10 ms·

Nearly 20% of cancer drugs defective in four African nations

185 points by woldemariam 1y ago

kurthr 1y ago
The political uncertainties of western countries where "there is no truth" and "facts don't matter" could easily bring this level of systemic corruption to them as well. People love to rage bait and say how bad it is now, but that seems to have largely led to groups giving up on enforcing norms, and bodes poorly for the future.
- firesteelrain 1y ago
  I don’t see how. FDA is widely respected.
  - nathan_compton 1y ago
    15 years ago the president was widely respected.
    - hinkley 1y ago
      16 years ago not so much.
      - amluto 1y ago
        In both cases, the FDA was generally run and staffed by non-political people who were at least vaguely competent. I have plenty of issues with how the FDA operated, but it didn’t matter much who was president. Today, most of the Cabinet positions are held by people who love to talk, who are generally extremely wealthy and/or well connected, and who are generally unqualified for their jobs. And, even more relevantly, they have been very heavily interfering in the operation of their respective departments.
  - labster 1y ago
    [flagged]
    - dmoy 1y ago
      Oh man did rfk jr actually do something with flouride, like directly out of the movie? I haven't been paying a ton of attention to rfk's actions.
  - thfuran 1y ago
    The FDA has been approving generics from factories known to have repeatedly failed prior audits or had products recalled for quality issues without re-inspecting the factories or inspecting the drugs on import. And they're doing it via a special process that bypasses the ordinary review process and over the objections of many of the inspectors.
    - reginald78 1y ago
      Was just reading about this one a few weeks ago, I couldn't find the article again but I believe it was based around the book Bottle of Lies. Basically the political pressure to keep drugs available and costs down has them looking the other way. And it has been going on since at least the Obama administration IIRC.
  - protocolture 1y ago
    Is it? Australia wont import FDA certified beef. For great reason.
    - firesteelrain 1y ago
      I think you mean USDA. Australia doesn’t allow most USDA beef because of strict biosecurity rules. Australia’s one of the world’s biggest beef exporters. There’s not much incentive for them to open the door to a competitor unless the protocols align perfectly.
      - protocolture 1y ago
        So the FDA has no hand in Beef?
        firesteelrain 1y ago
        To my knowledge no
  - s_dev 1y ago
    Not after the opioid crisis in the US. That was the job of the FDA to prevent that exact scenario. They approved Purdue Pharma opioids for non-chronic usage when European/Canadian regulators did not. Hence why the crisis was largely contained to the United States.
    - nickff 1y ago
      Canada has had many opioid-related overdoses and deaths: https://health-infobase.canada.ca/substance-related-harms/opioids-stimulants/ https://health-infobase.canada.ca/substance-related-harms/op... The numbers seems roughly proportional to US opioid deaths (though I haven’t taken a detailed look, and there may be differences in the way deaths are categorized): https://nida.nih.gov/research-topics/trends-statistics/overdose-death-rates#Fig4 https://nida.nih.gov/research-topics/trends-statistics/overd...
- ggm 1y ago
  Leo Szilard (he's credited with theorising purposeful fission and patenting core ideas long before the Manhattan project got off the ground) wrote a long time ago about a (dys/u)topia where technocrats made the decisions. He had this idea "the bund" would fix politics by moving decision making to pure evidence based rational methods. It wouldn't work, but when I see appeals to authority (FDA) enter the room, it's usually to feel superior because its a logical fallacy in argument but the place it actually fits (which btw, is here, in this thread) is that compliance to standards and policing them, is not "argument" it's the "you only had one job" part of the gig. "yes Mr Kennedy, these friends of yours are very nice at parties, but unfortunately they are neither qualified, nor actually capable of fulfilling their role and so no, you won't be appointing them" is what the Bund would do. Being able to take a compliance body oversight function and leverage it to remove adjuvents because of one paper, despite overwhelming evidence to the contrary, is precisely whats wrong in the current politicised situation. If people making generic cancer drugs for use in africa had to be held to the standards in the west, we'd all be better off. I have said elsewhere that if the US rejects flu vaccines because of the mercury, they should be checked for other compliance and standards, and subject to cold chain integrity shipped to economies who usually can't afford them, and can use them.
  - gsf_emergency_2 1y ago
    Too mind-fogged to help you out here.. just wanted to point ou his most famous patent, the Einstein-Szilard fridge (considerably less famous than the Einstein-Szilard letter, so I feel there's another argument for or against technocracy right there)
    - ggm 1y ago
      Because of concerns how toxic ammonia was, and how common leaks. Turned out to be useful many decades later when they were designing the cold chain for the H Bomb before solid duterium/lithium came along.
  - elcritch 1y ago
