The value of protecting the supply chain

Malaria kills 600,000+ people in Africa each year, and has attracted attention from some very well-funded and determined organisations aiming to wipe out malaria. But where there's money, there's opportunity for fraud, and this area is no exception.

It seems that the modern effectiveness of anti-malaria medication such as artemisinin derivatives is somewhat undermined by large-scale imports of fake medication into Africa:

That even doctors are unable tell real malaria drugs from fake is testament to just how complex the situation has become in Tanzania and Uganda, which together accounted for 20m of the 94m malaria cases reported globally in 2010.
Estimates vary, but some recent studies suggest that as many as a third of malaria drugs in the two countries are fake or substandard, and most are believed to have originated in China.

Let's review what happens here. Someone operating a pharmaceutical factory in China spends time and effort duplicating packaging and form of existing medications, to the point where even doctors can't be sure which package is fake and which is real. They insert it into the supply chain, presumably mixing it with legitimate shipments to muddy the source, and a doctor in Tanzania or Uganda spends time and effort treating a malarial child with no effect for several weeks until they realise that the medication is no good.

There's no comeback to the counterfeiters, as far as I can see. Tracking down where the fake medications got inserted into the supply chain would be near-impossible; the poor state of documentation and widespread bribery in Africa means that you can't trust any documentation or verbal assurance. The only approach I can see is some form of tamper-proofed boxes from the manufacturers: say, a small electronic lock with a serial number that the doctor can SMS to the manufacturer, then the manufacturer can SMS back an unlock code - and the unlock is one-time. This will obviously cost money, both in development and manufacture but at least it reduces the 30%+ ineffective rate of medicine which is only going to go up. I can't see the Chinese government cracking down on these factories.

The claims are backed up by commentator Chinagirl88:

I live and work in China in the medical profession and despite as some people have pointed out, the lack of hard evidence, the suspicion that the fake drugs originate from China is unfortunately all too believable. Despite nearly every week bringing some story of "crackdowns" on gangs making counterfeit goods of every description (since I've lived in China there has been a crackdown on fake drugs nearly every few months) this seems to provide little deterrent to the people wanting to get rich quick no matter what the cost to other humans.

The next time someone tells you how disgusting capitalism is, remind them of this example of what state-backed cronyism combined with a poor legal infrastructure does to sick and poor people.