Dataset Information

A collaborative epidemiological investigation into the criminal fake artesunate trade in South East Asia.

ABSTRACT: Since 1998 the serious public health problem in South East Asia of counterfeit artesunate, containing no or subtherapeutic amounts of the active antimalarial ingredient, has led to deaths from untreated malaria, reduced confidence in this vital drug, large economic losses for the legitimate manufacturers, and concerns that artemisinin resistance might be engendered.With evidence of a deteriorating situation, a group of police, criminal analysts, chemists, palynologists, and health workers collaborated to determine the source of these counterfeits under the auspices of the International Criminal Police Organization (INTERPOL) and the Western Pacific World Health Organization Regional Office. A total of 391 samples of genuine and counterfeit artesunate collected in Vietnam (75), Cambodia (48), Lao PDR (115), Myanmar (Burma) (137) and the Thai/Myanmar border (16), were available for analysis. Sixteen different fake hologram types were identified. High-performance liquid chromatography and/or mass spectrometry confirmed that all specimens thought to be counterfeit (195/391, 49.9%) on the basis of packaging contained no or small quantities of artesunate (up to 12 mg per tablet as opposed to approximately 50 mg per genuine tablet). Chemical analysis demonstrated a wide diversity of wrong active ingredients, including banned pharmaceuticals, such as metamizole, and safrole, a carcinogen, and raw material for manufacture of methylenedioxymethamphetamine ('ecstasy'). Evidence from chemical, mineralogical, biological, and packaging analysis suggested that at least some of the counterfeits were manufactured in southeast People's Republic of China. This evidence prompted the Chinese Government to act quickly against the criminal traders with arrests and seizures.An international multi-disciplinary group obtained evidence that some of the counterfeit artesunate was manufactured in China, and this prompted a criminal investigation. International cross-disciplinary collaborations may be appropriate in the investigation of other serious counterfeit medicine public health problems elsewhere, but strengthening of international collaborations and forensic and drug regulatory authority capacity will be required.

SUBMITTER: Newton PN

PROVIDER: S-EPMC2235893 | biostudies-literature | 2008 Feb

REPOSITORIES: biostudies-literature

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A collaborative epidemiological investigation into the criminal fake artesunate trade in South East Asia.

Newton Paul N PN Fernández Facundo M FM Plançon Aline A Mildenhall Dallas C DC Green Michael D MD Ziyong Li L Christophel Eva Maria EM Phanouvong Souly S Howells Stephen S McIntosh Eric E Laurin Paul P Blum Nancy N Hampton Christina Y CY Faure Kevin K Faure Kevin K Nyadong Leonard L Soong C W Ray CW Santoso Budiono B Zhiguang Wang W Newton John J Palmer Kevin K

PLoS medicine 20080201 2

<h4>Background</h4>Since 1998 the serious public health problem in South East Asia of counterfeit artesunate, containing no or subtherapeutic amounts of the active antimalarial ingredient, has led to deaths from untreated malaria, reduced confidence in this vital drug, large economic losses for the legitimate manufacturers, and concerns that artemisinin resistance might be engendered.<h4>Methods and findings</h4>With evidence of a deteriorating situation, a group of police, criminal analysts, ch ...[more]

PMID: 18271620

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Project description:The African lion is the only big cat listed on CITES Appendix II, and the only one for which international commercial trade is legal under CITES. The trade in lion body parts, and especially the contentious trade in bones from South Africa to Asia, has raised concerns spanning continents and cultures. Debates were amplified at the 2016 CITES Conference of the Parties (CoP17) when a proposal to up-list lions to Appendix I was not supported and a compromise to keep them on Appendix II, with a bone trade quota for South Africa, was reached instead. CoP17 underscored a need for further information on the lion bone trade and the consequences for lions across the continent. Legal international trade in bones to Asia, allegedly to supply the substitute 'tiger bone' market, began in South Africa in February 2008 when the first CITES permits were issued. It was initially unclear the degree to which bones were sourced from captive-origin lions, and whether trade was a threat to wild lion populations. Our original assessment of the legal CITES-permitted lion bone trade from South Africa to East-Southeast Asia was for the period 2008-2011 (published 2015). In this paper, we consolidate new information that has become available for 2012-2016, including CITES reports from other African countries, and data on actual exports for three years to 2016 supplied by a freight forwarding company. Thus, we update the figures on the legal trade in lion bones from Africa to East-Southeast Asia in the period 2008-2016. We also contextualise the basis for global concerns by reviewing the history of the trade and its relation to tigers, poaching and wildlife trafficking. CITES permits issued to export bones escalated from ±314y-1 skeletons from 2008-2011, to ±1312y-1 skeletons from 2013-2015. South Africa was the only legal exporter of bones to Asia until 2013 when Namibia issued permits to export skeletons to Vietnam. While CITES permits to export ±5363 skeletons from Africa to Asia from 2008-2015 were issued (99.1% from South Africa; 0.7% from Namibia) (51% for Laos), actual exports were less than stated on the permits. However, information on actual exports from 2014-2016 indicated that >3400 skeletons were exported in that period. In total, >6000 skeletons weighing no less than 70 tonnes have been shipped to East-Southeast Asia since 2008. Since few wild lions are hunted and poached within South African protected areas, skeletons for the legal trade appear to be derived from captive bred lions. However, confirmation of a 116kg shipment from Uganda to Laos, and reports of lion poaching in neighbouring countries, indicate that urgent proactive monitoring and evaluation of the legal and illegal trade is necessary in African lion range states where vulnerable wild lion populations are likely to be adversely affected.

Project description:Background and aimsBesides bananas belonging to the AAA triploid Mutika subgroup, which predominates in the Great Lakes countries, other AAA triploids as well as edible AA diploids, locally of considerable cultural weight, are cultivated in East Africa and in the nearby Indian Ocean islands as far as Madagascar. All these varieties call for the genetic identification and characterization of their interrelations on account of their regional socio-economic significance and their potential for banana breeding strategies.MethodsAn extensive sampling of all traditional bananas in East Africa and near Indian Ocean islands was genotyped with simple sequence repeat (SSR) markers, with particular emphasis on the diploid forms and on the bananas of the Indian Ocean islands, which remain poorly characterized.Key resultsAll the edible AA varieties studied here are genetically homogeneous, constituting a unique subgroup, here called 'Mchare', despite high phenotypic variation and adaptions to highly diverse ecological zones. At triploid level, and besides the well-known AAA Mutika subgroup, at least two other genetically related AAA subgroups specific to this region are identified. Neither of these East African AAA genotypes can be derived directly from the local AA Mchare diploids. However, it is demonstrated that the East African diploids and triploids together belong to the same genetic complex. The geographical distribution of their wild acuminata relatives allowed identification of the original area of this complex in a restricted part of island South-East Asia. The inferred origin leads to consideration of the history of banana introduction in Africa. Linked to biological features, documentation on the embedding of bananas in founding legends and myths and convincing linguistic elements were informative regarding the period and the peoples who introduced these Asian plants into Africa. The results point to the role of Austronesian-speaking peoples who colonized the Indian Ocean islands, particularly Madagascar, and reached the East African coasts.ConclusionsUnderstanding of the relations between the components of this complex and identifying their Asian wild relatives and related cultivars will be a valuable asset in breeding programmes and will boost the genetic improvement of East African bananas, but also of other globally important subgroups, in particular the AAA Cavendish.

Dataset Information

A collaborative epidemiological investigation into the criminal fake artesunate trade in South East Asia.

Publications

A collaborative epidemiological investigation into the criminal fake artesunate trade in South East Asia.

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