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Time of India
a day ago
- Health
- Time of India
Nearly 20% of cancer drugs defective in 4 African nations
Representative Image (AI-generated) An alarming number of people across Africa may be taking cancer drugs that don't contain the vital ingredients needed to contain or reduce their disease. It's a concerning finding with roots in a complex problem: how to regulate a range of therapeutics across the continent. A US and pan-African research group published the findings this week in The Lancet Global Health. The researchers had collected dosage information, sometimes covertly, from a dozen hospitals and 25 pharmacies across Ethiopia, Kenya, Malawi and Cameroon. They tested nearly 200 unique products across several brands. Around 17% — roughly one in six — were found to have incorrect active ingredient levels, including products used in major hospitals. Patients who receive insufficient dosages of these ingredients could see their tumors keep growing, and possibly even spread. Similar numbers of substandard antibiotics, antimalarial and tuberculosis drugs have been reported in the past, but this is the first time that such a study has found high levels of falsified or defective anticancer drugs in circulation. "I was not surprised by these results," said Lutz Heide, a pharmacist at the University of Tübingen in Germany who has previously worked for the Somali Health Ministry and has spent the past decade researching substandard and falsified medicines. by Taboola by Taboola Sponsored Links Sponsored Links Promoted Links Promoted Links You May Like local network access control Esseps Learn More Undo Heide was not part of the investigative group, but said the report shed light on a problem not previously measured. "I was delighted that, finally, someone published such a systemic report," he said. "That is a first, really significant systematic study of this area." Causes need addressing, but it's not straightforward: "There are many possible causes for bad-quality products," Marya Lieberman of the University of Notre Dame in the US, the investigation's senior researcher, told DW. Those causes can include faults in the manufacturing process or product decay due to poor storage conditions. But some drugs are also counterfeit, and that increases the risk of discrepancies between what's on the product label and the actual medicine within. Spotting substandard and falsified products can be difficult. Usually, a medical professional or patient is only able to perform a visual inspection — literally checking a label for discrepancies or pills and syringes for color differences — to spot falsified products. But that's not a reliable method. In the study, barely a quarter of the substandard products were identified through visual inspection. Laboratory testing identified the rest. Fixing the problem, Lieberman said, will require improving regulation and providing screening technologies and training where they're needed. "If you can't test it, you can't regulate it," she said. "The cancer medications are difficult to handle and analyze because they're very toxic, and so many labs don't want to do that. And that's a core problem for the sub-Saharan countries where we worked. Even though several of those countries have quite good labs, they don't have the facilities that are needed for safe handling of the chemo drugs established." Not only cancer treatments are affected: Nearly a decade ago, the World Health Organization found around one in 10 medicines used in low and middle-income countries were substandard or falsified. Independent research conducted since has backed those figures up, sometimes finding rates that are potentially twice as high. "This could lead to treatment failure, adverse reactions, disease progression," health economist Sachiko Ozawa told DW. Ozawa contributed to the investigation on anticancer drugs and has separately researched other cases of defective medicines. "For the community, there's also economic losses in terms of wasted resources,' she said. 'So countries may be spending a lot of money on medications that are not going to be effective." While high-income countries can monitor supply chains and have stringent regulatory systems in place to identify and withdraw suspect products, the infrastructure to do that is far from common in other regions. In those places, poor access to affordable medication often drives patients to less-regulated marketplaces. Inadequate governance and regulation, as well as a scarcity of surveillance and diagnostic equipment to test pharmaceuticals, are all contributing to the problem in Africa. "In high-income countries, I think there's a much more secure supply chain where you know the manufacturers are vetted, it has to go through very stringent regulatory processes to get gets tested more frequently," said Ozawa. The WHO told DW that following the report's findings, it was working with the four affected countries to address the problem. "We are concerned with the findings the article has highlighted. WHO is in contact with national authorities of four impacted countries and obtaining relevant data," it said in a statement. "We expect to assess full information to evaluate the situation, which often takes time and capacity. But we're committed to address these issues working with the relevant countries and partners." The WHO also reiterated its ongoing call for countries to improve their regulatory frameworks to "prevent incidents of substandard and falsified medicines, including in settings of cancer programs." Prevention, detection and response: In 2017, the WHO's review of substandard and falsified medicines offered three solutions based around prevention, detection and response. S topping the manufacture and sale of those medicines is the primary preventative measure, but where defective products make it to market, surveillance and response programs can prevent poor quality medicines from reaching patients. But regulatory reform sought by experts and authorities takes time. More immediate solutions are being developed in the form of better screening technologies. Lieberman is working on a "paper lab" — a type of test that can be used by trained professionals to chemically test the quality of a product before it's administered to a patient. Other laboratory technologies are also under development. One comforting point is that while a significant proportion of the medication circulating in medical facilities in the four African countries was defective, the majority of the products tested met required standards. "[With] two-thirds of the suppliers, all the products [were] good quality, so there are good quality suppliers," said Heide. "But a few of them really have a suspiciously high number of failing samples."
