Editor's note: The article below is taken from a VoxEU publication 'Drug quality and global trade' by Attaran et al. It finds that drug quality is poorer among Indian-labelled drugs purchased inside African countries than among those purchased inside India or middle-income countries.
Data from the Pharmaceutical Security Institute indicate that poor-quality medicines were found in 124 countries in 2011, with the problem more severe in low- and mid-income countries than in developed countries (IOM 2013). While much attention has been focused on intellectual property rights protection (notably issues surrounding the WTO's TRIPS agreement), poor-quality samples were more prevalent in cheap, generic drugs than in expensive, innovator-branded drugs when we tested drug samples from 18 low-to-mid-income countries (Bate et al. 2011). Moreover, many people in developing countries have to rely on cheaper, generic drugs for most diseases, and the percentage of imports in drug supply is as high as 70% in African countries (UNAIDS 2013). From the public-health perspective, international trade is arguably more important on the low end than on the high end of drug quality.
There is a widespread perception amongst pharmaceutical experts that some Indian manufacturers take advantage of the poor regulatory environment in certain countries to sell them products of inferior quality. When Ranbaxy, a major Indian generic drug manufacturer, was charged with selling adulterated drugs, fabricating data, and committing fraud, Dinesh Thakur, then director and global head of research information and ultimately the company's whistleblower, described how "Ranbaxy took its greatest liberties in markets where regulation was weakest and the risk of discovery was lowest" (Eban 2013). In a recent National Bureau of Economic Research working paper (Bate et al. ...
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