shipped all over the world

Failing safety nets

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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 that 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.