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Malaria is the most common protozoan infection and is one of the major public health problems in developing nations like Nepal. This study was conducted to find out total number of malaria cases in BPKIHS from 2006 to 2015 AD and to know the duration for which cases were admitted and improvement seen in them. This is a hospital based retrospective study conducted from 27th November to 10thDecember to see the number of malaria cases in B P Koirala Institute of Health Sciences, Dharan of Nepal, a tertiary level referral hospital in the Eastern Nepal. It was study in which secondary data, consistent with the diagnosis of malaria was collected from the Medical Record Section of BPKIHS and reviewed. Five hundred fifty four cases of malaria were enrolled. The patients were predominantly males (nearly 61.2%) and it was more commonly seen in 1-20 years age group (40.8%). Most of the cases were from Jhapa (22%), Sunsari (19.5%) and Morang (17.3%) District respectively. Most of the patients (69.9%) were admitted in Medicine wards. Almost 83.9% of admitted malaria cases were improved in BPKIHS.There seems to be decreasing number of cases since 2010 but still there is burden of malaria cases. We conclude that the problem of malaria is common and has become a key public health concern for all.

The proliferation of counterfeit and substandard medicines constitutes a major public health crisis in low- and middle-income countries, with The Gambia exemplifying regulatory fragility. This article contends that trademark infringement, often treated as a commercial issue, is a structural determinant of health, generating pathogenic legal exposures that intensify disease burden and inequity. A convergent mixed-methods design, grounded in legal epidemiology and health systems analysis, underpins the study. Quantitatively, it examines national data (2013–2023) on customs seizures, adverse drug reactions, and health facility records. Qualitatively, it integrates 32 semi-structured interviews with regulators, healthcare providers, and legal experts, alongside analysis of national and international policy frameworks. A literature synthesis situates The Gambia within the global counterfeit medicines burden, underscoring West Africa’s vulnerability due to porous borders, fragmented institutions, and the limited utility of mobile authentication in resource-constrained settings. Findings reveal profound systemic weaknesses: legal ambiguities, overlapping mandates, chronic underfunding of enforcement agencies, and limited public access to verified pharmaceutical data. Thematic analysis highlights policy incoherence and accountability gaps, while regression modelling demonstrates a significant link between weak trademark enforcement and counterfeit drug proliferation. The 2022 acute kidney injury outbreak from contaminated syrups illustrates these failures. The study concludes that combatting counterfeit medicines requires reframing trademark protection as a public health imperative. It recommends integrated legal-regulatory reform, multisectoral governance, capacity-building for enforcement bodies, and consumer empowerment through accessible verification tools. Embedding legal determinants into pharmaceutical policy offers a novel pathway to strengthening health security and restoring public trust in The Gambia and comparable contexts.