Research Shows That Fake Medications Are Killing Hundreds of Thousands Globally

Most of us are accustomed to picking up our prescription medication from the pharmacy without a second thought to its safety or reliability. But imagine if your child was ill and the medication you picked up was fake and caused your child to not only not recover but possibly die. That’s the terrifying situation faced by millions of parents around the world.

The spread of fake medicines is at pandemic proportions.  It’s estimated that over one million people die each year from fake drugs, according to Interpol, the world police agency. Peter Pitts, president of The Center for Medicine in the Public Interest puts the number of deaths in China alone at 300,000 annually.

Last year, European officials seized over 34 million fake meds in two months while Irish drug enforcement confiscated 1.7 million pounds of counterfeit and illegal drugs.

In April of 2015, the National Institutes of Health (NIH) reported that scientists inspected medications from around the world and found very disturbing news:

“Scientists inspected the quality of about 16,800 samples of anti-malarials, anti-tuberculosis medicines, antibiotics and anti-leishmaniasis drugs and reported from 9 to 41 percent failed to meet the specifications. Seven separate studies were carried out, primarily in low-resource settings, and included samples from public and private sources.”

World Health Organization 2017 Report

The new World Health Organization  (WHO) report on the public health impact of substandard and falsified medical products, estimates that up to 158,000 people die each year from taking fake malaria medication in sub-Sahara Africa. Counterfeit drugs may kill up to 169,000 children (ages 0-5) worldwide from pneumonia.

Shockingly, the study’s executive summary indicates that those suffering death or ill effects from the use of counterfeit drugs may be sorely underrepresented. The statistical and methodological models used in the study “…are likely to under represent the true impact of substandard and falsified medical products in both disease areas, owing to the lack of exhaustive data and the challenges of incorporating all impact factors into a single model.”

In other words, things are probably a lot worse. There is not yet enough international standardized agreement and cooperation to accurately reflect the true scope of the dangers of fake drugs.

Fake drugs are putting all of us at risk. They are a massive global public health threat.

What is a Fake Drug?

Simply put, fake drugs may:

  • have the correct ingredients but in the wrong amounts
  • have very little of the correct ingredients
  • not have any of the correct ingredients
  • may be misbranded and sold for incorrect purposes.

Fake drugs are meant to fool innocent people who then may face potentially dire consequences.

What Is the Scope of the Problem?

Medicinal forgeries are a growing and pervasive threat to worldwide health, especially in the battle against tuberculosis, malaria, and HIV/AIDS in the developing world.

The Poor and the Powerless

Of serious concern is that most of those suffering from the indignities of counterfeit medications are the poor and the powerless. It is in the developing world that this plague is most damaging. Legions of men, woman and children who lack resources and societal protections are suffering needlessly and are dying prematurely.

The Centers for Disease Control and Prevention (CDC) estimates that “Counterfeiting…is most common in countries where there are few or no rules about making drugs. An estimated 10%–30% of medicines sold in developing countries are counterfeit.”

Many of these nations have little to no infrastructure to deal with the problem. It is estimated by policy experts Amir Attaran and Roger Bate that 2/3 of the world’s nations have no medical regulatory infrastructure or have only incomplete and ineffectual regulation.

Organized Crime

The world’s drug supply is under siege by organized crime.

Fueling the worldwide plague is the profitability of selling fake drugs. It’s estimated to be a 75-billion-dollar market.  According to the Economist: “For criminals, fake pharma is lucrative, and the penalties are usually low. Indeed, the drug supply-chain is a cheat’s paradise.”

Criminals can easily make millions selling fraudulent drugs that are high in demand or too expensive for consumers to purchase. It happens regularly says Michael Deats of WHO: “…if a shortage occurs, hospitals and clinics will step outside the normal supply chain and the (criminals) exploit the situation.”

Desperate People do Desperate Things

Desperate people, who are sick and poor are the primary victims of criminal drug counterfeiting.  They live mostly in underdeveloped rural areas around the globe with little access to advanced medical care.

Local pharmacies are often stocked with cheap, substandard, or fake medications. There is little recourse but to buy what is available and affordable. Unfortunately, this often leads to watching loved ones succumb to malaria, tuberculosis, AIDs, and other treatable diseases.

The Development of Super-bugs

Fake drugs with either substandard and no proper ingredients promote mutations. Resistance to malaria and tuberculosis treatments is becoming widespread globally. This could be disastrous to the ongoing efforts to eradicate these diseases. For malaria alone, the World Health Organization (WHO) estimates that fake drugs are associated with up to 20 percent of the one million malaria deaths worldwide each year.

The tragedy of super-bug proliferation is directly linked to the growth of fake medicines.

