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<h1>The Briefing: Substandard medicines and antibiotic resistance</h1><section class="abstract"><p>A lot of research goes into our stories. Here are some of the resources we used to put together our story on the global industry behind fake drugs.&nbsp;</p>
</section><p>The manufacture and distribution of medicines is a global industry, tainted by fake and substandard products. Not only might these drugs not work as expected, but some are even contributing to antimicrobial resistance. In <a href="https://mosaicscience.com/story/fake-drugs-global-industry-putting-your-life-risk/">this feature for Mosaic</a>, Srinath Perur meets the experts attempting to track poor-quality medicines, and uncovers the magnitude of the problem.</p>
<p>If you want to dive deeper into this topic, here’s some further reading. We’ve broken things down into key subtopics, but otherwise these links aren’t listed in any particular order – so feel free to dip in and out.&nbsp;</p>

<h3>A global industry</h3>

<p>This <a href="https://www.theguardian.com/business/2009/jan/04/fake-pharmaceuticals-drugs-china-nhs">2009 Observer&nbsp;article</a> traces the journey of some counterfeit pills, which were produced by gangs in China, labelled in France, shipped to Singapore, then sold to the NHS in Liverpool.</p>
<p>The World Health Organization released <a href="http://www.who.int/medicines/regulation/ssffc/publications/GSMS_ExecutiveSummary_EN.pdf?ua=1">this report</a> in 2017, which outlines the problem of substandard and falsified medical products, gives evidence of its global scope, and suggests some ways it might be overcome.</p>
<p>Since globalisation has exacerbated the problem of fake medicines, <a href="https://jamanetwork.com/journals/jama/fullarticle/1674232">this 2013 review</a> argues that finding a solution will require similar levels of international cooperation. &nbsp;</p>
<p>For a more detailed exploration of the global fake drugs industry, including recent examples, further references, and useful images, check out <a href="https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.0020100">this 2005 paper</a>.&nbsp;</p>

<h3>Antibiotic resistance: the basics</h3>

<p><a href="https://www.huffingtonpost.co.uk/dr-james-kinross/the-drugs-dont-work-antib_b_18549512.html">This 2017 article</a> provides a simple introduction to the history of antibiotics, and how they have been misused over the years.</p>
<p>Maryn McKenna’s TED Talk&nbsp;<a href="https://www.youtube.com/watch?v=o3oDpCb7VqI">What do we do when antibiotics don’t work any more?</a> questions whether we are about to enter a post-antibiotic world, where we could once again die from relatively simple injuries.</p>

<h3>Global efforts against antibiotic resistance</h3>

<p><a href="http://www.who.int/news-room/fact-sheets/detail/antibiotic-resistance">This guidance</a> on antibiotic resistance, released earlier this year by the World Health Organization, gives an overview of what different sectors can do to combat the issue.</p>
<p><a href="http://www.bbc.com/future/story/20170607-how-we-can-stop-antibiotic-resistance">This feature for BBC Future</a> gives a comprehensive overview of the studies around antibiotic resistance, and asks how we might put a stop to it.</p>

<h3>How can we tackle fake drugs?</h3>

<p>In spite of the scale of the fake drugs industry, <a href="https://www.weforum.org/agenda/2015/08/how-do-we-combat-the-problem-of-counterfeit-drugs/">this article</a> argues that a sustainable solution is most likely to be found in local innovations.</p>
<p><a href="https://bmjopen.bmj.com/content/bmjopen/5/3/e006290.full.pdf">This 2015 paper</a> conducts a detailed evaluation of the effectiveness of different interventions to combat drug counterfeiting. The results found initiatives such as drug registration to be useful, while other interventions, such as the licensing of drug outlets, were found to be less effective.</p>
<p>In his <a href="https://mosaicscience.com/story/fake-drugs-global-industry-putting-your-life-risk/">feature for Mosaic</a>, Srinath Perur interviews Suresh Sati – a private investigator who is committed to exposing fake drug manufacturers. Head to <a href="https://twitter.com/fakesfreeindia?lang=en">Suresh’s Twitter page</a> for up-to-date information on his #FakesFreeIndia campaign. Suresh is also featured in the documentary <em>Lethal Fake Medicine</em>; <a href="https://vimeo.com/160436230">watch the trailer.</a></p>

