Latest news with #subSaharanAfrica
The Independent
12 hours ago
- Politics
- The Independent
World Bank warns that 39 fragile states are falling further behind as conflicts grow, get deadlier
The world's most desperate countries are falling further and further behind, their plight worsened by conflicts that are growing deadlier and more frequent. That is the sobering conclusion of the World Bank's first comprehensive study of how 39 countries contending with 'fragile and conflict-affected situations'' have fared since the COVID-19 pandemic struck in 2020. 'Economic stagnation —rather than growth —has been the norm in economies hit by conflict and instability,' said Ayhan Kose, the World Bank's deputy chief economist. Since 2020, the 39 countries, which range from the Marshall Islands in the Pacific to Mozambique in sub-Saharan Africa, have seen their economic output per person fall by an average 1.8% a year. In other developing countries, by contrast, it grew by an average 2.9% a year over the same period. More than 420 million people in the fragile economies are living on less than $3 a day — the bank's definition of extreme poverty. That is more than everywhere else combined, even though the 39 countries account for less than 15% of the world's people. Many of these countries have longstanding problems with crumbling infrastructure, weak governments and low levels of education. People in the 39 countries get an average of just six years of schooling, three years fewer than those in other low- and middle-income countries. Life expectancy is five years shorter and infant mortality is twice as high. Increasing conflicts have made things worse. In the 2000s, the world saw an annual average of just over 6,000 conflicts — in which organized groups used armed force against other groups or against civilians and cause at least one death. Now the annual average exceeds 20,000. The conflicts are more lethal, too: In the 2000s, they took an average of fewer than 42,000 lives a year. From 2000 through 2024, the number averaged almost 194,000. Of the 39 countries, 21 are involved in active conflicts, including Ukraine, Sudan, Ethiopia and Gaza. The World Bank finds that countries involved in high-intensity conflict — which kill more than 150 out of every 1 million people — see a cumulative drop of 20% after five years in their gross domestic product, the output of goods and services. More conflict also means more hunger: The World Bank estimated that 18% -- around 200 million – of the people in the 39 countries are 'experiencing acute food insecurity'' compared with just 1% in other low and middle-income countries. Some countries have managed to escape the cycle of conflict and economic fragility. Kose cites Nepal; Bosnia and Herzegovina; Rwanda; and Sri Lanka as relative success stories. And the World Bank report notes that the 39 countries do enjoy strengths, including natural resources such as oil and natural gas and a lot of young, working-age people at a time when many economies are aging. 'Some of them are very rich when it comes to their tourism potential,'' Kose said. 'But you need to have security established. You and I are not going to go and visit these places unless they are safe even though they might be the most beautiful places in the world.''
Zawya
2 days ago
- Business
- Zawya
Rwanda: African Development Bank kickstarts pioneering cable car project in Kigali
The African Development Bank ( has approved a grant of $500,000 to undertake a feasibility study into the first phase of a cable car transport network in Kigali, that will be sub-Saharan Africa's first aerial urban transit system. The funds, to be sourced from the Bank Group's Urban and Municipal Development Fund ( are expected to help pave the way for the Kigali Urban Cable Car Project, a 5.5 km mobility initiative valued at $100 million and promising to ease the city's traffic congestion, reduce greenhouse gas emissions, and connect underserved communities to jobs and essential services. The Urban and Municipal Development Fund (UMDF) is a trust fund hosted by the African Development Bank, which provides direct support to cities, to mobilize funding and technical assistance, develop partnerships, city engagement, project identification and investment. Phase 1 of the project will comprise two critical transit corridors: Nyabugogo Taxi Park to the Central Business District (CBD) Hub; and the Kigali Convention Center to Kigali Sports City, connecting public landmarks such as Amahoro Stadium, BK Arena, and the newly developed Zaria Court. The feasibility study is expected to position the project to attract international investment, including through platforms such as the Africa Investment Forum (AIF). The UMDF provided funding for the feasibility of another project in the country, the Kigali Urban Transport Improvement project, to help attract