the private sector. The small sample sizes in this study might exaggerate any problem, but a potentially serious problem may well exist. To the extent that diversion of medicines exacerbates stock-outs, this is a public health problem, and a perversion of donor intent, but there are other possible harms of diversion, such as increased trade in counterfeit, and expired and otherwise substandard medicines.

Keywords: artemisinin-based combination therapy (ACT), Africa, malaria, public sector

Download Article [PDF] 

Creative Commons License This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution - Non Commercial (unported, v3.0) License. The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. Permissions beyond the scope of the License are administered by Dove Medical Press Limited. Information on how to request permission may be found at: http://www.dovepress.com/permissions.php

Other articles by this author:

Subsidizing artemisinin-based combination therapies: a preliminary investigation of the Affordable Medicines Facility – malaria

Bate R, Hess K, Tren R, Mooney L, Cudjoe F, Ayodele T, Attaran A

Research and Reports in Tropical Medicine 2012, 3:63-68

Published Date: 18 July 2012

Anti-infective medicine quality: analysis of basic product quality by approval status and country of manufacture

Bate R, Mooney L, Hess K, Milligan J, Attaran A

Research and Reports in Tropical Medicine 2012, 3:57-61

Published Date: 16 July 2012

Readers of this article also read:

Green synthesis of water-soluble nontoxic polymeric nanocomposites containing silver nanoparticles

Prozorova GF, Pozdnyakov AS, Kuznetsova NP, Korzhova SA, Emel’yanov AI, Ermakova TG, Fadeeva TV, Sosedova LM

International Journal of Nanomedicine 2014, 9:1883-1889

Published Date: 16 April 2014

Liposomes and nanotechnology in drug development: focus on ocular targets

Honda M, Asai T, Oku N, Araki Y, Tanaka M, Ebihara N

International Journal of Nanomedicine 2013, 8:495-504

Published Date: 14 February 2013

Methacrylic-based nanogels for the pH-sensitive delivery of 5-Fluorouracil in the colon

Ashwanikumar N, Kumar NA, Nair SA, Kumar GS

International Journal of Nanomedicine 2012, 7:5769-5779

Published Date: 15 November 2012

A novel preparation method for silicone oil nanoemulsions and its application for coating hair with silicone

Hu Z, Liao M, Chen Y, Cai Y, Meng L, Liu Y, Lv N, Liu Z, Yuan W

International Journal of Nanomedicine 2012, 7:5719-5724

Published Date: 12 November 2012

Cross-linked acrylic hydrogel for the controlled delivery of hydrophobic drugs in cancer therapy

Deepa G, Thulasidasan AK, Anto RJ, Pillai JJ, Kumar GS

International Journal of Nanomedicine 2012, 7:4077-4088

Published Date: 27 July 2012

Corrigendum

Chen ZQ, Liu Y, Zhao JH, Wang L, Feng NP

International Journal of Nanomedicine 2012, 7:1709-1710

Published Date: 30 March 2012

Crystallization after intravitreal ganciclovir injection

Pitipol Choopong, Nattaporn Tesavibul, Nattawut Rodanant

Clinical Ophthalmology 2010, 4:709-711

Published Date: 14 July 2010

Pharmacokinetics and tolerance study of intravitreal injection of dexamethasone-loaded nanoparticles in rabbits

Linhua Zhang, Yue Li, Chao Zhang, et al

International Journal of Nanomedicine 2009, 4:175-183

Published Date: 4 September 2009