How defective cancer drugs are endangering lives in four African countries
A new study has revealed that one in six cancer medications in Kenya, Ethiopia, Malawi and Cameroon contains defective formulations that could either kill patients or allow cancer to spread unchecked.
Published in The Lancet, the research uncovered dangerous inconsistencies in the potency of chemotherapy drugs, some of which were so diluted they could not treat cancer effectively, while others were so concentrated they risked poisoning patients.
The study was conducted between April 2023 and February 2024 across Kenya, Ethiopia, Malawi, and Cameroon. Researchers collected 251 samples of commonly used cancer drugs, including cisplatin, methotrexate, doxorubicin, and cyclophosphamide, from 12 major hospitals and 25 pharmacies. Alarmingly, between 14% and 24% of all samples failed quality tests.
Active pharmaceutical ingredient (API) levels varied widely, from as low as 28% to as high as 120% of the labelled strength. This means some patients may have been receiving doses too weak to fight their cancer, while others were exposed to potentially fatal overdoses.
The study also revealed that nearly a quarter of the medications tested had already expired, some by almost a year. However, expired drugs did not consistently fail laboratory tests more than non-expired ones, suggesting that poor manufacturing and supply chain lapses are to blame for much of the problem.
“Nearly a quarter of the products (59 [24%] of 251) had expired before analysis, some by nearly a year, but the expired products did not fail HPLC assay at a higher rate than the non-expired products. Ten of the 59 post-expiry products failed assay (ie, a 17% failure rate), whereas 38 of the 189 pre-expiry samples failed assay (ie, a 20% failure rate); these rates were not different at the 95% CI. Failing products were found in all four countries and in both major hospitals and private pharmacies (with no difference in failure rates at the 95% CI),” the researchers noted.
Experts used high-performance liquid chromatography (HPLC) to analyse the samples and compare them against the US Pharmacopoeia standards. They found that visual inspections alone were almost useless in detecting defective drugs. The sensitivity of visual checks was just 9%, meaning most poor-quality drugs appeared normal to the eye. “Many quality defects, such as a shortage of an uncoloured active pharmaceutical ingredient, are not visually apparent,” the authors explained.
Disclaimer: The image used in this article is AI-generated
This story is written and edited by the Global South World team, you can contact us here.
