Fake artesunate in southeast Asia

Artesunate is a key antimalarial drug in the treatment of multidrug-resista nt Plasmodlum falclparum malaria in southeast Asia. We investigated the dis tribution of counterfeit artesunate tablets by use of the validated, simple , and inexpensive Fast Red TR dye technique. We also aimed to identify dist inguishing characteristics of the fake drugs. Of 104 shop-bought "artesunat e" samples from Cambodia, Laos, Myanmar (Burma), Thailand, and Vietnam, 38% did not contain artesunate. Characteristics such as cost and physical appe arance of the tablets and packaging reliably predicted authenticity. The il licit trade in counterfeit antimalarials is a great threat to the lives of patients with malaria. The dye test will assist national malaria control au thorities In urgently needed campaigns to stop this murderous trade.