Patients in emerging markets want greater access to medicines, but supplying medicines cheaply is proving problematic. Part of the difficulty is the proliferation of illegal counterfeits in the poorest markets. Yet our new research shows that substandard medicines—those legally but poorly produced—pose an equally dangerous threat to patients¹. Without a strong commitment from pharmaceutical companies and drug regulators around the globe, the problem will worsen.

The demand for medicines from the growing middle class in India, China, and, more recently, Africa is creating opportunities for pharmaceutical companies. McKinsey projects that by 2025 China and India will be respectively the third- and fifth-largest consumers in the world. African households with discretionary spending are also set to increase by 50 percent over the next ten years. These trends are significant for major Western companies like Bayer and Novartis, who already generate 25 percent of their revenue from emerging markets, up from single-digit percentages only a decade ago.

Roger Bate is the Legatum Fellow in Global Prosperity, and Julissa Milligan is a research assistant at AEI.