<h3>More from Mosaic</h3>

<p>Mike Barrett’s feature <a href="https://mosaicscience.com/story/penicillin-first-patient-history-albert-alexander-AMR-DRI/">Penicillin’s first patient</a>&nbsp;details the remarkable recovery of Constable Albert Alexander, after he was treated with the first ever antibiotic. &nbsp;</p>
<p>On receiving the 1945 Nobel Prize in Physiology or Medicine for discovering penicillin, Alexander Fleming warned: “There is a danger&nbsp;that the ignorant man may easily under-dose himself and, by exposing his microbes to non-lethal qualities of the drug, make them resistant.” In <a href="https://mosaicscience.com/story/gonorrhoea-gonorrhea-STI-Thailand-clap-USA-AMR-super/">Wherever you are, time is running out for treating gonorrhoea,</a> Sophie Cousins warns that two-thirds of countries have reported gonorrhoea cases that resist all known antibiotics.</p>
<p>In <a href="https://mosaicscience.com/story/how-malaria-defeats-our-drugs/">How malaria defeats our drugs,</a> Ed Yong investigates how drugs have gradually become resistant to parasites.</p>

<h3>What to do if you suspect you have fake medicine</h3>

<p>In the UK contact&nbsp;<a href="https://yellowcard.mhra.gov.uk/">The Yellow Card Scheme</a>;&nbsp;in the US&nbsp;contact&nbsp;<a href="https://www.fda.gov/Drugs/ResourcesForYou/Consumers/BuyingUsingMedicineSafely/CounterfeitMedicine/ucm235435.htm">The FDA</a>;&nbsp;in India contact the&nbsp;<a href="https://cdsco.gov.in/opencms/opencms/en/consumer/">Central Drugs Standard Control Organization</a>; in Australia contact&nbsp;<a href="https://www.tga.gov.au/reporting-problems">The Department of Health</a>.</p>

<p>The manufacture and distribution of medicines is a global industry, tainted by fake and substandard products. Not only might these drugs not work as expected, but some are even contributing to antimicrobial resistance. In <a href="https://mosaicscience.com/story/fake-drugs-global-industry-putting-your-life-risk/">this feature for Mosaic</a>, Srinath Perur meets the experts attempting to track poor-quality medicines, and uncovers the magnitude of the problem.</p>
<p>If you want to dive deeper into this topic, here’s some further reading. We’ve broken things down into key subtopics, but otherwise these links aren’t listed in any particular order – so feel free to dip in and out.&nbsp;</p>

<h3>A global industry</h3>

<p>This <a href="https://www.theguardian.com/business/2009/jan/04/fake-pharmaceuticals-drugs-china-nhs">2009 Observer&nbsp;article</a> traces the journey of some counterfeit pills, which were produced by gangs in China, labelled in France, shipped to Singapore, then sold to the NHS in Liverpool.</p>
<p>The World Health Organization released <a href="http://www.who.int/medicines/regulation/ssffc/publications/GSMS_ExecutiveSummary_EN.pdf?ua=1">this report</a> in 2017, which outlines the problem of substandard and falsified medical products, gives evidence of its global scope, and suggests some ways it might be overcome.</p>
<p>Since globalisation has exacerbated the problem of fake medicines, <a href="https://jamanetwork.com/journals/jama/fullarticle/1674232">this 2013 review</a> argues that finding a solution will require similar levels of international cooperation. &nbsp;</p>
<p>For a more detailed exploration of the global fake drugs industry, including recent examples, further references, and useful images, check out <a href="https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.0020100">this 2005 paper</a>.&nbsp;</p>

<h3>Antibiotic resistance: the basics</h3>

<p><a href="https://www.huffingtonpost.co.uk/dr-james-kinross/the-drugs-dont-work-antib_b_18549512.html">This 2017 article</a> provides a simple introduction to the history of antibiotics, and how they have been misused over the years.</p>
<p>Maryn McKenna’s TED Talk&nbsp;<a href="https://www.youtube.com/watch?v=o3oDpCb7VqI">What do we do when antibiotics don’t work any more?</a> questions whether we are about to enter a post-antibiotic world, where we could once again die from relatively simple injuries.</p>

