title: Collaborative health and enforcement operations on the quality of antimalarials and antibiotics in southeast Asia.
abstract: Counterfeit (or falsified) and substandard medicines pose a major public health risk. We describe the findings of Operation Storm I and II conducted in 2008-2009 to combat counterfeit medicines through partnership between national customs, Drug Regulatory Agencies (DRAs), and police in Cambodia, Indonesia, Laos, Myanmar, Singapore, Thailand, and Vietnam. Samples were obtained from seizures and market surveillance by national DRAs. Laboratory analysis using spectroscopic and chromatographic techniques and examination of packaging were performed. Ninety-three suspect antibiotics and 95 antimalarial samples were collected. Of the 93 antibiotics, 29 (31%) had % active pharmaceutical ingredient content (%API) < 85% or > 115% (including one counterfeit). Of the 95 antimalarials, 30 (32%) had %API < 85 > 115% API (including one counterfeit). A significant minority of samples, antimalarials (13%) and antibiotics (15%), were collected in plastic bags with minimal or no labeling. Of 20 ampicillin samples, 13 (65%) contained < 85% API (with one counterfeit containing additional amoxicillin). Of 34 oral artesunate samples, 7 (21%) contained %API out of the 85-115% range. Coordinated and synergistic partnership adopted by the participating countries, International Criminal Police Organization (INTERPOL), World Health Organization (WHO), and laboratories facilitated a platform for discussions and intelligence sharing, helping to improve each participating country's capacity to combat poor-quality medicines.
authors.forename: Yuk Lin
authors.initials: YL
authors.lastname: Yong
authors.forename: Aline
authors.initials: A
authors.lastname: Plançon
authors.forename: Yen Hui
authors.initials: YH
authors.lastname: Lau
authors.forename: Dana M
authors.initials: DM
authors.lastname: Hostetler
authors.forename: Facundo M
authors.initials: FM
authors.lastname: Fernández
authors.forename: Michael D
authors.initials: MD
authors.lastname: Green
authors.forename: Sourisak
authors.initials: S
authors.lastname: Sounvoravong
authors.forename: Suon
authors.initials: S
authors.lastname: Nara
authors.forename: Mam
authors.initials: M
authors.lastname: Boravann
authors.forename: Thitikornkovit
authors.initials: T
authors.lastname: Dumrong
authors.forename: Nurjaya
authors.initials: N
authors.lastname: Bangsawan
authors.forename: Min Yong
authors.initials: MY
authors.lastname: Low
authors.forename: Chin-Chin
authors.initials: CC
authors.lastname: Lim
authors.forename: Ruth Lee Choo
authors.initials: RLC
authors.lastname: Ai
authors.forename: Paul N
authors.initials: PN
authors.lastname: Newton
mesh_terms: D000900:Anti-Bacterial Agents / Q000592:standards*; D000962:Antimalarials / Q000592:standards*; D001210:Asia, Southeastern; D058110:Counterfeit Drugs; D004349:Drug Packaging; D007391:International Cooperation; D007880:Legislation, Drug
chemical_list: D000900:Anti-Bacterial Agents; D000962:Antimalarials; D058110:Counterfeit Drugs