If there is one crime condemned worldwide it is the sale and smuggling of counterfeit medicines. Sometimes close copies and sometimes dangerous substances, this crime kills on a grand scale.
Counting the number of its victims accurately is difficult because of the subversive nature of the trade, but some think-tanks have tried. The US-based International Policy Network has claimed fake tuberculosis (TB) and malaria drugs alone kill 700,000 people annually worldwide. This was based on World Health Organisation (WHO) analysis claiming that at least 200,000 malaria deaths per year would be prevented if patients were not using counterfeit medicines. It added this to peer-reviewed academic studies suggesting 10% of TB medicine is fake – and with 9 million TB victims worldwide and a 50% chance of death if the disease is not treated properly, counterfeit TB meds kill another 450,000 people anually.
The manufacture and trade in fake pharmaceuticals is almost impossible to measure precisely. In future, the extent of the problem may become clearer through a new WHO initiative. At a meeting in November 2012, 200 member states agreed to develop data collecting systems on substandard and falsified medicines. A WHO capacity-building project is also testing and developing surveillance tools for low- and middle-income countries.
The goal of having clear data adhering to common collection standards is to help orientate drug quality programmes. The IoM report noted: ‘If the data indicate that substandard medicines are the main problem in one part of the world, then better regulation of manufacturers can do much to improve the problem.
‘Similarly, if it becomes clear that a country has a problem with diverted medicines in commerce, then distribution chain improvements would enhance the national drug safety programme.’
The Pharmaceutical Security Institute (PSI) conducted an open source review of fake medicine seizures in 2011. In India, it highlighted the seizure of 250,000 counterfeit dosage units of Coscold cough tablets; and 388,000 ‘spurious’ antibiotics. While the Indian government and pharma companies are battling the menace of fake drugs, the country’s vast population and a deeply ingrained disregard within the public and private sector to respect legally mandated procedures pose serious challenges.
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