One of the unwritten, unspoken and rarely thought-about assumptions of those buying medicines is that they will work. We take it for granted that the medicines we buy will work as the scientists who developed the product intended. But in many places this is not the case--especially in Africa and to a lesser extent in Asia and Latin America.

The reasons are complex, but essentially there are three types of ‘problem products’: counterfeit, substandard and degraded. Counterfeits are products which are passed off as something they are not. Substantial effort is put into creating perfect copies of real packaging, but little care is usually put into making the products properly. Such drugs are a real threat to rich and poor alike. The most widely faked drugs are Viagra, painkillers and diet pills; but increasingly drugs for many serious conditions and infections, particularly in poorer locations, are causing problems.

Substandard products are those where manufacturers are sloppy and, ignoring gross negligence, unintentionally make bad copies of drugs. This category is probably vast in poor nations. Degraded products are properly manufactured but become bad because of incorrect storage. This is a significant concern in places with no electricity for refrigeration and no cold chain transport storage. Recent research has tried to identify the causes of these problems and the extent to which they are harming people. My own research, published in Research and Reports in Tropical Medicine last December, analysed the prevalence of the problem and also which types of manufacturers were at fault. The findings are concerning, especially for African countries. Nearly 20% of the African-sourced drugs we tested failed at least one quality control test: in other words they almost certainly would not work as intended.

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Roger Bate is the Legatum Fellow in Global Prosperity at AEI.