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Table 1 Impact of poor-quality medicines from modelling studies (as obtained from a rapid-review of published literature)

From: Tackling the blind spot of poor-quality medicines in Universal Health Coverage

No Region/Country Age-group Disease condition Therapeutic group of medicine Estimated prevalence of poor-quality medicines, % Impact Source (Ref.)
Estimated deaths, median Economic costs, USD million, 2017  
1 Sub-Saharan Africa Under-5 Malaria Antimalarial 0–40 122,350a NDb [17]
2 Global Under-5 Acute LTRIc/Pneumonia Antimicrobials 10 72,430–169,271d NDb [15]
Sub-Saharan Africa Under-5 Malaria Antimalarial 7.6e 116,000f 38.5f
3 LMICsg ND ND All 13.6 ND 31250h [18]
4 LMICs All Tuberculosis Anti-TBi 6.7j 255,115 ND [19]
LMICs All HIV/AIDS Anti-Retroviral 4.2j 72,183k ND
5 Nigeria All Malaria Antimalarial 12–50l 12,300m 892m [20]
6 Congo (DRC)n Under-5 Malaria Antimalarial 19 10,370m 151m [21]
7 Uganda Under-5 Malaria Antimalarial 21–31o 1100p 31 [22]
  1. aMedian for 2010
  2. bND not determined/not specified
  3. cLRTI lower respiratory tract infections
  4. dThe figures refer to excess deaths for 2010. The lower figure is the estimate for when the antimicrobials have reduced activity while the higher figure is the case for no activity
  5. eArtemisinin Combination Therapies, ACTs, only
  6. fMedian value for the higher of two alternative estimates
  7. gLow- and middle-income countries
  8. hMedian market size of substandard and falsified medicines. Data as reported from eight studies dating from 2003 to 2017
  9. iAnti-Tuberculosis
  10. jMedian prevalence rate for the therapeutic group of medicine
  11. kLost disability-adjusted life years (DALYs) rather than mortality
  12. lVariable depending on antimalarial class: 12% for ACTs, 50% for chloroquine and other treatments
  13. mAnnual mean values
  14. nDemocratic Republic of Congo
  15. oVariable depending on antimalarial class: 21% for ACTs, 22% for quinine and 31% for other treatments
  16. pAdditional annual deaths due to SF antimalarial medicines