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A state of Dual Pandemic: COVID-19 & Falsified Products

by Public Health Update

A state of Dual Pandemic: COVID-19 & Falsified Products

Nirdesh Baral and  Sandip Pahari

COVID-19 has been declared as pandemic by WHO at 11th March 2020. As of 25 April 2020, more than 2.84 million cases of COVID-19 have been reported in 185 countries and territories, resulting in more than 199,000 deaths, it has become a threat to the human existence.[1] The whole world is focused to mitigate this problematic situation. Nearly, all the country round the globe has imposed lockdown to restrict the mobility of their situation to reduce the transmission of the virus. The increased demand of the many essential products such as medicines, groceries and recent cutoff of their supplies has disturbed the equilibrium of the economy.

Related reading: Digital advocacy in context of COVID-19 | Rashmi Acharya

In this state of panic, the trend of product adulteration has been rapidly reported around the world. Falsified/Unregistered medicines has been widely supplied. Similarly, wide variety groceries and food items for daily consumption is also adulteration and substandarized is also found. It becomes extremely important to understand term “Falsified”, “Unregistered”,” adulteration ” and ” Substandard”. Substandard also called “out of specification”, these are authorized medical products that fail to meet either their quality standards or specifications, or both. Unregistered/unlicensed medical products that have not undergone evaluation and/or approval by the National or Regional Regulatory Authority for the market in which they are marketed/distributed or used, subject to permitted conditions under national or regional regulation and legislation. Falsified medical products that deliberately/fraudulently misrepresent their identity, composition or source.[2] Food Adulteration refers to the process by which the quality or the nature of a given food is reduced through addition of adulterants or removal of vital substance. Food adulterants refer to the foreign and usually inferior chemical substance present in food that cause harm or is unwanted in the food.[3]

Variety of news have been reported about the increase in supply of the substandard products around the globe. Recently, Nepal has canceled the medical supply deals with Chinese Company as the 19 items including PPE and testing kits to be supplied for fighting with COVID-19 was found substandard.[4] We can also find various of unregistered instant hand sanitizer flooded in market since COVID outbreak.Some sanitizer have benzalkonium chloride  as active ingredient but CDC recommends at least 60% alcohol against corona prevention.[5]

Apart from medicinal equipment, various daily commodities such as rice, cereals, vegetables, oil, ghee, milk etc has been adulterated making them potentially hazardous to human health. We have been hearing adulterated food distribution in the relief campaign by government.[6][7]

List of common food Adulterants [8]

Food productsAdulterants added
MilkWater, chalk, urea, caustic soda and skimmed milk
DaalMetanil yellow
SpicesAsafoetida, Metanil yellow,Sudan Red
OilPalm Oil,Dalda


Health Implication

Substandard and falsified medical products may cause harm to patients and fail to treat the diseases for which they were intended and also increasing chances for microbial resistance. They lead to loss of confidence in medicines, healthcare providers and health systems. Addition to this, adulterants have huge negative health impacts. Most of the adulterants are carcinogenic causing various of stomach, colon, skin cancer etc

Preventive Measures and Recommendation

Individual Measures

It is necessary for an individual to be aware about these substandard product.  Common measures to be applied by consumer could be :

  1. Lack of authenticity; no verification logo or certificate
  2. Spelling mistakes and poor grammar on the packaging
  3. Websites that do not display a physical address or landline
  4. Websites offering prescription only medicines without a prescription
  5. Suspiciously low-priced products.

Government Measures

The primary measures from the government would be strict monitoring and penal system to maintain quality in these vital commodities. Taking about Nepal Government of Nepal also has regulatory body such as Department of Drug Administration, Consumer Forum. Various laws and acts such as Drug Act 2035, Drug Standard Regulation 2043, Health Technology Product and Medical Device Directives 2074, Drug Enquiry and Inspection Regulation 2040 are existing and hence must be strictly formulated. Recently, DDA has released a guidelines to standardized instant hand sanitizer, These body must be effectively work in this period to eliminate the viral marketing and use of the substandard products

  1. Proper surveillance of the implementation food laws.
  2. Monitoring of the activities with periodical records of hazards regarding food adulteration.
  3. Consumer awareness programs organized by holding exhibitions/seminars/training programs and publishing pamphlets.
  4. Strict actions regarding the punishment for those who are involved in food adulteration.
  5. Multi sectoral coordination and support from NGO and relevant stakeholders


  1. COVID-19 Dashboard by the Center for Systems Science and Engineering (CSSE) at Johns Hopkins University (JHU)”ArcGISJohns Hopkins University. Retrieved 25 April 2020.
  2. Substandard and falsified medical products [Internet]. Who.int. 2020 [cited 25 April 2020]. Available from: https://www.who.int/news-room/fact-sheets/detail/substandard-and-falsified-medical-products
  3. Food Adulteration, Types of Food Adulteration and Mitigation Measures – Public Health Notes [Internet]. Public Health Notes. 2020 [cited 25 April 2020]. Available from: https://www.publichealthnotes.com/food-adulteration-types-of-food-adulteration-and-mitigation-measures/
  4. India P. Nepal scraps medical supply deal of Chinese company; finds product of substandard quality [Internet]. Business-standard.com. 2020 [cited 25 April 2020]. Available from: https://www.business-standard.com/article/pti-stories/nepal-scraps-medical-supply-deal-of-chinese-company-finds-product-of-substandard-quality-120040200742_1.html
  5. You Might Be Buying a Hand Sanitizer That Won’t Work for Coronavirus [Internet]. ProPublica. 2020 [cited 25 April 2020]. Available from: https://www.propublica.org/article/coronavirus-hand-sanitizers-cdc-recommended-alcohol
  6. Substandard relief materials distributed in Bajura [Internet]. The Himalayan Times. 2020 [cited 25 April 2020]. Available from: https://thehimalayantimes.com/nepal/substandard-relief-materials-distributed-in-bajura/
  7. Mayor arrested for distributing substandard essentials in Bara [Internet]. The Himalayan Times. 2020 [cited 25 April 2020]. Available from: https://thehimalayantimes.com/nepal/mayor-arrested-for-distributing-substandard-essentials-in-bara/
  8. Today E, Affairs G, Microfacts L, digital. Common food adulterants [Internet]. India Today. 2020 [cited 25 April 2020]. Available from: https://www.indiatoday.in/education-today/gk-current-affairs/story/common-food-adulterants-in-india-1370601-2018-10-19


Nirdesh Baral, 7th Sem BPH Student, School of Health and Allied Sciences, Pokhara University, Email: [email protected], Cell No. +977-9816138346

Sandip Pahari, Assistant Professor, School of Health and Allied Sciences, Pokhara University, Email: [email protected], Cell No. +977-9846261237


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