Business Insider
a day ago
- Health
- Business Insider
Nearly 1 in 6 cancer drugs found in Africa are defective, study finds
A new study has found that almost 17% of cancer drugs sampled in Ethiopia, Kenya, Malawi, and Cameroon were substandard or counterfeit, raising concerns over patient safety and gaps in pharmaceutical regulation across Africa. A study published in The Lancet Global Health revealed nearly 17% of cancer medications sampled in Ethiopia, Kenya, Malawi, and Cameroon were substandard or counterfeit. Approximately one in six tested medications had incorrect levels of active ingredients, highlighting risks to patient safety and treatment efficacy. The study attributes issues to factors like poor manufacturing practices and storage conditions, as well as counterfeiting. Published in The Lancet Global Health, the study tested nearly 200 unique cancer drug products collected from hospitals and pharmacies in the four African countries. It found that around one in six contained incorrect levels of active ingredients, putting patients at risk of ineffective treatment and disease progression. Researchers said causes ranged from poor manufacturing and inadequate storage to deliberate counterfeiting. The problem is difficult to detect visually: only about 25% of the defective products could be flagged by inspecting packaging or color, while the majority required laboratory testing to uncover quality failures. 'If you can't test it, you can't regulate it,' said Marya Lieberman of the University of Notre Dame, who led the investigation. 'The cancer medications are difficult to handle and analyze because they're very toxic, and so many labs don't want to do that.' The study points to big challenges for many African countries in making sure cancer drugs are safe. Many places don't have the right labs or trained staff to properly test these medicines. Even where labs do exist, they often can't handle these very strong and dangerous drugs. WHO Addresses Cancer Drug Quality Concerns The World Health Organization (WHO) said it is in contact with authorities in the four affected countries to review the findings and develop a response plan. 'We are concerned with the findings the article has highlighted,' the WHO said in a statement. 'We expect to assess full information to evaluate the situation... But we're committed to address these issues working with the relevant countries and partners.' Defective or falsified medicines are not new challenges in Africa. Previous studies have found similar rates of poor-quality antibiotics, antimalarials, and tuberculosis treatments. The WHO has estimated that roughly 10% of all medicines in low- and middle-income countries are substandard or falsified, leading to treatment failures, adverse reactions, and wasted healthcare spending. Despite the worrying results, researchers noted that most of the cancer drugs tested did meet quality standards, with around two-thirds of suppliers consistently delivering safe products. Experts called for improved manufacturing oversight, stronger regulatory frameworks, and investment in local testing capacity. They also pointed to new screening technologies under development, such as portable 'paper lab' tests designed to help detect poor-quality medicines before they reach patients.
Hindustan Times
14-05-2025
- Health
- Hindustan Times
In fight against TB, poor nutrition a silent killer
MUMBAI: A 32-year-old woman from a Worli slum is battling tuberculosis (TB) for the second time. A few months ago, she was diagnosed with drug-resistant TB—a more severe and harder-to-treat version of the disease. The woman lacks a crucial component in her treatment regimen – one no doctor can provide. The truth is, adequate nutrition alone would greatly raise her chances of recovery. Studies have shown that malnutrition fuels deaths and drug resistance in TB patients, undermining efforts to treat patients with all forms of the disease. On the other hand, a nutrient-rich diet significantly enhances positive outcomes. Part of the reason the woman is malnourished is that, for the last four months, she has not received the ₹1,000 monthly nutritional support under the government's Nikshay Poshan Yojana. The sum, recently doubled, is meant to help TB patients afford the bare essentials of a recovery-friendly diet. 