    Ah yes because technocrats are never prone to groupthink or missing the forest because of the trees, et cetera. There was a fascinating article I read years back about how much of China’s top leadership had engineering degrees, unlike in western countries. Then the article pointed out how that led to things like the one-child act based on research in the 1970s predicting mass starvation. That one child policy is now leading to possible demographic collapse after causing decades of social strife. Be careful what you wish for, as you’re possibly a variable which could optimized out. Alternatively consider the long term ramifications of leaving pandemic responses purely in the hands of unelected epidemiologists whose primary focus is a virus and not the overall welfare of a population. Those are not the same thing after all, even if they seem like it at first glance. IMHO, alternative means of thinking are needed in a governmental system for the best overall outcomes.
- pjc50 1y ago
  There's a lot of money for the few in systematic corruption! This is something that has to be constantly fought against. R have embraced it entirely, but it's also prevalent on the D side especially in machine-politics cities. Which is why everyone's really so upset about the NY Mayor primary. People have gone on record in the papers about being annoyed that the bribes - sorry, donations - they prepaid to Cuomo are now invalid.
- GuinansEyebrows 1y ago
  american right-libertarianism is a thought-terminating ideology. "government bad, only private sector good" presupposes that we can't collectively provide services to residents/citizens, even when that's proven very effective in other countries.
deleted 1y ago
[deleted]
hinkley 1y ago
I'll never forget a coworker telling me that in a previous job hunting round he had interviewed with a pharmaceutical group that was tracking the manufacturing process for batches of drugs and comparing the little tolerance mistakes (heated a little too high or held at temp a little too long or not quite long enough) and finding a market where they can sell that batch. You'd like to think that companies have factories with quality control laws and there are local people trying to ensure that all of their product are up to the local standards. What you don't expect is that they are binning them like Intel CPUs, where they just make a batch and hope for the best, take cream off the top until the priority orders are done and then everyone else gets whatever is left. You might get a slightly better product sometimes but not be so lucky the next time.
- xdfgh1112 1y ago
  Does that mean that generics really are worse than the brand pharmaceuticals. Or are they binned the same way? In the UK I know the NHS buys generics, which implies they are effective, but I wonder.
  - Retric 1y ago
    Generally it’s different companies manufacturing generics. Instead this mostly comes down to how effective each countries regulations are.
    - hinkley 1y ago
      This is also my understanding, but perhaps I am meant to understand that to be the case.
  - throwawaysleep 1y ago
    Generics tends to be different companies altogether.
  - lmpdev 1y ago
    Generics lack the ownership of the intellectual property, but that’s about it Generics are effective
navigate8310 1y ago
[flagged]
- SanjayMehta 1y ago
  India isn’t even mentioned in the article.
  - deleted 1y ago
    [deleted]
- manishsharan 1y ago
  I actually read the actual study on Lancet. unfortunately for you, your vile prejudice can not be justified by this study.
aurizon 1y ago
Africa and China are awash with fake meds - perhaps even in India. Large amounts of fake drugs are common in Africa/China = deaths are common. Pharmacies are very aware of this and watch their sources. The big problem is very good copies of the container, box and printed insert that mimic exactly the true drugs are everywhere. A copied box/insert/vial/tablet that costs $1 can hold drugs worth $200 or more. There are gangs that buy them from China and try to insert them in the supply chain. I was with Sanofi-Pasteur(before I retired) and we had strict QC controls on every batch(every single ingredient). Every ingredient was sampled and tested locally and a sample sent to various head offices in USA/Canada/UK/etc. Batch ingredients were kept in locked areas and only allowed out in a weighed batch amount. The whole area was a clean and watched area with limited access badges on each person working there. You could only enter your zone and use your lunch/toilet area. Some ingredients are active and can have high values. Some are inert fillers. 1 milligram of fentanyl is minuscule = it ends up in a 25 or 50 milligram pressed tablet for ease of patient/pharmacy handling. Even adding the inert is complex as the active and the inert must mix with no settling or gravity segregation. Often the active is mixed with an intermediate diluent and a fluid that will not dissolve either and mixed in wiped surface mixer to make a very uniform paste which was then dried and granulated and this was added to the final diluent and a 'binder'. The binder is a material that will glue the tablet together in a high speed press. Some tablets get an enteric coating that resists acid but dissolves in the lower gut alkaline state = breaks and dissolves. Fentanyl and other strong opioids are killers in small amounts, so extreme precautions are taken to ensure correct doses.
theospeak 1y ago
You are going to rue the day. Enjoy your temporary comforts. You got so used to speaking of other people that are not in your demographic (especially Africans) as almost human that Africa will also not shed a tear should America be gone tomorrow And yes, we will survive your abscence, like we had since the beginning of time Tick tock (Or Tik Tok:-), more aptly)
debarshri 1y ago
A lot of low-quality and addictive generic drugs has created an opioid crisis in Africa too [1]. [1] https://www.bbc.com/news/articles/cwyew21yyjzo https://www.bbc.com/news/articles/cwyew21yyjzo