Actions Must be Taken

Fake drugs are responsible for hundreds of thousands of deaths each year. The number may even be in the millions. The poor and powerless living in under-resourced environments are victimized most often by the unscrupulous behavior of organized criminals.

The situation is made worse by the often-opposing interests of pharmaceutical companies, national governments, international organizations, and enforcement agencies. This lack of coordination and concerted effort leads to unnecessary ill health and loss of human life along with the development of super bugs that undermines years of valiant efforts to eradicate treatable global diseases.

Efforts are being made but more must be done. Middle and low-income countries continue to suffer. People are dying every day.

Needed Cooperation

Andrea Bomo, a journalist from Cameroon, puts the need for cooperation succinctly:

“Everybody has their role to play: the media, NGOs, pharmaceutical industry and the civil society. The government also has a big responsibility: providing equal access to medicines to the population, raising awareness about the danger of fake medicines in the population and at different levels of the supply chain, taking regulatory and strong legal actions to limit the infiltration of fake drugs into the market and supporting local and international initiatives fighting for the safety and health of the population.”

Regulations

For efforts to work, poorly resourced nations need assistance from developed countries and international organizations to bolster their drug regulatory and enforcement agencies. If these institutions remain weak, the creators of fake medicines will continue to flourish and profit from the misfortune of millions of innocent people.

Pharmaceutical companies need to look beyond their parochial patent and intellectual property worries and take seriously the damage being done by fake medications globally. They are important partners in the efforts to limit, if not eradicate the plague of fake medications.

Less resourced nations must have access to affordable medications that are justly distributed and available to those in need. Without such availability and access, the seeds of criminal activity will continue to grow and flourish, and people will continue to die.

Related CE Article:

One Doctor (out of many) Explains How Prescription Drugs Are Killing Us

 

Why Death Rates Of White Non-Hispanic Americans Are Soaring

In September 2015, researchers announced that death rates have been rising dramatically since 1999 among middle-aged white Americans with a high school degree or less. This dramatic assertion contradicted decades of increasing longevity among all Americans.

A Health Affairs study found this to be especially true for white, female high school drop-outs whose life expectancy “has fallen so much over the past 18 years that these women are now expected to die five years younger than their mothers did.”

Researchers called this occurrence Deaths of Despair. Why? The deaths were mostly caused by suicide, drugs, and alcohol, not the usual things that kill Americans.

What was causing so many white, middle age Americans (45 to 54) to resort to such extreme behaviours leading to their premature deaths?

The reasons were unclear at the time. But in 2017, the same researchers followed up with a clearer explanation for why they thought these deaths were happening. The reasons have to do with what social epidemiologists call Social Determinants of Health (SDoH).

The Social Determinants of Health

Most of us are familiar with the idea of disease as a biological process. We recognize that there are genetic, dietary, and environmental elements that make us healthy or ill. But there is more to the story of what makes us healthy as individuals, as communities, and as a nation.

How often have you considered the role social conditions play as a primary source of our well-being or our state of disease?

Social scientists have steadily, over decades, documented how adverse social conditions can be directly deleterious to health outcomes. These factors are called the social determinants of health (SDoH).

According to the Centers for Disease Control and Prevention (CDC), the social determinants or causes consist of the “conditions in the places where people learn, work, and play” and they “affect a wide range of health risks and conditions.” SDoHs are the causes behind the causes. In other words, the conditions under which we live heavily influence the levels of health or the depths of illness we achieve.

The CDC further defines our health as “determined in part by access to social and economic opportunities; the resources and supports available in our homes, neighborhoods, and communities; the quality of our schooling; the safety of our workplaces; the cleanliness of our water, food, and air; and the nature of our social interactions and relationships.”

This manner of thinking owes a great debt to Thomas McKeown, a British physician who studied death records from the 19th century to the 1960s for England and Wales.

Paula Braveman, MD, indicates that McKeown discovered that mortality rates fell “steadily decades before the availability of modern medical-care such as antibiotics and intensive care units.” McKeown attributed the increase in life expectancy to “improved living conditions, including nutrition, sanitation and clean water.”

Decades of research in this vein has led Tom Boyce, Chief of University of California San Fransisco’s Division of Developmental Medicine, to confidently assert: “Socioeconomic status is the most powerful predictor of disease, disorder, injury and mortality we have.” For example, poor adults who have limited income, poor education, and job status live nearly eight years less than those whose income is well over the poverty level.

It’s been well established by social epidemiologists that health disparities are pronounced in communities that suffer poor housing, low income, dangerous neighborhoods, and substandard education.

So What’s Happening to Non-Hispanic White People in America?

Current research is finding very disturbing trends.

Case and Deaton, authors of the original research cited above, who discovered the Deaths of Despair phenomenon, published an update in March 2017 clarifying what seems to be happening nationwide.