critical investment. Construction is expected to begin in late 2026, with commissioning scheduled for 2028. Once complete, the cable car will convey over 50,000 passengers a day on a 15-minute end-to-end journey, integrating into the city's existing transport infrastructure. African Development Bank Group president Dr. Akinwumi Adesina, said: 'This transformative project aligns perfectly with the Bank's vision for sustainable, green climate-resilient urban mobility infrastructure, and with the Bank's Ten-Year Strategy, which focuses on urbanization, and the Alliance for Green Infrastructure in Africa (AGIA), a global partnership initiative driven by the African Development Bank Group, Africa50 and the African Union. By financing Rwanda's urban cable car system, we are investing in a scalable model of low-carbon, inclusive public transport that cities across Africa can emulate.' The project is anchored in Rwanda's Green Taxonomy, E-mobility Strategy, and Climate and Nature Finance Strategy (CNFS) and aligns closely with Rwanda's national climate objectives, which target a 38% reduction in carbon emissions by 2030 and carbon neutrality by 2050. The project implementation is expected to follow a Public-Private Partnership model, according to Imena Munyampenda, the Director General of Rwanda Transport Development Agency. The feasibility study plans to draw lessons from successful cable car systems in La Paz, Bolivia, and Singapore. The system will prioritize access for the disabled, employment opportunities for girls, women and low-income residents; and job creation, capacity building and technology transfer. 'This pioneering feasibility study is a game-changing milestone,' said Solomon Quaynor, African Development Bank's Vice President for Private Sector, Infrastructure, and Industrialization. 'Through the UMDF, AfDB is laying the foundation for an investment-ready green infrastructure asset that offers both impact and returns.' Blended Financing The $100 million funding structure will comprise a strategic mix of grants, concessional loans, blended finance, and technical assistance. The UMDF grant will fund an assessment of the project's viability gap. The Rwandan government, the African Development Bank Group, and other development partners, will collaborate to offer blended financing, along with commercial funding from the International Finance Corporation (IFC), Africa50, the Trade and Development Bank (TDB), the Africa Finance Corporation (AFC), as well as private investors and the Alliance for Green Infrastructure in Africa (AGIA). Distributed by APO Group on behalf of African Development Bank Group (AfDB).
Zawya
2 days ago
- Business
- Zawya
How Ecobank is helping SMEs thrive under AfCFTA?
Souleymane Diagne (pictured opposite), Group Head of Trade at Ecobank is convinced that the African Continental Free Trade Area (AfCFTA) has opened up a vast and unprecedented opportunity for the continent's SMEs, the backbone of Africa's economy, to thrive and generate great wealth for Africa. By opening up access to market op- portunities beyond national borders, the AfCFTA can help African SMEs to expand their production capacity, modernise their business operations, and create more jobs across their supply chains. AfCFTA, which became operational in 2021, aims to eliminate most tariffs on goods and services traded among African Union member countries, while enabling the free movement of businesspeople and capital. According to estimates by the World Bank, the AfCFTA will increase Africa's income by $450bn, increase in- tra-African exports by more than 81% and boost the continent's GDP by 7% by 2035. However, Diagne points out that African SMEs face several challenges in accessing the opportunities that the AfCFTA presents. A major obstacle holding back SMEs is limited visibility of market opportunities in different countries on the continent. Financing also remains a significant hurdle. Indeed, the International Monetary Fund (IMF) estimates that nearly half of the 40m SMEs active in sub-Saharan Africa lack access to credit, despite these enter- prises accounting for 90% of businesses on the continent and employing 60% of the workforce. Moreover, a significant number of Af-rican SMEs operate in the informal sec- tor, which presents its own unique set of challenges. These enterprises often lack official registration, proper governance structures, and standardised accounting practices, making it difficult for them to secure loans and investments from formal financial institutions. The informal nature of these busi- nesses also means they are less likely to benefit from government policies and initiatives aimed at supporting SMEs. Addressing the challenges Souleymane Diagne insists that these challenges must need to be definitively addressed for African SMEs to reap the full benefits of the AfCFTA. Ecobank is already working on smoothing out the road to prosperity and is at the forefront of empowering SMEs to overcome these challenges through its Ecobank Single Market Trade Hub. Launched in 2021, this platform con- nects registered businesses across Africa and allows them to capitalise on oppor- tunities within the unified market created by AfCFTA. 