A new multi-country study has found that nearly one in six cancer medicines sold and used in parts of Africa are substandard or falsified, raising serious safety and treatment concerns for thousands of patients battling the disease.
The research — conducted in Kenya, Ethiopia, Cameroon, and Malawi — revealed that 17% of 191 samples of seven commonly used cancer drugs did not contain the correct amount of active pharmaceutical ingredient (API).
The study was carried out between 2023 and 2024 by a team of scientists from the U.S. and Africa, including researchers at Addis Ababa University.
“We found substandard or falsified anticancer medicines in all four countries. These products were present in both major cancer hospitals and private pharmacies,” the researchers said.
Rising Cancer Burden, Weak Oversight
Cancer cases are rising sharply across Africa, with more than 800,000 people diagnosed every year, according to the researchers.
In Kenya and Ethiopia alone, the number of people receiving cancer treatment has grown from a few thousand a decade ago to over 75,000 patients annually.
However, many national drug regulatory agencies lack the tools and capacity to verify the quality of imported anticancer drugs — a gap that leaves patients vulnerable to ineffective or toxic medicines.
The researchers warn that the combination of high demand, high drug costs, and weak regulation has created a market ripe for exploitation by counterfeit or poorly manufactured products.
How the Study Was Done
Samples of seven drugs — including cisplatin, methotrexate, doxorubicin, oxaliplatin, cyclophosphamide, ifosfamide, and leucovorin — were collected from 12 hospitals and 25 pharmacies across the four countries.
Using high-performance liquid chromatography (HPLC), a gold-standard laboratory method, the team measured the actual quantity of active ingredients in each product and compared it to pharmacopeial standards.
Any drug found to contain less than 90% or more than 110% of the stated dosage was deemed substandard. Out of 191 unique batches tested, 32 failed the assay.
“One of the most alarming findings was that fake or substandard drugs looked identical to genuine ones,” the report noted. “Only three of the failed products showed visible irregularities.”
Call for Stronger Regulation
The researchers have shared their findings with regulators in the four participating countries and urged governments to invest in post-market surveillance systems for cancer drugs, similar to efforts that improved the quality of antimalarial medicines in the early 2000s.
They also called on the global research community to focus more attention on the quality of oncology medicines in low- and middle-income countries.
“Cancer chemotherapy is a delicate balance between killing the cancer and harming the patient,” the report warned. “If doses are too low, patients lose their window for effective treatment. If too high, toxicity can be fatal.”
The findings underscore an urgent need for stricter quality control systems and better regional cooperation to protect cancer patients from dangerous counterfeit or low-quality medicines.
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