Fake Pills that Kill

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Massive increase in counterfeit medicine in the Asia Pacific

By Chris Cubbage, ASM.

Described as the crime of the 21st century, the counterfeiting of currency and consumer products are common problems that plague governments and manufacturers throughout most of the Asia Pacific. Of all the different counterfeit and falsified goods produced, and the range is vast, none are more potentially damaging than the production, distribution, and consumption of counterfeit and falsified medicines.

According to the World Health Organisation (WHO), a significant fraction of the world’s drug supply is counterfeit and falsified. Estimates of counterfeit drugs range from 10 to 15 per cent for the world drug supply, to more than 25 per cent in developing countries (Gibson, 2004). The Philippines Department of Health has placed the amount of fake or counterfeit drugs in the country at around 10 per cent. In 2005, it was estimated by WHO and the Federal Drug Administration (FDA) that worldwide sales of counterfeit drugs represented between USD$32 billion and $35 billion annually; that is $88 to $96 million in sales each day (Cockburn, 2006). Recent trends suggest a massive increase in counterfeit or falsified drug sales to over $75 billion globally in 2010, an increase of more than 92 per cent from 2005. Asia remains the largest source economy. According to WHO statistics, as much as 35 per cent of the fake and substandard drugs in the world are produced by India and 20 per cent by China (Hajani, 1998).

The sometimes indifferent attitude towards counterfeiting by both Asian consumers and authorities has increased a low-risk, high-reward system for organized crime. Alarmingly, there has been an increase in the counterfeiting of “lifesaving” drugs meant to prevent or treat asthma, malaria, cancer, HIV/AIDS, tuberculosis, blood pressure and heart conditions, diabetes, and severe diarrhoea (Lyebecker, 2003). Despite the obvious risk that counterfeit medicine represents, little is known about its true prevalence, impact, existing intervention strategies and challenges, and other issues critical to developing evidence-based strategies to stem the flow. Counterfeit or falsified medicines have been found recently to be produced from large professional factories with the potential to produce thousands of pills per day.

Local drug manufacturers have been found to make legitimate products during the day and counterfeits by night (Saywell, 2002). This has led to counterfeit medicines being discovered in the legal supply chain, that is, through licensed wholesalers and parallel traders. Three out of four incidences of pharmaceutical crime involved developing countries either as source, transit or seizure point, or a country where illegal pharmaceuticals were discovered.

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