'At Ecobank, we see Africa as more than just a continent, it is home, and we are passionate about continuing to sustain- ably transform its socio-economic land- scape using trade as a key lever,' he says. 'In this quest, Ecobank Single Market Trade Hub is a key contribution to the Af- CFTA as a key pillar under the AU Agenda 2063.' The platform provides valuable infor- mation about the AfCFTA, enables import- ers and exporters to upload their profiles, and facilitates online matchmaking to enable businesses to find partners. Once a match is made, transactions can be seamlessly concluded using Ecobank's trade and payment solutions, which are available across 35 African markets. 'Registration is free and open to non- Ecobank clients. The idea is to ensure there's visibility of products and services across the continent,' Diagne explains, revealing that over 7,500 importers and exporters are profiled on the platform. 'Our vision is simple; leverage our 30m+ customer base, unrivalled expertise on the African markets, payment capabilities and unparalleled network advantage to stimu- late a truly integrated marketplace where African businesses can connect, access trade opportunities, and contract across 35 African markets,' he says. Diagne is proud of the fact that the bank is registering significant growth in the number of successful connections achieved via the platform. 'A concrete example comes from Guinea, where Kaba Textile, a textile production company, has benefited significantly from the Ecobank Trade Hub,' he notes. Sékou Kaba, General Manager, Kaba Textile, shared his experience, stating that he discovered the platform through his relationship with Ecobank Guinea: 'I was able to establish a new partnership with Vintage Shop, a clothing retail company based in Guinea. This partnership al- lowed me to strengthen my resources and achieve a transaction volume of $10,000. Through this platform, I hope to develop new partnerships and expand my inter- national relations.' Diagne gives the example of another client, also based in Guinea and operat- ing in the paint industry, who noted that the platform contributed to increasing revenue through a collaboration with Mé- tal Guinée. 'He completed a transaction exceeding $8,000 and expressed his am- bition to establish additional partnerships, pool resources, and enhance his experi- ence with other companies.' The financial link Diagne says that the goal is not just to provide visibility for African traders, but to build trust between African businesses and foster greater trade and investment between countries on the continent. To do this, Ecobank has partnered with other like-minded players in African finance. 'We've been keen to partner with stake- holders who share our vision and recently collaborated with Afreximbank to interface Ecobank's Single Market Trade Hub with the MANSA Digital Repository platform,' he notes. This collaboration allows users of the Ecobank Single Market Trade Hub to ac- cess MANSA's extensive database to con- duct effective customer due diligence and know-your-customer checks. Diagne reveals that Ecobank is cur- rently scaling up its financing for SMEs, bolstered by its recent partnership with the African Guarantee Fund (AGF). Last year, Ecobank and the AGF signed a $200m risk-sharing facility to enhance the bank's lending capacity to SMEs, including women-owned enterprises. This agreement marks the third re- newal of Ecobank's collaboration with AGF. The initial guarantee, provided by AGF in 2013, covered seven countries with a total guaranteed portfolio of $50m. In 2018, the guarantee's scope expanded to 14 countries, resulting in cumulative disbursements of $230m. The renewed $200m partnership now extends to 27 countries within Eco- bank's African network, offering 50% coverage for qualifying SMEs across all target markets. This partnership with AGF comes on the back of similar deals with other financial institutions aimed at boosting the bank's lending to SMEs. 'Partnerships with the AGF and other development fi- nance institutions have helped us scale the quantum of financing we provide to SMEs,' Diagne says. 