Sparking new collaboration and multi-stakeholder discussion on substandard and falsified medicines at MQPH 2018

The conference brought together experts from academia, public health, pharmacy, chemistry, law, ethics, social sciences, public engagement, health policy, with national medicines regulatory authorities, NGOs, international organisations and donors. Many conference partners, including the World Health Organization, United States Pharmacopeia (USP), the Wellcome Trust and the Concept Foundation, presented the latest evidence on substandard, falsified and unregulated medicines, and discussed strategies to tackle this global challenge.

Opening speakers Dr Suzanne Hill, Director of the Essential Medicines and Health Products Department of the World Health Organization (WHO), Professor Louise Richardson, Vice-Chancellor of the University of Oxford, Ms Agnes Sitta Kijo, Acting Director General of the Tanzanian Food and Drugs Authority (TFDA), and Professor Sir Nicholas White, Chairman of the MORU Tropical Health Network, called for collaborative efforts beyond geographic borders and sectoral divisions to more urgently intervene to address the serious public health problem of substandard and falsified medical products.

Dr Hill highlighted how as many as 1 in 10 medicines in low and middle-income countries are estimated to be substandard or falsified, and billions of dollars are wasted on substandard or falsified (SF) medical products every year. Dr Hill called for delegates to develop more research to demonstrate the socio-economic impact and cost of substandard and falsified medical products and explained how this could be used to generate more investment from governments. Michael Deats, Group Lead for Substandard and Falsified Medical Products at WHO, presented the work and results of the Global Surveillance and Monitoring System. A number of talks from experts from the Belgium government, Oxfam and the Nigerian parliament focused on the legal and regulatory opportunities and challenges at a global and national level.

It is widely known that antimalarials are a frequent target of criminals, and substandard antimalarials have often been reported in low and middle-income countries. Evidence suggests that sub-therapeutic doses of antimalarials are accelerating the emergence and spread of drug-resistant parasites. Professor Lisa White, Head of MAEMOD at MORU/ University of Oxford, described the development of mathematical models to understand how substandard and falsified medicines affect patient outcomes and contribute to antimicrobial resistance (AMR).

Dr Raffaella Ravinetto of the Institute of Tropical Medicine in Antwerp and scientific advisor at QUAMED, discussed how to optimise medicine quality in supply chains. Raffaella presented examples of loopholes in Asia and Africa that allow substandard and falsified medicines to infiltrate the supply chain in public, private and non-for-profit sectors. Delegates heard a call for more collaboration among stakeholders to optimise the quality of medicines in the supply chain.

Across many sessions at the conference, a lack of evidence and the need for better data standardisation were raised as ongoing challenges, especially in low and middle-income settings. To help address this challenge, IDDO & MORU Network presented an interactive mapping system that tabulates and displays publicly available evidence on the quality of essential medicines, starting with antimalarials, anti-retrovirals and antidiabetic medical products. This tool will be made publicly available online soon. Clark Freifeld from Boston Children's Hospital presented the work he and the IDDO/MORU Network team are conducting, aimed at searching and visualising information on medicine quality from the lay literature in multiple languages. These tools will give us more understanding on the epidemiology of SF medicines on a global scale and how they change through time and space and will provide a valuable resource for policymakers and civil society.

Participants from many organisations explained how SF medical products negate the benefits of access to modern healthcare, especially for the most vulnerable. Many of the conference partners are key stakeholders for the new Medicines We Can Trust campaign (#MedsWeCanTrust) launched earlier this year.

A short statement from the conference participants, will be released soon, followed by a broader consensus statement outlining the key medicine quality policy and research issues to prioritise going forward. It is expected this statement will be released in Spring 2019, in conjunction with activities coordinated by the Medicines We Can Trust Campaign (#MedsWeCanTrust).

Professor Paul Newton, Director of Lao-Oxford-Mahosot Hospital Wellcome Trust Research Unit (LOMWRU) and Head of the IDDO Medicine Quality Group explained, "The conference consensus statement will outline the key opportunities and priority 'next steps' to tackle poor quality medicines. We hope to organise many more opportunities to collaborate and make a real difference to the lives of those affected by this unacceptable global health challenge."

A selection of conference photos will be uploaded onto the MQPH website shortly https://www.tropicalmedicine.ox.ac.uk/medicinequality2018/photos/

Follow @IDDOnews to read the conference highlights and search for #MQPH2018 and #MedsWeCanTrust

For media enquiries please email Andrea Stewart: andrea.stewart@iddo.org

If would like to learn more about our work on Medicine Quality, please visit our Medicine Quality programme or email.