Published in The Lancet Global Health, the study tested nearly 200 unique cancer drug products collected from hospitals and pharmacies in the four African countries. It found that around one in six contained incorrect levels of active ingredients, putting patients at risk of ineffective treatment and disease progression.
Researchers said causes ranged from poor manufacturing and inadequate storage to deliberate counterfeiting. The problem is difficult to detect visually: only about 25% of the defective products could be flagged by inspecting packaging or color, while the majority required laboratory testing to uncover quality failures.
“If you can’t test it, you can’t regulate it,” said Marya Lieberman of the University of Notre Dame, who led the investigation. “The cancer medications are difficult to handle and analyze because they’re very toxic, and so many labs don’t want to do that.”
The study points to big challenges for many African countries in making sure cancer drugs are safe. Many places don’t have the right labs or trained staff to properly test these medicines. Even where labs do exist, they often can’t handle these very strong and dangerous drugs.
WHO Addresses Cancer Drug Quality Concerns
The World Health Organization (WHO) said it is in contact with authorities in the four affected countries to review the findings and develop a response plan.
“We are concerned with the findings the article has highlighted,” the WHO said in a statement. “We expect to assess full information to evaluate the situation… But we’re committed to address these issues working with the relevant countries and partners.”
Defective or falsified medicines are not new challenges in Africa. Previous studies have found similar rates of poor-quality antibiotics, antimalarials, and tuberculosis treatments. The WHO has estimated that roughly 10% of all medicines in low- and middle-income countries are substandard or falsified, leading to treatment failures, adverse reactions, and wasted healthcare spending.
Despite the worrying results, researchers noted that most of the cancer drugs tested did meet quality standards, with around two-thirds of suppliers consistently delivering safe products.
Experts called for improved manufacturing oversight, stronger regulatory frameworks, and investment in local testing capacity. They also pointed to new screening technologies under development, such as portable “paper lab” tests designed to help detect poor-quality medicines before they reach patients.
Cancer rates in Africa are expected to rise significantly in the coming decades, making safe and effective treatment a growing health priority.