'We have designed long-term credit programmes for quali- fying SMEs that enable us to structure financing at scale for them,' he explains. Ecobank Sierra Leone, for example, signed a $25m risk sharing facility with British International Investment, the UK government's development finance insti- tution, in October 2024 to help the lender upsize its SME loan book in the country. Commercial banks often require SMEs to provide substantial collateral to se- cure large loans to mitigate risk. How- ever, this frequently disadvantages SMEs, which typically have limited resources. By partnering with Development Finance Institutions through risk-sharing facilities – as Ecobank has done – lenders can effectively manage risk while alleviating the collateral burden on SMEs. This col- laboration presents a viable solution for supporting the growth and development of SMEs. As the economic history of all countries shows, national wealth is almost always in direct proportion to that of SMEs, which also generate more employment than any other structures. By thus empowering the SME sector in a connected Africa, Ecobank is actively contributing to Africa's overall prosperity and progress. n 'We've been keen to partner with stakeholders who share our vision and recently collaborated with Afreximbank to interface Ecobank's Single Market Trade Hub with the MANSA Digital Repository platform.' © Copyright IC Publications 2022 Provided by SyndiGate Media Inc. (
Mail & Guardian
2 days ago
- Health
- Mail & Guardian
‘It's heartbreaking': bad cancer drugs shipped to more than 100 countries
The burden of cancer is growing, particularly in low- and middle-income regions. In sub-Saharan Africa, for example, instances of cancer have doubled in the last 30 years. (File photo) Vital chemotherapy drugs used around the world have failed quality tests, leaving cancer patients in more than 100 countries at risk of ineffective treatments and potentially fatal side effects, The drugs in question form the backbone of treatment plans for numerous common cancers — including breast, ovarian and leukemia. Some drugs contained so little of their key ingredient that pharmacists said giving them to patients would be as good as doing nothing. Other drugs, containing too much active ingredient, put patients at risk of severe organ damage or even death. 'Both scenarios are horrendous,' said one pharmacist. 'It's heartbreaking.' Doctors from multiple countries told TBIJ of the drugs in question not working as expected, leaving patients suddenly unresponsive to treatment. Other patients suffered side effects so toxic that they could no longer tolerate the medicine. The variance found in the levels of active ingredient was alarming. In some cases, pills from the same blister pack contained different amounts. These findings expose huge holes in the global safety nets intended to prevent profit-seeking manufacturers from cutting corners and to protect patients from bad drugs. All the while, patients and governments with stretched resources are paying the price for drugs that don't work. A global killer Cancer is one of the biggest killers worldwide, linked to around 10 million deaths every year — roughly one in six. The burden of cancer is growing, particularly in low- and middle-income regions. In sub-Saharan Africa, for example, instances of cancer have doubled in the last 30 years. Much of the global demand for treatment is met by so-called generic drugs. These are versions of a drug that can be made once the original maker's exclusivity rights have expired and are typically made far more cheaply. The bad drugs described in this investigation were all generics. Generics are widely used in all countries but are most crucial in those with fewer resources, where costlier treatments might be beyond reach. If generics were not available in sub-Saharan Africa, for instance, 'any cancer treatment would be likely inaccessible to most of the population', said Claudia Martinez of the Access to Medicine Foundation*, an NGO. In chemotherapy drugs, the active ingredient — which fights cancer cells — is also highly toxic. Patients need to receive enough of it to treat the cancer but not so much that they overdose and suffer damaging side effects. As such, hospital pharmacists calculate doses carefully and, in doing so, rely on the amount of active ingredient being exactly what's stated on the label. Research from a Working with collaborators in Cameroon, Ethiopia, Kenya and Malawi, researchers at the University of Notre Dame, Indiana in the US, analysed drug samples from the four countries. Of 189 samples that had not expired at the time of testing, about one fifth failed. This consisted of 20 different brands of generic drugs made by 17 manufacturers (see a full list of the brands that failed 'We were all taken aback when we saw the results,' said Marya Lieberman, the professor who led the research. More than 30 manufacturers made products to a good standard. But for patients receiving the poor-quality drugs, the effects could be devastating. 'Once a person has been diagnosed with cancer, there's a limited window of opportunity for treatment to work,' said Lieberman. 