Here’s what they have found:

  • Mid-life mortality rates for all educated classes continues to fall nationwide.
  • Middle-aged non-Hispanic whites with a high school diploma or less have experienced increasing mid-life mortality since the late 1990s.
  • These whites now have a mortality rate 30% higher than blacks in 2015.
  • Originally centered in the southwest in 2000, Deaths of Despair is now nation-wide, including Appalachia, Florida, and the west coast.

According to Prof. Shannon M. Monnat, “Over the past decade, nearly 400,000 people in the U.S. died from accidental drug overdoses and drug-induced diseases. Nearly 400,000 more committed suicide, and over 250,000 died from alcohol-induced diseases like cirrhosis of the liver.”

Most of these increases occurred among white non-Hispanics.

Why Is This Happening?

What makes non-Hispanic white Americans with high school diplomas or less resort to drugs, alcohol, and suicide?

Case and Deaton, in their 2017 article, document an array of social determinants that may explain the unfortunate predicament of a growing segment of the American population. The Brookings Institute’s summary of the research indicates that Deaths of Despair are accompanied “by measurable deterioration in economic and social well-being, which has become more pronounced for each successive birth cohort. Marriage rates and labor force participation rates fall . . . while reports of physical pain, and poor health and mental health rise.”

Case and Deaton have accumulated compelling evidence of the “pain, distress, and social dysfunction in the lives of working class whites that took hold as the blue-collar economic heyday of the early 1970s ended, and continued through the 2008 financial crisis and the subsequent slow recovery.

With the ever-looming twin spectres of globalization and technological change, white Americans were faced with dwindling resources and shrinking opportunities. Unions faltered, mining spiralled downward, pensions disappeared, and high paying working-class jobs dwindled. Social institutions faded. Church attendance decreased, marriage became less common, while men were less likely to find good jobs or even be in the labour market at all.

These trends continue to deepen and spread. Outcomes for non-Hispanic white Americans are expected to worsen.

What Is to Be Done?

If social epidemiologists are correct, illness within a population is shaped, in part, by social dysfunctions or political imbalances such as poor educational opportunities, unemployment or underemployment, lack of access to health care, political dis-empowerment, and a breakdown in social institutions.

Changing current socioeconomic dynamics will take decades to ameliorate. Robust economic and structural policies need articulation addressing deepening white American marginalization.

At a minimum, policies mitigating the negative impacts of globalization and technological change need to include a societal and governmental commitment to:

  • Address and alleviate the negative impact of global trade agreements, especially on regional populations that may be losers in the rush to globalization and open markets.
  • Provide proper job training and retraining, apprenticeships, quality education, and career development to affected areas.
  • Maintain an effective safety net to address problems of unemployment, social dysfunction, nutrition, and mental and physical health.
  • Support access to healthy food, clean water, medical services, drug and alcohol rehabilitation, affordable housing, and the rule of law.
  • Address the social, emotional, and reproductive needs of white women who have been disproportionately affected by despair and hopelessness.

Illness in the SDoH paradigm is related to the daily living conditions people endure. Solutions to the Deaths of Despair need to help people maintain and improve their daily living conditions, preserve hope, and live with dignity.

Watch this video to learn more about the Deaths of Despair research.

How Bad Medical Research is Destroying Our Health & Faith in Science

Our trust in science is waning. Do you believe what you hear from scientists? Like many Americans, you may be losing trust in what science is telling you.

A Huffington Post December 2013 poll found that only 36 percent of us have a “lot” of trust in the reliability of scientific information. 78 percent think that scientific studies are often or sometimes tainted by political ideology. And 82 percent believe scientific findings are often or sometimes influenced by the companies sponsoring the research. This is a disquieting trend.

This lack of confidence is especially strong regarding the nutritional and medical professions. One day it’s bad to eat eggs, the next day it’s good. A recent survey conducted by the International Food Information Council (IFIC) underscores how confused we really are:

Seventy-eight percent of the 1,002 respondents indicated they have encountered conflicting information about what constitutes a healthy food. Fifty-six percent felt that the confusion made them doubt the choices they were making food wise. Liz Sanders, director of research and partnerships at the foundation and a co-author of the survey said in a CNN report that:

“Americans rely on many different sources for their information when it comes to what foods to eat and what foods to avoid. Not all of these sources are really highly trusted, and it is likely that these sources share inconsistent information.”

How often have you found yourself or heard a family member dismissing a new nutritional study by saying “Forget it, these reports are too confusing and always changing. I’m going to eat and do what I like.” As it turns out, you and your family member share your confusion with a majority of Americans.

Why Are We Losing Trust In Science?

