NextBillion - An Initiative of the William Davidson Institute at the University of Michigan

Thursday, September 24, 2015

Victoria Amponsah was worried when she entered a clinic in Accra, Ghana, to deliver her son — she was especially distrustful of the quality of medicines at the clinic. She had heard stories and seen firsthand many other women from her village enter the clinic to give birth and not come out.

Her fears are not unfounded. UNICEF estimates that 90 percent of medicines used to treat postpartum hemorrhage in Ghana were found to be substandard and that 1 in every 68 women in Ghana will die from postpartum bleeding during childbirth.

But Victoria was lucky — when she began experiencing postpartum hemorrhaging, a complication of childbirth characterized by excessive bleeding that accounts for 30 percent of all obstetric deaths in Africa, she was given a good-quality dose of oxytocin which helps control bleeding.

Postpartum bleeding is treatable, yet Victoria’s survival and that of many others is left to chance.

In the United States, we presume the medicines we obtain and consume, whether generic or over-the-counter, are safe and contain the correct amounts of the ingredients needed for them to work. But in many other parts of the world, no such level of trust exists. This is especially true in many resource-limited countries in Africa, where 30 to 60 percent of the lifesaving treatments available to combat the most deadly health conditions are likely to be substandard, and if used, are unlikely to fully work, according to the International Policy Network.  

So what are substandard medicines? They are legal drugs that fall short of their quality specifications. Many are made, stored or distributed under poor quality conditions and contain little to none of the active ingredients needed for them to work. They can lead to drug resistance and inadequate treatment, which pose an urgent threat to vulnerable populations and jeopardize progress in combating malaria, tuberculosis, HIV/AIDS and obstetric complications like Victoria’s.