Figure 1: Example of counterfeit chloroquine phosphate tablets found in Cambodia in 2004

20

Figure 2: Example of counterfeit artesunate found in the Mekong Subregion in 2004

21

Figure 3: Example of counterfeit amoxicillin capsules found in Cambodia, 2009

21

Figure 4: Multi-colour medicine sachets of cocktail pills repacked by retail drug outlets are still available in some parts of the countries in the Mekong Subregion. This photo was taken in Cambodia in 2011

22

Figure 5: Map of countries of the Mekong Subregion with dots illustrating the locations of pharmaceutical sample collection sites

30

Figure 6: Methodological framework on medicine quality monitoring applied in the GMS by the United States Pharmacopeia Promoting the Quality of Medicines Program

31

Figure 7: Three levels of testing for checking the quality of the samples

32

Figure 8: Basic tests used in the medicines quality monitoring programme in the Mekong Subregion

33

Figure 9: Officers conduct a simple disintegration test of oseltamivir tablets in Cambodia

34

Figure 10: Training on basic testing for field monitoring of anti-infective medicines in Thailand, 2009

35

Figure 11: Training on quality control technique and procedures to detect counterfeit and substandard medicines to central and field laboratory staff in Vietnam

35

Figure 12: Percentage of samples failing quality testing by country

40

Figure 13: Quality of medicine samples collected in Cambodia between 2002-2008 showing the proportion of products that passed and failed quality testing

41

Figure 14: Quality of medicine samples collected in Lao PDR between 2003-2008 showing the proportion of products that passed and failed quality testing

42

Figure 15: Quality of medicine samples collected in Vietnam between 2004-2008 showing the proportion of products that passed and failed quality testing

43

Figure 16: Quality of four categories of anti-microbial medicine samples collected and tested in the region (2003-2008)

44

Figure 17: Quality of anti-malarials collected by country

45

Figure 18: Inspectors of the Food and Drug Department of Lao PDR inspect retail pharmacy outlets as part of the monotherapies ban policy implementation in Lao PDR

46

Figure 19: Quality of antibiotics collected and tested by country

48

Figure 20: Quality of anti-TB medicines collected and tested by country

49

Figure 21: Quality of ARVs collected and tested by country

50

Figure 22: Counterfeit medicines by country

51

Figure 23: Counterfeit medicines found in Cambodia between 2005-2008

51

Figure 24: Percentage of counterfeit medicines from each distribution channel out of total counterfeit samples found in the countries surveyed

56

Figure 25: Consumers’ risk of receiving bad medicines from pharmacies at the border provinces in each of the countries

58

Figure 26: Consumers’ risk of receiving bad medicines from hospitals in the border provinces in each of the countries

58

Figure 27: Consumers’ risk of receiving bad medicines from clinics in the border provinces in each of the countries

59

Figure 28: Consumers’ risk of receiving bad medicines from malaria clinics in the border provinces in each of the countries

59

Figure 29: Consumers’ risk of receiving poor quality medicines from various distribution channels in the border provinces of Cambodia

60

Figure 30: Consumers’ risk of receiving poor quality medicines from various distribution channels in the border counties of Yunnan Province

61

Figure 31: Consumers’ risk of receiving poor quality medicines from various distribution channels in the border provinces of Lao PDR

61

Figure 32: Consumers’ risk of receiving poor quality medicines from various distribution channels in the border provinces of Thailand

62

Figure 33: Consumers’ risk of receiving poor quality medicines from various distribution channels in the border provinces of Vietnam

62

Figure 34: Diagrammatic depiction of the factors in the medicine process – critical to quality

64

Figure 35: Conceptual spheres of regulatory control

66

Figure 36: Conceptual spheres of the four main regulatory functions

67