185 points by woldemariam 1y ago

The political uncertainties of western countries where "there is no truth" and "facts don't matter" could easily bring this level of systemic corruption to them as well. People love to rage bait and say how bad it is now, but that seems to have largely led to groups giving up on enforcing norms, and bodes poorly for the future.

firesteelrain 1y ago
I don’t see how. FDA is widely respected.
- nathan_compton 1y ago
  15 years ago the president was widely respected.
  - hinkley 1y ago
    16 years ago not so much.
    - amluto 1y ago
      In both cases, the FDA was generally run and staffed by non-political people who were at least vaguely competent. I have plenty of issues with how the FDA operated, but it didn’t matter much who was president. Today, most of the Cabinet positions are held by people who love to talk, who are generally extremely wealthy and/or well connected, and who are generally unqualified for their jobs. And, even more relevantly, they have been very heavily interfering in the operation of their respective departments.
- labster 1y ago
  [flagged]
  - dmoy 1y ago
    Oh man did rfk jr actually do something with flouride, like directly out of the movie? I haven't been paying a ton of attention to rfk's actions.
- thfuran 1y ago
  The FDA has been approving generics from factories known to have repeatedly failed prior audits or had products recalled for quality issues without re-inspecting the factories or inspecting the drugs on import. And they're doing it via a special process that bypasses the ordinary review process and over the objections of many of the inspectors.
  - reginald78 1y ago
    Was just reading about this one a few weeks ago, I couldn't find the article again but I believe it was based around the book Bottle of Lies. Basically the political pressure to keep drugs available and costs down has them looking the other way. And it has been going on since at least the Obama administration IIRC.
- protocolture 1y ago
  Is it? Australia wont import FDA certified beef. For great reason.
  - firesteelrain 1y ago
    I think you mean USDA. Australia doesn’t allow most USDA beef because of strict biosecurity rules. Australia’s one of the world’s biggest beef exporters. There’s not much incentive for them to open the door to a competitor unless the protocols align perfectly.
    - protocolture 1y ago
      So the FDA has no hand in Beef?
      - firesteelrain 1y ago
        To my knowledge no
- s_dev 1y ago
  Not after the opioid crisis in the US. That was the job of the FDA to prevent that exact scenario. They approved Purdue Pharma opioids for non-chronic usage when European/Canadian regulators did not. Hence why the crisis was largely contained to the United States.
  - nickff 1y ago
    Canada has had many opioid-related overdoses and deaths: https://health-infobase.canada.ca/substance-related-harms/opioids-stimulants/ https://health-infobase.canada.ca/substance-related-harms/op... The numbers seems roughly proportional to US opioid deaths (though I haven’t taken a detailed look, and there may be differences in the way deaths are categorized): https://nida.nih.gov/research-topics/trends-statistics/overdose-death-rates#Fig4 https://nida.nih.gov/research-topics/trends-statistics/overd...
ggm 1y ago
Leo Szilard (he's credited with theorising purposeful fission and patenting core ideas long before the Manhattan project got off the ground) wrote a long time ago about a (dys/u)topia where technocrats made the decisions. He had this idea "the bund" would fix politics by moving decision making to pure evidence based rational methods. It wouldn't work, but when I see appeals to authority (FDA) enter the room, it's usually to feel superior because its a logical fallacy in argument but the place it actually fits (which btw, is here, in this thread) is that compliance to standards and policing them, is not "argument" it's the "you only had one job" part of the gig. "yes Mr Kennedy, these friends of yours are very nice at parties, but unfortunately they are neither qualified, nor actually capable of fulfilling their role and so no, you won't be appointing them" is what the Bund would do. Being able to take a compliance body oversight function and leverage it to remove adjuvents because of one paper, despite overwhelming evidence to the contrary, is precisely whats wrong in the current politicised situation. If people making generic cancer drugs for use in africa had to be held to the standards in the west, we'd all be better off. I have said elsewhere that if the US rejects flu vaccines because of the mercury, they should be checked for other compliance and standards, and subject to cold chain integrity shipped to economies who usually can't afford them, and can use them.
- gsf_emergency_2 1y ago
  Too mind-fogged to help you out here.. just wanted to point ou his most famous patent, the Einstein-Szilard fridge (considerably less famous than the Einstein-Szilard letter, so I feel there's another argument for or against technocracy right there)
  - ggm 1y ago
    Because of concerns how toxic ammonia was, and how common leaks. Turned out to be useful many decades later when they were designing the cold chain for the H Bomb before solid duterium/lithium came along.
- elcritch 1y ago
  Ah yes because technocrats are never prone to groupthink or missing the forest because of the trees, et cetera. There was a fascinating article I read years back about how much of China’s top leadership had engineering degrees, unlike in western countries. Then the article pointed out how that led to things like the one-child act based on research in the 1970s predicting mass starvation. That one child policy is now leading to possible demographic collapse after causing decades of social strife. Be careful what you wish for, as you’re possibly a variable which could optimized out. Alternatively consider the long term ramifications of leaving pandemic responses purely in the hands of unelected epidemiologists whose primary focus is a virus and not the overall welfare of a population. Those are not the same thing after all, even if they seem like it at first glance. IMHO, alternative means of thinking are needed in a governmental system for the best overall outcomes.
pjc50 1y ago
There's a lot of money for the few in systematic corruption! This is something that has to be constantly fought against. R have embraced it entirely, but it's also prevalent on the D side especially in machine-politics cities. Which is why everyone's really so upset about the NY Mayor primary. People have gone on record in the papers about being annoyed that the bribes - sorry, donations - they prepaid to Cuomo are now invalid.
GuinansEyebrows 1y ago
american right-libertarianism is a thought-terminating ideology. "government bad, only private sector good" presupposes that we can't collectively provide services to residents/citizens, even when that's proven very effective in other countries.

