Anti-D prophylaxis should protect all newborns from haemolytic disease, regardless of their country of residence According to a World Health Organization (WHO) study, the observed failure rate of substandard and falsified medicines (SFM) in low-and middle-income countries is estimated to be over 10%, with an estimated spend of US$30.5 billion [1]. The problem embraces drugs in many areas of healthcare. We report on monoclonal anti-Ds, used for many years in low-and middle-income countries, for prophylaxis of RhD haemolytic disease of the foetus and newborn (HDFN), which have never been shown to meet the standards of anti-D immunoglobulin (Ig). The consequences of using these drugs in postnatal women might be very serious, even fatal, for their offspring. The prevention of HDFN by administration of anti-D Ig to D-negative women has been a triumph of medicine. In Europe, North America and Australia, before prophylaxis, 16%-17% of D-negative women delivering ABO-compatible, D-positive infants developed anti-D after delivery of a second D-positive infant [2]. Several clinical trials, over 6 years, on male volunteers and then on thousands of D-negative primiparae delivering ABO compatible, D-positive infants, many of them tested after delivery of a second D-positive infant, showed that postnatal