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    The term “poor-quality medicines” is something of a catch-all. It includes “sub-standards”, medicines that have had inadequate quality control or that have degraded from improper storage or the passage of time. And it includes falsified medicines – fakes – that claim to be what they are not. These may not be made by the manufacturer whose name is on the package and they may not contain the stated ingredients in the stated quantities. (1) Poor-quality medicines might not work. They usually have none or only part of the active ingredient they are supposed to contain. This would mean that the illnesses of those people who consume them would be left to take their course. Consuming them can even kill you because the contaminants in the medicines can end up causing severe infections. (2) Poor-quality medicines can be life-threatening even if you don’t take them. Antimicrobial drugs (including antibiotics and antivirals) that have too little active ingredient are generally accepted to help disease-causing bugs evolve so that they develop resistance to treatment even with good-quality antimicrobials. And then these bugs spread. (3) The factors that speed up the development of antimicrobial resistance — high rates of infections, the overuse and misuse of antimicrobials, poor sanitation, poor-quality medicines — are more common in low- and middle- income countries, which means that so is resistance. But microbes travel easily across the world in foodstuffs being exported and in the bodies of humans. And often, resistant microbes can transfer genetic material to each other to become even more dangerous to humans. (4)The result: infections that were simple to cure are back with a vengeance. Conditions like tuberculosis and HIV are getting harder to treat. In the future, a routine surgery could become risky and cancer treatment more challenging. There is a real danger of returning to a time where any one of us could pick up an infection and find that medicines are unable to produce the intended results. (5) In 2010, Indians consumed the most antibiotics per person in the world. Medicines, including antimicrobials, are easily available over the counter despite rules that forbid this. A recent study found that a large number of antibiotics were on sale without being approved either in India or in the country of the manufacturer. On an international level, further complicating the picture is the fact that different countries have different standards of quality. (6) Ensuring medicine quality is a global challenge. A pill might be manufactured from ingredients sourced from multiple countries, shipped via several ports, packaged and repackaged in various countries and ultimately sold via an internet pharmacy. The number of points at which fakes or substandards could enter the chain is staggering, so international coordination and regulation is essential. (7) - Srinath Perur Glossary: active ingredient - a chemical component in a medicine responsible for its intended effects antivirals - drugs that treat infections caused by viruses microbes - microorganisms, especially the ones causing diseases (480 words) Source (edited): 'Fake drugs: the global industry putting your life at risk' - https://mosaicscience.com/story/fake-drugs-global-antibiotics-amr- counterfeit-meds/ Based on your understanding of the passage, answer the questions given below.

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