While urgent action is needed to address the public health menace of substandard and falsified medical products, the Jan. 28 news article “Fake drugs driving Ugandans back to witch doctors” did not identify the underlying causes or the appropriate solutions to the problem. Medicines of poor quality continue to proliferate because nearly all impoverished countries have little or no capacity to monitor the medicines imported into their countries. Investments — of technical capacity and money — are few and far between from the wealthy world.
The U.S. trade representative has made matters worse by negotiating numerous trade agreements that have increased medicine prices in poor countries by undermining the supply of low-cost generic medicines. Patients often buy falsified medicines because they cannot afford to pay high prices for legitimate products. As the trade representative continues to export strict intellectual-property rules that increase medicine prices, many more poor people will turn to dangerous medicines and other forms of inadequate health care.