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Background: Some medicines for sale in developing countries are approved by a stringent regulatory authority (SRA) or the World Health Organization (WHO) prequalification program; many of these are global brands. This study ascertains whether medicines approved by SRAs or the WHO perform better in simple quality tests than those that have not been approved by either. Methods: Over the past 4 years, 2652 essential drugs (products to treat malaria, tuberculosis, and bacterial infections) were procured by covert shoppers from eleven African cities and eight cities in a variety of mid-income nations. All samples were assessed using the Global Pharma Health Fund eV Minilab® protocol to identify whether they were substandard, degraded, or counterfeit.Results: The failure rate among SRA-approved products was 1.01%, among WHO-approved products was 6.80%, and 13.01% among products that were not approved by either. African cities had a greater proportion of SRA- or WHO-approved products (31.50%) than Indian cities (26.57%), but they also experienced a higher failure rate (14.21%) than Indian cities (7.83%). The remainder of cities tested had both the highest proportion of approved products at 34.46% and the lowest failure rate at 2.70%. Products made in Africa had the highest failure rate at 25.77%, followed by Chinese products at 15.74%, Indian products at 3.70%, and European/US products, which failed least often, at 1.70%. Most worrying is that 17.65% of Chinese products approved by the WHO failed. Conclusion: The results strongly indicate that approval by either an SRA or the WHO is correlated with higher medicine quality at a statistically significant level. The comparatively high failure rates among WHO-approved products suggest there may be some weakness in post-marketing surveillance of these products, especially of Chinese-made WHO-approved products. The discrepancy between the failure rate of WHO-approved products from India (2.39%) and China (17.65%) is cause for concern. It is possible that more of the failures originating in China are counterfeit products, but this cannot be ascertained without greater help from the manufacturers themselves. [ABSTRACT FROM AUTHOR]

Agnes Binagwaho and colleagues describe Rwanda's experience of pharmacovigilance for malaria and tuberculosis, and call for a global treaty and leadership by the World Health Organization to address the global manufacture and trade in substandard and falsified medicines. Please see later in the article for the Editors' Summary

Presents a letter to the editor about malaria control and public health.

The article offers the author's insights on the state of public health in Zimbabwe from 2000-2008 when white-owned farms were confiscated. He mentions the coalition formed by Zimbabwe President Robert Mugabe and Prime Minister Morgan Tsvangirai which has urged some help for the cholera epidemic. He cites Kimberley Process' role in approving diamond mining operations in the Marange fields, despite the industry's perceived accountability for the country's economic state.

The article offers information on the objectives of the Global Fund to Fight AIDS, Tuberculosis, and Malaria (GFATM) and also focuses on efforts being made by GFATM to prevent drug theft. It mentions that GFATM is conducting its own investigation into medicine theft, following the reports published on such thefts. It informs that GFATM is aimed at assisting poor nations to build up their own competence to deliver healthcare to their own people and follow international health policy.

The article discusses the key aspects of economic and political freedom as mentioned by the "Wall Street Journal." It measures several indices which include governance, education, health, social capital, security and personal freedom. It concludes that subjective well-being and free trade may drive a country to prosperity.

The article presents the author's views on the United Nation's (UN) superstitious decision of reducing the use of the insecticide DDT in controlling malaria. He questions the UN's contradictory step of first declaring DDT as a vital component in stopping malaria and then eventually making plans to reduce its use and promoting more dangerous malaria control techniques. He believes that UN's politically correct decision has caused worry over public health.

The author reflects on the potential benefits of the European Union's (EU's) new regulations on pesticide use that are designed to protect public health. However, he argues that the new regulation would only end harming the pesticide industry instead. In addition, he argues that the new regulation is likely to lower the number of pesticides on the market, as well how frequently they will be used.

The article provides information concerning the impact of fake drugs on the health of poor people in Nigeria. The author implies that most Nigerians distribute their own malaria treatment. And adds that Nigerians know the symptoms and the time-tested remedy. The author also infers that modern drugs work very well, however complicating malaria treatment is a burgeoning industry of fakes and pseudo-pharmaceuticals with suspicious provenance. Transparency International has once ranked country as the most corrupt place.

The article discusses cancellation of patents of Western companies and development of cheap drugs in Thailand. Doctor Margaret Chan, director general of the World Health Organization (WHO) was not pleased with Thailand's move wherein she emphasized that increased production of cheap drugs is likely to benefit government officials than the poor and sick people. Moreover, Thailand's health ministry plans Government Pharmaceutical Organization (GPO) production and sale of copy drugs to hospitals that may worsen the health condition of patients for GPO's drug quality track record is very poor.

The article presents the author's view on the 12th International Anti-corruption Conference (IACC) of Transparency International (TI) attended by him on November 1. He informs that the focus of the conference was on relevant areas of defense and the arms trade, money laundering, extractive industries and infrastructure. The author asserts that Transparency International deserves commendation for examining and bringing attention to the prevalence of corruption in the health sector.

The author reflects on the significant contribution of the Bill and Melinda Gates Foundation to the U.S. public health and environment. He suggested that the charity should support HIV and malaria clinical research. It has done little in any of the actual priority areas distinguished by the Copenhagen Consensus. He contended that Gates should realize that aid flows reflect the cost of providing services for the poor. He added that its aid the people less accountable to their population.

The author suggests that the World Bank (WB) should abandon its disease control activities, given its dismal record in funding projects to cure life-threatening diseases. In India, for instance, WB is still supporting chloroquine, a malaria medicine, when evidence shows that the disease in the country has become resistant to that drug. No less than the World Health Organization has said since 2003 that chloroquine should not be used in areas where the rate of treatment failure of the disease surpasses 15%. WB should instead redirect its efforts to funding the building of medical schools, clinics, and laboratories.

The article reflects on the situation of AIDS in the West African country of Sierra Leone and other concerns with respect to healthcare aid for the country. Estimates from the World Health Organization (WHO), the World Bank and other multilateral agencies revealed that Sierra Leone has one of the world's worst-performing health sectors with aid for HIV care displacing the more valuable child immunization work and competent staffs are drawn away from these basic but vital services towards the more rewarding HIV program.

This article focuses on issues pertaining to the results of a research study conducted by the World Health Organization and the London School of Hygiene and Tropical Medicine which saw a connection between climate change and child malarial deaths in developing countries. A key condition for a malaria outbreak is a sufficient pool of parasite-infected humans and animals that allows the malaria parasite to perpetuate its life cycle. The main thrust of the World Health Organization's campaign is the use of bednets, which has a far lower success rate than the use of insecticides. This article argues that the World Health Organization should not blame global climate change for health problems associated with the anopheles mosquito.

Opposes the decision of Great Britain government to ban the use of growth-promoting antibiotics. Growing resistance of bacteria to antibiotics; Importance for people to properly use antibiotics; Discussion on the problem; Reason of the government for decision.

Focuses on the public's concern on the safety of commercial products. Health risk; Ability of science to detect, isolate and test the adverse effects of chemicals; Plant chemicals that disrupt animal production; Environmental protection.