'And if someone is treated with an ineffective product, they can lose that precious window.' The majority of failed drugs had too little active ingredient (for most this meant less than 88% of the amount stated on the label) while some contained too much (more than 112%). Both thresholds were decided by researchers based on international standards. 'Both scenarios are horrendous in my eyes,' said Shereen Nabhani-Gebara, vice chair of the British Oncology Pharmacists Association. 'It takes a lot of courage for someone with cancer to accept a diagnosis, but then to be short-changed like this when they are trying their best is heartbreaking — because this is someone's life.' Tracking the threat Over the past six years, these brands of drugs have been shipped to more than 100 countries in every populated continent on the planet. They range from low- and middle-income nations like Nepal, Ethiopia and North Korea, to wealthy countries such as the US, UK and Saudi Arabia. The worst-performing drug in the study is made by Indian manufacturer Venus Remedies. It is a drug called cyclophosphamide, which is often used to treat cancers including lymphoma and breast cancer. All eight samples of this Venus Remedies drug failed, with six containing less than half the amount of active ingredient claimed by the manufacturer. One contained just over a quarter of the stated dose, which according to several cancer pharmacists would be as effective as no treatment at all. The drug has been shipped to six countries, with its largest importer being Ethiopia. Wondemagegnhu Tigeneh, a clinical oncologist in the Ethiopian capital Addis Ababa, told TBIJ that he has treated patients with chemotherapy drugs he believes did not work. 'I have a suspicion that the active ingredient was lower than expected,' he said, remembering a drug he gave to a recent patient who had responded well to the first three rounds of treatment. But on the next round, their progress suddenly stopped. Because he has no means to test them, Tigeneh can never be sure of the quality of a given drug. But in his 20 years treating cancer, he has learned to notice tell-tale signs. Sometimes, for instance, there is a complete absence of side-effects such as nausea or hair loss. 'That makes it difficult to trust that particular drug,' he said. Then there are the patients whose disease he struggles to get under control, such as a patient whose response to treatment halted without warning. Rather than reducing the size of the tumour enough to enable surgery, his team has been forced to move onto a second-line treatment. If that fails, the next stage is palliative care. 'It's very sad,' said Tigeneh. 'We didn't used to see things like this.' Cancer patients in Ethiopia have far better access to treatment facilities now than they did 20 years ago. It doesn't seem, however, that the standard of medicines has kept pace. A 2020 study of cancer drugs in Ethiopia included 20 samples of cisplatin which were all found to be substandard, averaging just over half of the stated content. One researcher who tests the quality of drugs in the country told TBIJ that they find bad medicines wherever they go. Venus Remedies told TBIJ that the study results were 'not scientifically plausible' given the company's 'validated manufacturing systems and quality controls'. It said it has received no complaints or concerns about the batches in question and shared the results of its own testing that indicated they were of a good standard. It said storage conditions in the supply chain, which can affect drug quality, might have affected the researchers' test results. However, the absence of similar quality issues across the entire data set suggests this is not the case. Venus Remedies is one of three companies or regulators that queried the methodology used by the lab, saying it deviated from international standards or could give erroneous results. However, Lieberman said that, although her results are not intended for regulatory purposes, her researchers' methods are based on those used by regulatory labs and were verified for suitability, accuracy, and precision. Both the findings and methods have been scrutinised by independent academics. Toxic effects About 3 200km south of Addis Ababa, in Malawi, specialist cancer care has only been available for around 15 years. In one of the poorest countries in the world, patients depend on healthcare being free at the point of need. That means clinics have to rely on generic drugs. A pharmacist specialising in cancer care in central Malawi told TBIJ of seeing patients at his hospital overdose on methotrexate, a drug used to treat leukaemia and lymphoma. Malawi has also imported two of the brands of methotrexate the researchers in this investigation found to contain too much active ingredient: Zuvitrex, made by Zuvius Lifesciences, and Unitrexate, made by United Biotech. Neither company responded to multiple requests for comment. This sort of excess can be just as harmful as a deficit. A bad overdose can leave a patient with lifelong side effects or even kill them. As Nabhani-Gebara said: 'More is not better.' The Malawian pharmacist said patients at his hospital have suffered severe vomiting and nausea after overdosing on methotrexate, while others had to be moved onto a second-line treatment, which might not be as effective. For some patients, the side effects were so severe that they had to pause treatment entirely — giving the cancer a chance to grow. When a sample of the methotrexate in question was tested as part of a research project taking place at the time, it was found to be too high in active ingredient. 