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

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

No	Region/Country	Age-group	Disease condition	Therapeutic group of medicine	Estimated prevalence of poor-quality medicines, %	Impact		Source (Ref.)
No	Region/Country	Age-group	Disease condition	Therapeutic group of medicine	Estimated prevalence of poor-quality medicines, %	Estimated deaths, median	Economic costs, USD million, 2017
1	Sub-Saharan Africa	Under-5	Malaria	Antimalarial	0–40	122,350^a	ND^b	[17]
2	Global	Under-5	Acute LTRI^c/Pneumonia	Antimicrobials	10	72,430–169,271^d	ND^b	[15]
2	Sub-Saharan Africa	Under-5	Malaria	Antimalarial	7.6^e	116,000^f	38.5^f	[15]
3	LMICs^g	ND	ND	All	13.6	ND	31250^h	[18]
4	LMICs	All	Tuberculosis	Anti-TBⁱ	6.7^j	255,115	ND	[19]
4	LMICs	All	HIV/AIDS	Anti-Retroviral	4.2^j	72,183^k	ND	[19]
5	Nigeria	All	Malaria	Antimalarial	12–50^l	12,300^m	892^m	[20]
6	Congo (DRC)ⁿ	Under-5	Malaria	Antimalarial	19	10,370^m	151^m	[21]
7	Uganda	Under-5	Malaria	Antimalarial	21–31^o	1100^p	31	[22]

^aMedian for 2010
^bND not determined/not specified
^cLRTI lower respiratory tract infections
^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
^eArtemisinin Combination Therapies, ACTs, only
^fMedian value for the higher of two alternative estimates
^gLow- and middle-income countries
^hMedian market size of substandard and falsified medicines. Data as reported from eight studies dating from 2003 to 2017
ⁱAnti-Tuberculosis
^jMedian prevalence rate for the therapeutic group of medicine
^kLost disability-adjusted life years (DALYs) rather than mortality
^lVariable depending on antimalarial class: 12% for ACTs, 50% for chloroquine and other treatments
^mAnnual mean values
ⁿDemocratic Republic of Congo
^oVariable depending on antimalarial class: 21% for ACTs, 22% for quinine and 31% for other treatments
^pAdditional annual deaths due to SF antimalarial medicines

ISSN: 2052-3211