<h3>Global efforts against antibiotic resistance</h3>

<p><a href="http://www.who.int/news-room/fact-sheets/detail/antibiotic-resistance">This guidance</a> on antibiotic resistance, released earlier this year by the World Health Organization, gives an overview of what different sectors can do to combat the issue.</p>
<p><a href="http://www.bbc.com/future/story/20170607-how-we-can-stop-antibiotic-resistance">This feature for BBC Future</a> gives a comprehensive overview of the studies around antibiotic resistance, and asks how we might put a stop to it.</p>

<h3>How can we tackle fake drugs?</h3>

<p>In spite of the scale of the fake drugs industry, <a href="https://www.weforum.org/agenda/2015/08/how-do-we-combat-the-problem-of-counterfeit-drugs/">this article</a> argues that a sustainable solution is most likely to be found in local innovations.</p>
<p><a href="https://bmjopen.bmj.com/content/bmjopen/5/3/e006290.full.pdf">This 2015 paper</a> conducts a detailed evaluation of the effectiveness of different interventions to combat drug counterfeiting. The results found initiatives such as drug registration to be useful, while other interventions, such as the licensing of drug outlets, were found to be less effective.</p>
<p>In his <a href="https://mosaicscience.com/story/fake-drugs-global-industry-putting-your-life-risk/">feature for Mosaic</a>, Srinath Perur interviews Suresh Sati – a private investigator who is committed to exposing fake drug manufacturers. Head to <a href="https://twitter.com/fakesfreeindia?lang=en">Suresh’s Twitter page</a> for up-to-date information on his #FakesFreeIndia campaign. Suresh is also featured in the documentary <em>Lethal Fake Medicine</em>; <a href="https://vimeo.com/160436230">watch the trailer.</a></p>

<h3>More from Mosaic</h3>

<p>Mike Barrett’s feature <a href="https://mosaicscience.com/story/penicillin-first-patient-history-albert-alexander-AMR-DRI/">Penicillin’s first patient</a>&nbsp;details the remarkable recovery of Constable Albert Alexander, after he was treated with the first ever antibiotic. &nbsp;</p>
<p>On receiving the 1945 Nobel Prize in Physiology or Medicine for discovering penicillin, Alexander Fleming warned: “There is a danger&nbsp;that the ignorant man may easily under-dose himself and, by exposing his microbes to non-lethal qualities of the drug, make them resistant.” In <a href="https://mosaicscience.com/story/gonorrhoea-gonorrhea-STI-Thailand-clap-USA-AMR-super/">Wherever you are, time is running out for treating gonorrhoea,</a> Sophie Cousins warns that two-thirds of countries have reported gonorrhoea cases that resist all known antibiotics.</p>
<p>In <a href="https://mosaicscience.com/story/how-malaria-defeats-our-drugs/">How malaria defeats our drugs,</a> Ed Yong investigates how drugs have gradually become resistant to parasites.</p>

<h3>What to do if you suspect you have fake medicine</h3>

<p>In the UK contact&nbsp;<a href="https://yellowcard.mhra.gov.uk/">The Yellow Card Scheme</a>;&nbsp;in the US&nbsp;contact&nbsp;<a href="https://www.fda.gov/Drugs/ResourcesForYou/Consumers/BuyingUsingMedicineSafely/CounterfeitMedicine/ucm235435.htm">The FDA</a>;&nbsp;in India contact the&nbsp;<a href="https://cdsco.gov.in/opencms/opencms/en/consumer/">Central Drugs Standard Control Organization</a>; in Australia contact&nbsp;<a href="https://www.tga.gov.au/reporting-problems">The Department of Health</a>.</p>

<img src="https://mosaicscience.com/mwt-republish-img/1567/republish.gif" />This <a href="https://mosaicscience.com/story/briefing-substandard-medicines-and-antibiotic-resistance">article</a> first appeared on <a href="https://mosaicscience.com">Mosaic</a> and is republished here under a Creative Commons licence.
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