'It's very worrying,' the pharmacist said. He told TBIJ that he and his colleagues have on occasion had to stop using an entire batch of chemotherapy medicine and send samples to the national drug regulator after the medicine changed colour — a sign something is wrong with it. 'We had patients scheduled for clinic,' he said, 'and then we had to break the news to them that we don't have medicines.' Failing safety nets Countries all over the world have systems in place to stop bad drugs reaching patients. However, there are huge disparities in their effectiveness. According to Chaitanya Kumar Koduri of the US Pharmacopeia, an organisation that sets standards for medicines in the US and internationally, '70% of countries cannot take care of their own medicine quality'. Most governments have a national regulator — but their remit and resources vary hugely. And even the better-funded regulators are far from foolproof. The US Food and Drug Administration (FDA), for instance, is struggling to keep up with inspections of manufacturing plants domestically and in India and China, and has admitted that its inspections have not been a reliable indicator of drug quality. The FDA recently announced it would expand unannounced inspections at foreign manufacturing facilities, saying this would help expose those who falsify records or hide violations. It told TBIJ 'that inspections and reviews will continue to ensure [drug] safety and efficacy'. One of the countries where medicine regulation ranks the lowest, according to the WHO, is Nepal. It is also one of the biggest importers of the failed chemotherapy brands in this investigation. Despite there being more than 20 000 brands of medicine on the market there, the country's drugs regulator has set a target of testing just 22 drugs in the next 12 months — and none of them chemotherapy drugs. Narayan Prasad Dhakal, the regulator's director general, told TBIJ that its lab cannot currently test cancer drugs and admitted that the situation around quality-testing is 'a concern'. He also said that while his department has the power to recall cancer drugs based on external evidence, it has never done so. The issue is especially fraught for patients who may have travelled from remote, rural areas to get treatment that then may not even work. Laxmi Kumari, whose two-year-old son is being treated for cancer in Kathmandu, Nepal's capital, has had to procure chemotherapy drugs from private pharmacies. The treatment has cost the family nearly two lakh rupees (R30 000), equivalent to several months' average salary in Nepal, and yet they have no reassurance that it will be effective. 'We have no way of knowing the quality of the medications being used in his treatment,' said Kumari. 'We rely entirely on what the doctors recommend.' 'Neither patients nor their families have any way of knowing the quality of these drugs,' said Smriti Pokharel of the Wish Nepal Foundation, which helps children from low-income families access cancer treatment. 'Even doctors face challenges in verifying their quality. No one seems willing to take responsibility for ensuring proper treatment for cancer patients.' Race to the bottom Generic drug manufacturers are operating in a global market that healthcare professionals and experts agree is driven by one thing: price. It's a market in which those operating under a less watchful eye can find ways to undercut their competitors. This could mean scrimping on the amount or quality of the active ingredient — the most expensive component — or using cheap or outdated machinery. Research shows that the majority of substandard drugs occur due to problems with manufacturing, quality control, packaging or storage. The results can be fatal. Four children died in Colombia after being given contaminated cancer drugs in 2019. Three years later, another batch of bad medicine caused the deaths of at least 10 children in Yemen who were being treated for leukaemia. The price-driven market creates a dangerous dynamic in which the number of companies making a particular drug shrinks and shrinks until global supply is precariously dependent on just a handful of manufacturers. Should one company