deleted 1y ago

[deleted]

hinkley 1y ago

I'll never forget a coworker telling me that in a previous job hunting round he had interviewed with a pharmaceutical group that was tracking the manufacturing process for batches of drugs and comparing the little tolerance mistakes (heated a little too high or held at temp a little too long or not quite long enough) and finding a market where they can sell that batch. You'd like to think that companies have factories with quality control laws and there are local people trying to ensure that all of their product are up to the local standards. What you don't expect is that they are binning them like Intel CPUs, where they just make a batch and hope for the best, take cream off the top until the priority orders are done and then everyone else gets whatever is left. You might get a slightly better product sometimes but not be so lucky the next time.

xdfgh1112 1y ago
Does that mean that generics really are worse than the brand pharmaceuticals. Or are they binned the same way? In the UK I know the NHS buys generics, which implies they are effective, but I wonder.
- Retric 1y ago
  Generally it’s different companies manufacturing generics. Instead this mostly comes down to how effective each countries regulations are.
  - hinkley 1y ago
    This is also my understanding, but perhaps I am meant to understand that to be the case.
- throwawaysleep 1y ago
  Generics tends to be different companies altogether.
- lmpdev 1y ago
  Generics lack the ownership of the intellectual property, but that’s about it Generics are effective

navigate8310 1y ago

[flagged]

SanjayMehta 1y ago
India isn’t even mentioned in the article.
- deleted 1y ago
  [deleted]
manishsharan 1y ago
I actually read the actual study on Lancet. unfortunately for you, your vile prejudice can not be justified by this study.

aurizon 1y ago

Africa and China are awash with fake meds - perhaps even in India. Large amounts of fake drugs are common in Africa/China = deaths are common. Pharmacies are very aware of this and watch their sources. The big problem is very good copies of the container, box and printed insert that mimic exactly the true drugs are everywhere. A copied box/insert/vial/tablet that costs $1 can hold drugs worth $200 or more. There are gangs that buy them from China and try to insert them in the supply chain. I was with Sanofi-Pasteur(before I retired) and we had strict QC controls on every batch(every single ingredient). Every ingredient was sampled and tested locally and a sample sent to various head offices in USA/Canada/UK/etc. Batch ingredients were kept in locked areas and only allowed out in a weighed batch amount. The whole area was a clean and watched area with limited access badges on each person working there. You could only enter your zone and use your lunch/toilet area. Some ingredients are active and can have high values. Some are inert fillers. 1 milligram of fentanyl is minuscule = it ends up in a 25 or 50 milligram pressed tablet for ease of patient/pharmacy handling. Even adding the inert is complex as the active and the inert must mix with no settling or gravity segregation. Often the active is mixed with an intermediate diluent and a fluid that will not dissolve either and mixed in wiped surface mixer to make a very uniform paste which was then dried and granulated and this was added to the final diluent and a 'binder'. The binder is a material that will glue the tablet together in a high speed press. Some tablets get an enteric coating that resists acid but dissolves in the lower gut alkaline state = breaks and dissolves. Fentanyl and other strong opioids are killers in small amounts, so extreme precautions are taken to ensure correct doses.

theospeak 1y ago

You are going to rue the day. Enjoy your temporary comforts. You got so used to speaking of other people that are not in your demographic (especially Africans) as almost human that Africa will also not shed a tear should America be gone tomorrow And yes, we will survive your abscence, like we had since the beginning of time Tick tock (Or Tik Tok:-), more aptly)

debarshri 1y ago

A lot of low-quality and addictive generic drugs has created an opioid crisis in Africa too [1]. [1] https://www.bbc.com/news/articles/cwyew21yyjzo https://www.bbc.com/news/articles/cwyew21yyjzo