Almost one in five chemotherapy medicines sampled in several African countries have been found to contain dangerously incorrect doses, new research has revealed.
Chemotherapy is a drug treatment that uses powerful chemicals to kill fast-growing cells (cancer) in the body.
The investigation, featured in The Lancet Global Health, examined 251 samples of seven widely prescribed cancer treatments sourced from hospitals, licensed pharmacies, and unregulated vendors in Ethiopia, Kenya, Malawi, and Cameroon between April 2023 and February 2024.
Researchers discovered that 19 per cent of the drugs fell short of internationally recognised quality standards. Some contained barely a quarter of the amount of active ingredient stated on the label, while others had more than 120 per cent – a level that could be harmful.
The study involved Nigerian postgraduate student Ekezie Okorigwe of the University of Notre Dame in the United States, who worked alongside a multinational team. He said his interest in the issue was driven by a strong sense of public trust in healthcare.
While speaking to PUNCH Healthwise, he explained that when people buy medicine, they should expect it to work as intended, stating that, “Bad quality drugs can harm the body in ways that cannot always be reversed, even if treatment is later corrected.”
Okorigwe added that substandard chemotherapy treatments waste resources, undermine medical progress, and leave patients suffering unnecessarily.
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As part of the project, the researchers are creating a low-cost, portable tool to help identify poor-quality cancer medicines.
Called the chemoPAD, it is a paper-based testing card capable of detecting the most dangerous cases – those with less than half the required dosage – at a fraction of the cost of full laboratory analysis.
Professor Marya Lieberman, the lead researcher and Okorigwe’s academic adviser, likened the testing method to batik fabric printing. The chemoPAD uses wax-printed channels that carry water to react with a small smear of the medicine. If the drug is of poor quality, it generates distinctive colours.
While not a replacement for laboratory procedures, which can cost as much as $1,200 and require dozens of tablets, the chemoPAD can analyse a single pill and provide a quick field assessment. The technology was first applied to antibiotics and tuberculosis treatments, and the team intends to adapt it for a wider range of medicines, including antimalarials.
According to Lieberman, weak regulation, cost pressures, and complicated distribution networks are major drivers of poor-quality medicines in Africa.
With cancer rates in sub-Saharan Africa doubling over the past three decades, health specialists warn that counterfeit or substandard drugs could further depress already low survival outcomes.
Okorigwe believes that regular, accessible quality checks should become a routine part of medical practice.
“Clinicians in the field cannot carry out complex lab procedures,” he said. “We need straightforward, reliable tools that safeguard patients – and that’s exactly what we’re aiming to deliver.”
