BackgroundSince 1998 the serious public health problem in South East Asia of counterfeit artesunate, containing no or subtherapeutic amounts of the active antimalarial ingredient, has led to deaths from untreated malaria, reduced confidence in this vital drug, large economic losses for the legitimate manufacturers, and concerns that artemisinin resistance might be engendered.Methods and FindingsWith evidence of a deteriorating situation, a group of police, criminal analysts, chemists, palynologists, and health workers collaborated to determine the source of these counterfeits under the auspices of the International Criminal Police Organization (INTERPOL) and the Western Pacific World Health Organization Regional Office. A total of 391 samples of genuine and counterfeit artesunate collected in Vietnam (75), Cambodia (48), Lao PDR (115), Myanmar (Burma) (137) and the Thai/Myanmar border (16), were available for analysis. Sixteen different fake hologram types were identified. High-performance liquid chromatography and/or mass spectrometry confirmed that all specimens thought to be counterfeit (195/391, 49.9%) on the basis of packaging contained no or small quantities of artesunate (up to 12 mg per tablet as opposed to ∼ 50 mg per genuine tablet). Chemical analysis demonstrated a wide diversity of wrong active ingredients, including banned pharmaceuticals, such as metamizole, and safrole, a carcinogen, and raw material for manufacture of methylenedioxymethamphetamine (‘ecstasy'). Evidence from chemical, mineralogical, biological, and packaging analysis suggested that at least some of the counterfeits were manufactured in southeast People's Republic of China. This evidence prompted the Chinese Government to act quickly against the criminal traders with arrests and seizures.ConclusionsAn international multi-disciplinary group obtained evidence that some of the counterfeit artesunate was manufactured in China, and this prompted a criminal investigation. International cross-disciplinary collaborations may be appropriate in the investigation of other serious counterfeit medicine public health problems elsewhere, but strengthening of international collaborations and forensic and drug regulatory authority capacity will be required.

The transfer of fluid and trace elements from the slab to the mantle wedge cannot be adequately explained by simple models of slab devolatilization. The eclogite-facies mélange belt of northern New Caledonia represents previously subducted oceanic crust and contains a significant proportion of talc and chlorite schists associated with serpentinite. These rocks host large quantities of H 2 O and CO 2 and may transport volatiles to deep levels in subduction zones. The bulk-rock and stable isotope compositions of talc and chlorite schist and serpentinite indicate that the serpentinite was formed by seawater alteration of oceanic lithosphere prior to subduction, whereas the talc and chlorite schists were formed by fluid-induced metasomatism of a mélange of mafic, ultramafic and metasedimentary rocks during subduction. In subduction zones,

BackgroundPlasmodium falciparum malaria remains a major public health problem. A vital component of malaria control rests on the availability of good quality artemisinin-derivative based combination therapy (ACT) at the correct dose. However, there are increasing reports of poor quality anti-malarials in Africa.MethodsSeven collections of artemisinin derivative monotherapies, ACT and halofantrine anti-malarials of suspicious quality were collected in 2002/10 in eleven African countries and in Asia en route to Africa. Packaging, chemical composition (high performance liquid chromatography, direct ionization mass spectrometry, X-ray diffractometry, stable isotope analysis) and botanical investigations were performed.ResultsCounterfeit artesunate containing chloroquine, counterfeit dihydroartemisinin (DHA) containing paracetamol (acetaminophen), counterfeit DHA-piperaquine containing sildenafil, counterfeit artemether-lumefantrine containing pyrimethamine, counterfeit halofantrine containing artemisinin, and substandard/counterfeit or degraded artesunate and artesunate+amodiaquine in eight countries are described. Pollen analysis was consistent with manufacture of counterfeits in eastern Asia. These data do not allow estimation of the frequency of poor quality anti-malarials in Africa.ConclusionsCriminals are producing diverse harmful anti-malarial counterfeits with important public health consequences. The presence of artesunate monotherapy, substandard and/or degraded and counterfeit medicines containing sub-therapeutic amounts of unexpected anti-malarials will engender drug resistance. With the threatening spread of artemisinin resistance to Africa, much greater investment is required to ensure the quality of ACTs and removal of artemisinin monotherapies. The International Health Regulations may need to be invoked to counter these serious public health problems.

We present analytical results from four dredge locations across the eastern Zealandia continental margin and adjacent ocean crust. The 115 Ma dacites dredged from the West Wishbone Ridge (WWR) are isotopically primitive, weakly adakitic, slabderived lavas. The 97 Ma A-type granites and a basalt from the easternmost Chatham Rise enlarge the known area of postsubduction Gondwana magmatism. Amphibolite-grade schists from a fault block south of the Chatham Rise provide a critical bridge between the Zealandia and West Antarctica belts of Jurassic-Cretaceous accretionary prism rocks. The new recognition of the WWR as a remnant of a 115 Ma intraoceanic subduction system means that previous hypotheses of the WWR as a fracture zone or spreading ridge require modification. The dacite ages constrain the start of Osbourn Trough spreading, which caused breakup of the Hikurangi-Manihiki igneous plateau, to before 115 Ma. We speculate that, after 115 Ma, the WWR was rifted by an intraoceanic spreading center that developed along its southeast side. Impingement of this spreading center against the Gondwana margin led to widespread 95-100 Ma postsubduction magmatism, variable lithospheric stretching, and ultimately continental splitting of Zealandia and West Antarctica across basement trends.

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