slip up, thousands of patients can be left without the drugs they depend on. It's a situation that played out in the US recently. Between 2018 and 2022, Intas Pharmaceuticals — the parent company of Accord Healthcare, which made the worst-performing cisplatin tested in this investigation — grew its market share of cisplatin from 24% to 62%. It also increased its share in methotrexate fivefold in the same time period. All the while, prices of both these chemotherapy drugs dropped. Then, at the end of 2022, a surprise inspection by the US drug regulator revealed a 'cascade of failure' at an Intas factory in India, where staff were seen shredding and pouring acid on quality records. The shutdown that ensued sent shockwaves across the US, with nearly every major cancer centre reporting shortfalls in chemotherapy drugs during 2023, Accord Healthcare said the batch of cisplatin that failed our testing had met all established quality standards, and shared data from internal and external studies indicating its quality. It said it has not received any market concerns related to this batch. In India, the world's largest producer of generic drugs, questions have been raised over whether manufacturers are properly punished for producing drugs that aren't fit for purpose — and whether foreign regulators have proper oversight. 'The Indian government's interest is in trying to protect the industry,' said public health activist and former Big Pharma whistleblower Dinesh Thakur. Sixteen of the 17 manufacturers identified in this investigation are based in India and five have been previously flagged by a regulator for producing substandard batches of drugs. One of them, Zee Laboratories, has been flagged 46 times since 2018. India's drug regulator told TBIJ that Zee Laboratories has been audited and given a 'stop production order', which was lifted after the company resolved the problems in question. It did not give details about when this was, which issues it pertained to or whether the company faced any consequences. It's also unclear whether the manufacturers exposed in TBIJ's previous investigation into substandard asparaginase have faced any repercussions, despite 70 000 children with leukemia being at risk. Three of those companies — Getwell Pharmaceuticals, United Biotech and VHB Medi Sciences — also made some of the substandard drugs revealed by this investigation. Thakur said there's only one way to explain the production of weak drugs by big companies: 'Somebody's cutting corners.' Meanwhile, these medicines continue to fill pharmacy shelves. Zuvius Lifesciences and GLS Pharma have supplied their failed brands to over 40 countries. And in the past two years, Venus Remedies — which made the drug that pharmacists said wasn't worth prescribing — has been awarded a series of contracts and licences, including from the Pan American Health Organization to supply several essential cancer drugs to Latin American countries. India's drug regulator defended the oversight system, saying that failing drugs are recalled and manufacturers face 'either administrative penalties or legal prosecution in court'. Getwell Pharmaceuticals, GLS Pharma, VHB Medi Sciences and Zee Laboratories did not respond to multiple requests for comment. Shortage of resources In order to ensure that people across the world have access to safe, effective drugs, the WHO has put in place a series of steps. It has compiled a list of 'essential medicines', to help countries with limited resources know what to prioritise. It checks certain drugs, active ingredients and their manufacturers to create a pre-approved list that countries can trust. The WHO also oversees a set of standards for manufacturers and drugs that many countries refer to when importing medicines. However, these measures have their own limitations. The list of recommended medicines, for example, only expanded to include cancer drugs in 2019 and experts say WHO should include more of them on the list. Shalini Jayasekar-Zürn of the Union for International Cancer Control, a global membership organisation dedicated to taking action on cancer, says it currently only encompasses two cancer drugs, rituximab and trastuzumab. 'It would be great if the list was expanded to include more essential medicines, especially for cancer,' she said. While the WHO oversees standards for manufacturers and drugs, it's up to the countries buying medicines to make sure those standards are met — which is no easy task given the resources of national regulators. Meanwhile, Thakur said that one WHO scheme — a certificate system that says a given drug meets various standards — has been undermined by companies that have found 'workarounds' to get hold of the paperwork without improving quality. 