This World: Bad MedicineBMJ 2005; 331 doi: https://doi.org/10.1136/bmj.331.7509.165 (Published 14 July 2005) Cite this as: BMJ 2005;331:165
- Peter Winstanley, professor of clinical pharmacology
- University of Liverpool
BBC 2, Tuesday 12 July at 9 pm
This piece of investigative journalism covered the massive worldwide trade in substandard drugs and the harm that these do. Nigeria was the focus, but I suspect that the programme could have been made about almost any developing country.
The context in which this scam flourishes is one of, firstly, widespread failure to contain major killers, most notably infectious diseases such as malaria, tuberculosis, and HIV; secondly, personal and national poverty; and thirdly, underdeveloped regulatory systems.
Malaria and tuberculosis are both curable, and HIV can be contained by drugs, and people the world over have the right to expect standards of quality, efficacy, and safety. Tablets must contain the specified mass of the active ingredient, must not contain more than (defined) traces of contaminants, and must be bioavailable. Furthermore, the efficacy and safety of a drug must have been shown as part of rigorous clinical trials before the drug is launched. Legislation around these basic principles has evolved over the centuries but has most recently been …