'My monthly food expenses are around ₹2,000. So I skip the ₹700 protein powder prescribed by my doctor,' she told HT. A grim reality Vatsala was one of 2,800 people diagnosed with drug-resistant TB in Mumbai in 2024. That year, Mumbai recorded 60,051 TB cases—averaging 164 new cases diagnosed each day. In Maharashtra, TB detection rose marginally, by 2% in 2024 – 2,28,877 cases were reported, or 627 cases a day. In 2024, Mumbai alone witnessed 2,264 TB-related deaths—averaging over six deaths a day. Parel recorded the highest toll – 377 deaths, according to data obtained through the Right to Information Act, 2005. Nutritional support Health activists say the government should consider food a medical necessity for TB patients. Ganesh Acharya, a health activist working with TB patients in Mumbai, said, 'The ₹1,000 support should be raised to at least ₹2,500 if we want patients to recover. Nutrition is not a luxury—it is the core of TB treatment.' His concerns are reflected in the findings of the RATIONS trial—a landmark study (conducted between 2019 and 20-22, and published in The Lancet in 2023) in tribal Jharkhand, where TB-affected families were provided macronutrient-rich food baskets (1,200 kcal for patients and 750 kcal for household contacts). The trial showed significantly improved treatment outcomes and a reduction in TB incidence among contacts (family members). Based on this, a modelling study published in The Lancet Global Health (March 2025) estimated that providing food and supplements to just 50% of India's TB-affected households could prevent 361,200 deaths and 880,700 new TB cases between 2023 and 2035. Dr Finn McQuaid, one of the RATIONS researchers, told Hindustan Times, 'My understanding is that ( ₹1,000) is a big step in the right direction but it's not quite there yet. Another issue is that the composition of food baskets is important (they must contain sufficient proteins and micronutrients), which cash support alone may not address.' Dr Pranay Sinha, assistant professor at the Boston University School of Medicine, said implementation, not just policy design, is the bigger challenge. 'Lack of access to banking and other logistical delays prevent persons with TB from receiving the money at the most critical juncture of their treatment. We need some operational innovations to ensure that PWTB get the money as soon as possible post-diagnosis.' Role of Body Mass Index BMI is a key clinical indicator in TB outcomes—lower BMI increases mortality risk. However, McQuaid cautions against targeting support based on BMI. The RATIONS trial showed benefits even in patients with normal BMI, he underscores. On the flipside, Dr Pranay Sinha points out, even TB patients with normal BMI may suffer micronutrient deficiencies, noting studies linking Vitamin A deficiency to a ten-fold TB risk and citing 25% mortality in patients with BMI below 14 in Tamil Nadu, where he advocates early inpatient nutritional care. Sponsor a patient Experts feel it is not wise to lean too heavily on government schemes for nutritional support, an issue the Ni-kshay Mitra scheme hopes to address. A government scheme, it aims to enhance community involvement in the fight against TB by linking patients with supporters, or 'mitras', who provide assistance. Pulmonologist Dr Vikas Oswal said, 'The ₹1,000 is not meant to cover an entire diet, but it's a helpful supplement. The Ni-kshay Mitra initiative enables individuals and organisations to sponsor patients and provide regular food baskets.' However, patients from high-burden areas such as Govandi and Dharavi told HT that this support too is inconsistent. A 44-year-old autorickshaw driver from Dharavi, who is undergoing treatment for bone tuberculosis, said he last received the food basket in November 2024. 'The local politician who was distributing it stopped. The basket had apples, pomegranates, and grains—it helped us survive for seven months. I can't work due to my health, and my wife supports the household. TB medicines kill my appetite, but getting good food encourages me to eat better than just dry roti at home,' he said. According to the Ni-kshay Mitra dashboard, Maharashtra currently has 1,50,579 people undergoing TB treatment. While 14,194 donors have registered under the scheme—and 83.2% committed to providing food baskets for at least six months—coverage remains patchy. In Dadar, of the 3,041 patients under treatment, only 1,569 received food baskets. In another ward, just 1,646 out of 2,133 got assistance—barely 60%. 'There's a system,' said Acharya, 'but it's breaking where it's needed the most.' Dr Sandeep Sangale, Joint Director (TB and Leprosy), Maharashtra, dismissed claims that some TB patients are still receiving ₹500 instead of the revised ₹1,000 nutrition support. 'All patient accounts are centrally linked and payments are generated alphabetically through the system. There is no possibility of anyone receiving ₹500 now. The disbursal is done every three months, so patients in earlier payment cycles may have received a lump sum for three months. The next instalment will be credited once their cycle resumes,' he said.
