Increasing Antiretroviral Drug Access for Children With HIV Infection

A study was done to examine the drug quality in USAID-assisted countries. In Cameroon 284 samples of three antimalarial drugs from 132 different sources in 16 villages and cities throughout the country were collected. Drug quality was assessed by a simple color reaction test and semi-quantitative thin-layer chromatography. Fifty (38%) of 133 chloroquine 52 (74%) of 70 quinine and 10 (12%) of 81 antifolates had either no active ingredient an insufficient active ingredient the wrong ingredient or unknown ingredient(s). In the Congo Fake antiretrovirals were found in Lubumbashi in December 2003. The bottles and blisters which were not in carton boxes were labeled "Triomune" (stavudine lamivudine and nevirapine) and "Duovir" (lamivudine and zidovudine) both of which are Ciplas brand products. Preliminary investigations showed that fake labels were put on bottles containing non-ARV pharmaceutical products. Some tablets have been identified to contain fluvoxamine (antidepressant) or cyclobenzaprine (muscle relaxant). Counterfeiters have targeted health prescribers and patients to buy these cheap ARVs. (excerpt)