“Counterfeit drugs kill!” reads the World Health Organization's (WHO's) anticounterfeiting slogan. Yet no one had ever calculated just how many deaths fake meds cause. So, last year, Andreas Seiter, the World Bank's global pharmaceutical industry fellow in Washington, DC, crunched the numbers. Drawing on estimates from the WHO, Health Action International and others, Seiter estimated the health and economic costs of substandard and counterfeit antimalarial drugs in a typical malaria-endemic African country of 20 million people—about the size of Ghana. Here are Seiter's back-of-the-envelope calculations:

4 million—Number of drug treatments for malaria per year.

800,000—Number of treatments with ineffective malaria drugs.

4,000—Number of childhood deaths owing to these ineffective drugs.

0.5—Days per year spent by the average worker to pay for these ineffective drugs.

3.2 million—Total number of working days spent to earn money for ineffective drugs.

Source: Clin. Pharmacol. Ther. 85, 576–578 (2009).