Setting aside the issue of religious fundamentalism, which can account for some of the mistrust of science, one possibility is the growing unreliability of many medical and nutritional practices and research. In the past few decades, there have been many medical and nutritional ideas that were later proven to be incorrect and even harmful.

Here’s a list of just a few confusing medical and nutritional practices prevalent in the past few decades that may have had a negative impact on your health:

  • Stents – stents cost about $30k a piece and are performed on over half a million Americans each year but there is little data indicating they prevent stroke.
  • High Carbohydrate Diets – touted as the cure for heart disease for over 40 years, they have led to an obesity and diabetes epidemic with no clear support for their efficacy.
  • Arthroscopic Knee Surgery – up to one million surgeries have been performed each year but a systematic review in the British Medical Journal found that for patients with meniscus tears it was no better than exercise therapy.
  • Vitamin Elong thought to prevent cancer and heart disease. Numerous international studies found no benefit for protection against heart disease, stroke or cancer.
  • Proton Pumps – the treatment of GERD costs Americans a billion dollars a year. Long term use (greater than 14 days) can lead to serious side-effects, such as  such as clostridium difficile infection, pneumonia, and malabsorption of calcium and magnesium leading to bone fractures and cardiac abnormalities.

As I’ve written elsewhere and as you can see from the above list, the health of millions of people is routinely compromised by flawed medical research and practices.

Medical journalist Richard Harris, makes some damaging revelations in Rigor Mortis: How Sloppy Science Creates Worthless Cures, Crushes Hope and Wastes Billions:

1 – the state of biomedical research

…medical researchers made much more progress between 1950 and 1980 than they did in the following three decades. Consider the development of blood-pressure drugs, chemotherapy, organ transplants, and other transformative technologies. Those all appeared in the decades before 1980.

2 – the development of new pharmaceutical drugs

The rate of drug approval has been falling since the 1950s…if you extrapolate the trend, starting in 1950, you’ll find that drug development comes to a halt in 2040.

In 2005 Dr. John P.A. Ioannidis, currently a professor in disease prevention at Stanford University, published the most widely accessed article in the history of the Public Library of Science (PLoS) entitled Why Most Published Research Findings Are False. It stated:

“There is increasing concern that most current published research findings are false.”

And that “…in modern research, false findings may be the majority or even the vast majority of published research claims.”

Ioannidis’ research model indicated that up to 80 percent of non-randomized research studies (the most common kind of study) are wrong, along with twenty-five percent of randomized trials (the supposed gold standard of research). Incredulously, these studies are published in top peer reviewed medical journals.

Much of what our physicians prescribe to us is wrong. Our doctors use research to inform their medical decisions – decisions about what drug to prescribe, which surgery to elect, and the best health strategy to adopt. They are often making crucial treatment decisions for depression, Alzheimer’s, type 2 Diabetes, cancer, obesity, etc. based on bad, incomplete or hidden medical research.

The Evolution of Bad Medical Science

Why is this happening? Why is so much of biomedical research so poorly done?

As it stands now, researchers are typically rewarded (tenure, grants, better jobs, etc.) for publishing a quantity of publications in prestigious journals. They do this by

  • Running small and statistically weak studies (they are easy to do) that produce only positive results since journals tend to not publish negative findings.
  • Ignoring negative findings.
  • Publishing only new and exciting findings that journals are looking for.
  • Never checking old findings for accuracy and replicability.
  • Changing methodologies in mid-stream to assure positive results.

The result is a proliferation of false and misleading findings that confuse scientists and the rest of us, waste billions of dollars and undermine the scientific endeavour and our health.

To tackle why this is happening, two scientists, Smaldino and McElreath, created a computational model based on evolutionary theory (natural selection) to explain the rising tide of weak biomedical research. They did this by simulating virtual research labs competing under conditions that exist today. The labs that put more effort into their research received fewer publications. The labs that published more received more grants, students and prestige.

The Results

Over numerous simulations and generations, the labs that were most successful (most publications, grants, etc.) passed their approach on to the next generation and proliferated. The labs that did not publish large amounts of research did not get the grants and prestige and did proliferate as readily.

As occurs in natural selection, the most successful labs recreated themselves with greater frequency.

Ed Yong of the Atlantic Monthly summarized the results: “Over time, and across many simulations, the virtual labs inexorably slid towards less effort, poorer methods, and almost entirely unreliable results.”

Conclusion

With the emphasis on quantity of publication, the forces of natural selection will continue to select for poor research, false findings, muddled methodology and accelerating confusion in the world of health and bio medical research. Replicability of findings will continue to falter as poor research studies abound.

The losers in all of this are those of us trying to make sense of what science is telling us so we can live better, more wholesome, and healthier lives.

Related CE Article:

Peer-Reviewed Science Losing Credibility As Large Amounts of Research Shown To Be False