Counterfeit drugs are a big problem in the developing world. Up to 30% of medicines sold in parts of Africa, Latin America, and Asia are fakes, according to figures from the World Health Organization. And the consequences sometimes can be deadly. In Pakistan, in 2012, more than 100 heart patients died after taking faulty drugs that caused averse reactions.
Marya Lieberman, a chemistry professor at the University of Notre Dame, says there's a desperate need for speedier and cheaper drug testing, and that's what her Paper Analytical Device Project (PAD) aims to offer. By putting testing capability into the hands of doctors, pharmacists, and consumers, she hopes to weed out counterfeits before they cause harm.
"Buyers in developing countries are extremely price-driven, and often the people buying the medicine are not the people taking them. These factors make it easier for manufacturers whose products are not of the best quality to slip into markets," she says.
The most common type of fakes are "under-dosed" drugs that come with lower-than-advertised amounts of active ingredients. In the case of antibiotics, these medicines may actually promote disease, Lieberman says. If the dose isn't high enough, the drug trains bacteria to develop resistance, thus harming the wider population as pathogens take on new form.
Lieberman's team has developed two paper-based tests. The first is a 12-lane card showing the presence of various chemicals. The second, developed by graduate student Nicholas Myers, shows the quantity of chemicals present. Both aim to offer an alternative to "high-performance liquid chromatography" (HPLC), an expensive and time-consuming lab-based procedure.
"It's not as good as an HPLC, but it also doesn't cost $60,000 a machine. You will still need confirmation testing [after initial testing with the cards] but we think we can make them for about $1.50," Lieberman says.
The 12-lane card contains various reagents—substances that react in the presence of a material. Testers swipe a crushed pill over the lanes, then dip the bottom of the card in water, drawing liquid upwards. When the water reaches the swipe-point, it sets off a reaction, indicating with different colors what's there. Much of the test-card is printed using a Xerox ColorQube wax printer (costing about $600), after which a "spotting" robot fills in the reagents. The second card currently needs to be hand-painted.
PAD has received funding from USAID's Development Innovation Ventures program. Lieberman's says the 12-lane test is ready for commercialization, while the second test is closing in on that stage. Myers is also developing an app that would automatically record results from test photos.
"The big goal here is to improve the turnaround time for testing drugs," Lieberman says. "At the moment, because of the costs involved, it may take months or even years for [a sample] to be analyzed. We have to reduce that time, so more drugs in the market get tested."
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Photos: Barbara Johnston/University of Notre Dame