Euronews
27-02-2025
- Health
- Euronews
Demand for palliative care is surging worldwide as people live longer but unhealthier lives
It's one of the only universal facts of life: everybody dies. That's where palliative care, which aims to improve patients' quality of life and relieve pain from serious and often incurable illnesses, comes in. It can include everything from breathing exercises to painkilling drugs, and can take place at home, in hospice, in a nursing home, or at the hospital – ideally long before someone is on death's doorstep. Yet a new study has found that millions of people lack access to palliative care, even as demand continues to rise worldwide. The number of people in need of palliative care has surged by 74 per cent over the past three decades, reaching 73.5 million in 2021, according to the study, which was published in The Lancet Global Health. Four in five of these people are in lower-income countries, where the need for palliative care has grown by 83 per cent since 1990. But demand has also risen by 46 per cent in high-income countries during that time. 'Life expectancy is increasing, but healthy life expectancy is not keeping pace,' Dr Libby Sallnow, a palliative care physician who leads the Marie Curie Palliative Care Research Department at University College London in the UK and was not involved with the new study, told Euronews Health. While many palliative care patients have terminal conditions, it is different from hospice or end-of-life care. The global research team identified demand for palliative care by tracking the number of people with 'serious health-related suffering,' or those with health-related pain or an impact on their quality of life that cannot be relieved without professional help. How palliative care needs have changed Demand for palliative care has evolved over time, the study found. Since the 1990s, infectious diseases have waned as a driver – despite a brief global uptick during the COVID-19 pandemic – largely due to a decline of infections in lower-income countries. Meanwhile, the need for palliative care because of cancer, heart disease, dementia, and other chronic conditions has grown in recent decades, particularly in high-income countries, the report found. Today in low-income countries, most patients in need of palliative care are women ages 20 to 49. In higher-income countries, it's mostly women ages 70 and up, likely related to dementia. 'People are living for longer with more illness and more serious health-related suffering,' Sallnow said. 'We see a need to manage this much earlier in the life course [and not just] the last few days or weeks' of someone's life, she added. Worldwide, children also make up a smaller share of people grappling with serious health-related suffering. That percentage fell from 25 per cent in 1990 to 14 per cent in 2021, the report found. That's 'a real achievement,' Sallnow said. Gaps in access It's not the first report to identify a major gap in palliative care services. Last year, the World Health Organization's (WHO) European office, which spans 53 countries, raised the alarm about the estimated 4.4 million people in need of palliative care in the region who die each year. That toll is expected to rise in the coming years. Nearly four in 10 of these patients have cancer, while a third have heart disease, 16 per cent have dementia, and 6 per cent have chronic lung diseases, the organisation said. The European Association for Palliative Care recommends that countries have two specialised palliative services per 100,000 people. Across Europe, that average is 0.79, according to a 2021 study that found that more than half of European countries had limited resources for palliative care. The new report described the lack of access to palliative care globally as 'one of the most neglected and inequitable facets of health systems'. The WHO pointed to a handful of barriers, including the lack of specialised palliative care doctors and medical training, low awareness of how palliative care can help patients, and legal restrictions on opioid painkillers. Meanwhile Sallnow wants to see palliative care 'decoupled' from cancer or end-of-life care, and instead integrated into other medical specialties. 'The first step is for healthcare to recognise that death is inevitable and the aim of medicine is not only to avoid death, it is also to relieve suffering,' Sallnow said.
New York Times
17-02-2025
- Health
- New York Times
An Invisible Medical Shortage: Oxygen
At the height of the Covid-19 pandemic, millions of people in poor nations died literally gasping for breath, even in hospitals. What they lacked was medical oxygen, which is in short supply in much of the world. On Monday, a panel of experts published a comprehensive report on the shortage. Each year, the report noted, more than 370 million people worldwide need oxygen as part of their medical care, but fewer than 1 in 3 receive it, jeopardizing the health and lives of those who do not. Access to safe and affordable medical oxygen is especially limited in low- and middle-income nations. 'The need is very urgent,' said Dr. Hamish Graham, a pediatrician and a lead author of the report. 'We know that there's more epidemics coming, and there'll be another pandemic, probably like Covid, within the next 15 to 20 years.' The report, published in The Lancet Global Health, comes just weeks after the Trump administration froze foreign aid programs, including some that could improve access to oxygen. Boosting the availability of medical oxygen would require an investment of about $6.8 billion, the report noted. 'Within the current climate, that's obviously going to become a bit more of a challenge,' said Carina King, an infectious disease epidemiologist at the Karolinska Institute and a lead author of the report. Still, she said, governments and funding organizations should prioritize medical oxygen because of its importance across health care. People of all ages may need oxygen for pneumonia and other respiratory conditions, for severe infections including malaria and sepsis, for surgeries and for chronic lung conditions. Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times. Thank you for your patience while we verify access. Already a subscriber? Log in. Want all of The Times? Subscribe.