'It's not worth the paper it's written on,' he said. The upshot, experts say, is that without the comprehensive oversight seen in countries like the UK, the WHO's processes don't stop substandard medicines making their way onto shelves. Reflecting on TBIJ's findings alongside his own experience, Thakur said that the WHO was 'clearly not' delivering on its stated purpose: to promote health, keep the world safe and serve the vulnerable. The WHO did not respond to several requests for comment made by TBIJ. A high price The cruel irony is that in this race to the bottom, it is the cancer patients who are often left to foot the bill. And those who have the least pay the most. In low income countries, the cost of 58% of essential cancer medicines is paid by patients, compared with 1.8% in upper-middle-income countries. One cancer pharmacist in Ethiopia estimated that it could take over a year for a patient to save for cancer treatment. If that medicine then turns out to be faulty, they simply might not be able to afford to pay for another. 'Most people believe cancer is incurable,' they said. 'When they end up with a medicine that won't cure them, that's another tragedy.' 'For me, it's a question of fairness,' said Lieberman, the lead researcher. '[Patients] have the right to be treated with a medicine that actually is what it says it is. One that has the correct ingredients in it, that hasn't degraded, and that doesn't have things in it that will hurt them. It's too important.' * The Access to Medicine Foundation is part-funded by the Bill & Melinda Gates Foundation, one of TBIJ's funders. India, where about 20% of the world's generic drugs come from, plays a pivotal role in ensuring people everywhere can access affordable medicine. Sixteen of the 17 manufacturers of failed drugs in this investigation are based in India. While the majority of India-made drugs are safe, the country's generics industry has long been dogged by scandal. In 2013, Indian manufacturer Ranbaxy agreed to pay a fine of $500 million after its US subsidiary pleaded guilty to the improper manufacturing, storing and testing of drugs. In 2022 and 2023, Indian-made cough syrups were linked to the deaths of children in Gambia, Cameroon and Uzbekistan. And as recently as August 2024, it was reported that the regulator had found more than 50 drugs on the market to be substandard or fake, including some paracetamol and antacids.
Yahoo
3 days ago
- Health
- Yahoo
Bharat, GSK to halve price of malaria vaccine by 2028
By Maggie Fick and Jennifer Rigby LONDON (Reuters) -Drugmakers Bharat Biotech and GSK will cut the price of their malaria vaccine to $5 per dose by 2028, more than halving its current cost, they said on Wednesday. The vaccine, Mosquirix or RTS,S, was developed by GSK and the non-profit PATH, and was the first malaria vaccine to get approval from the World Health Organization in 2022. GSK is working on a technology transfer to Bharat, and will continue to supply the adjuvant part of the vaccine to Bharat when the Indian drugmaker fully takes over production of the shot by 2028. A phased reduction in price for the vaccine will begin immediately, GSK said in a statement with Bharat, reaching the target price of $5 by 2028. The price cut was "driven by process improvements, expanded production capacity, cost-effective manufacturing, and minimal profit margins," the statement read. Malaria kills more than 500,000 people annually, mainly children aged five and under in sub-Saharan Africa, according to WHO estimates. Cases and deaths fell significantly between 2000 and 2015, but progress has since stalled and even reversed, with a particular jump in mortality during the COVID-19 pandemic. Many experts have expressed hope that vaccines can help turn the tide in the fight against the mosquito-borne disease. But price has been an issue, particularly when compared to other tools to prevent malaria like bed nets. GSK has previously said it was committed to supplying up to 18 million vaccine doses between 2023 and the end of this year. The company plans to supply 15 million doses annually from 2026-2028, according to a spokesperson. Wednesday's announcement comes as Gavi - a global vaccine group that helps buy childhood vaccines in the world's poorest countries - holds an event in Brussels to raise funding for its work over the next five years, as governments pull back from international aid. GSK and Bharat said the price reduction showed their commitment to Gavi, which has been funding some of the roll-out of the malaria vaccine. Twelve African countries are set to introduce the vaccine in their routine immunisation programmes by the end of this year with Gavi's support. The other approved malaria vaccine, developed by the University of Oxford and the Serum Institute of India, is priced at under $4 a dose. Error in retrieving data Sign in to access your portfolio Error in retrieving data Error in retrieving data Error in retrieving data Error in retrieving data
