Approximately 3,000 children die from malaria every day, while pneumonia kills hundreds of thousands of children each year. 

With medication, both of these illnesses are treatable — but that might not be the case for many children in developing countries, where 1 in 10 drugs sold is “substandard” or counterfeit, according to the World Health Organization.

More than 200,000 deaths could be caused from fake or substandard medication each year, according to new reports. And the “fake drug” industry represents some $30 billion a year.

In a recent report, the WHO said that no countries are unaffected by fake or sub-par medication, but the problem is more widespread in developing countries and countries with ongoing conflict where healthcare systems are either compromised or do not exist.

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Instead of life-saving ingredients, counterfeit drugs often contain fillers like potato starch and chalk, the WHO reported. The agency found that many substandard drugs were produced in unhygienic environments — sometimes by unqualified people — and contained the wrong active ingredients.

In sub-Saharan Africa alone, the WHO estimates that falsified and substandard drugs contributed to anywhere between 72,000 and 267,000 fatal cases of malaria. In Southeast Asia, 53% of antimalarial medications sampled contained the incorrect amount of active ingredients.

These fake and poor-quality drugs not only fail to properly treat people’s illnesses, but can also increase resistance to treatment putting others at risk, the report said.

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While this issue is a global one, people living in poverty are among the hardest hit.

“Imagine a mother who gives up food or other basic needs to pay for her child’s treatment, unaware that the medicines are substandard or falsified, and then that treatment causes her child to die,” WHO Director-General Tedros Adhanom Ghebreyesus said in a statement.

Read more: Millions of Children at Risk After ‘Fake’ Vaccine Ring Busted

In 2012, nearly 2,000 people were arrested for producing and selling fake drugs in China, according to the BBC. Low-quality tuberculosis drugs killed 100 patients in Pakistan that same year, and fake antibiotics killed thousands in India over a five-year period, Newsweek reported.

In a press release, the WHO’s Assistant Director-General for Access to Medicines, Vaccines and Pharmaceuticals, Mariângela Simão, said to address the issues, “Countries need to assess the extent of the problem at home and cooperate regionally and globally to prevent the traffic of these products and improve detection and response.”

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200,000 Deaths Could be From $30 Billion Fake Drugs Trade: WHO

By Daniele Selby