Mexican authorities have raided pharmacies to scoop up counterfeit and substandard drugs. (© AP Images)

Great advances in global public health could be lost to a scourge of counterfeit and substandard medicines appearing in pharmacies everywhere.

Innovative medicines have saved lives from HIV/AIDS, malaria and tuberculosis, but when disease-causing pathogens encounter fake drugs, the diseases might win and the patients might lose.

“The pandemic of falsified and substandard medicines is pervasive and underestimated, particularly in low‐ and middle‐income countries where drug regulatory systems are weak or non-existent,” says Jim Herrington, a co‐editor of a special edition of The American Journal of Tropical Medicine and Hygiene devoted to this problem.

Scientists inspected almost 17,000 medication samples for quality and adherence to the legitimate manufacturers’ specifications for the drugs’ ingredients. The researchers found substandard or falsified drugs at different rates across the wide range of samples — as low as 9 percent and as high as 41 percent.

A Peruvian health ministry worker takes inventory of counterfeit drugs removed from pharmacies in Lima in 2012. (© AP Images)

Researchers describe a 2013 case in which more than 122,000 African children succumbed to malaria after they were treated with falsified drugs.

Tuberculosis has become more resistant to medications effectively used to treat it in the past, possibly because substandard drugs helped TB bacteria build new defenses against the drugs.

The publication also offers potential solutions, including these:

• An international framework to outlaw pharmaceutical counterfeiting and establish secure global supply chains for pharmaceutical distribution.

• Tools to help doctors detect bad drugs, such as the hand-held counterfeit detection device developed by the U.S. Food and Drug Administration and a chemically treated paper test that changes color when exposed to a substandard antimalarial drug.

Bad drugs aren’t the only substandard products on the global market, and the costs to consumers and producers alike are staggering.