Quality of vaccines and medicines must be monitored

EDITOR—Smith points to increasing international awareness about inadequate supplies of vaccines and drugs in tropical countries.1 Future private-public partnerships for better supply of vaccines and medicines for the world's poorest countries with “push” and “pull” mechanisms and financial allocation of billions of dollars by the American Congress would indeed imply adequate funds for researchers and others. Nevertheless, even that exorbitant fiscal input would provide little relief to many people living in tropical countries. Funds should be spared to monitor the quality of vaccines, drugs, and diagnostics in such countries.

There have been frequent reports of the poor quality of vaccines, drugs, and diagnostics in Asia, Africa, and Latin America. In Kelantan, a state in northwestern Malaysia, the contents of 14 of 33 phials of live poliovirus vaccine did not meet the criteria of a potent vaccine.2 Assay of active ingredients of tetracycline, co-trimoxazole, ampicillin-clavulanate, and chloroquine being offered to patients in Nigeria and …