Although we agree that medicines

Although we agree that purchase OF-1 medicines regulatory authorities need to be strengthened, we are seeing important progress. Recently, two national drug reference laboratories in sub-Saharan Africa received ISO-17025 accreditation—an internationally recognised standard regarding laboratory competency. These long-term gains represent sustainable health systems capacity building, enabling partner country medicines regulatory authorities to perform much needed quality testing. The President\'s Malaria Initiative is providing substantial support to countries to improve regulation and enforcement capacity of both the public and private sectors, and we are expanding efforts with partner countries to strengthen all areas of their pharmaceutical supply chain, including forecasting, storage, transportation, and inventory management. Finally, as a major procurer of artemisinin-based antimalarials, the Initiative employs a stringent quality assurance and quality control strategy, ensuring ribose only good quality drugs are used in support of US Government malaria programmes not only in sub-Saharan Africa, but also the greater Mekong subregion. Although there are various estimates of the burden of fake drugs, WHO believes that fake medicines are now a US$75 billion per year industry. We agree with Newton and colleagues that more must be done to assure quality of medicines, and second their call for an international public health convention on the topic.
We welcome the Comment by Keertan Dheda and colleagues (October issue) about our modelling study that assessed the effects and cost-effectiveness of several new tuberculosis diagnostic algorithms for adult pulmonary tuberculosis in Tanzania. However, we would argue that some key points about the importance of the work have been omitted.