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Fake malaria drug implicated in Burmese man's death

A 23-year old man in Burma with malaria died because the medicine he received was fake, according to an investigative report by an international team of researchers published in PLoS Medicine.

The patient went to a rural hospital in East Burma with a fever and was diagnosed as having a straightforward case of falciparum malaria. He was treated with the vital antimalarial drug artesunate, labeled as made by the company Guilin Pharmaceutical in China. This drug is usually extremely effective, yet the patient went into a coma and died.

The researchers, led by Paul Newton (University of Oxford), analyzed the artesunate tablets that had been used to treat the patient and found that they were fake, containing just 20% of the amount of active drug present in a genuine artesunate tablet.

When genuine artesunate was given to 600 patients with straightforward falciparum malaria in a study in East Burma, every single patient survived. Newton and colleagues conclude that the 23-year old man died from being given fake artesunate.

"Counterfeit artesunate continues to circulate on a vast scale in mainland Southeast Asia," say the authors. So far, only the Guilin Pharmaceutical brand of artesunate has been counterfeited.

Genuine artesunate is relatively expensive, creating a demand among poor, vulnerable people for cheaper alternatives--the counterfeiters, say the authors, are thus preying upon the poor.

Newton and colleagues fear that an epidemic of fake artesunate may also follow in the wake of the genuine artesunate that is being imported for use in sub-Saharan Africa, where the burden of malaria is greatest. The high cost and the shortage of genuine artesunate in Africa provide a favorable situation for the spread of fakes, which could put the lives of thousands of children at risk.

Fake artesunate was found in Cameroon in 2005, and fake dihydroartemisinin (a related antimalarial drug) was reported in Tanzani
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Contact: Andrew Hyde
ahyde@plos.org
44-122-346-3330
Public Library of Science
12-Jun-2006


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