The global trade in fake medicines is vast and growing, according to a newly released report by IPN (Keeping it real: combating the spread of fake drugs in poor countries). The spread of fake medicines results in millions of people unwittingly consuming cement, talcum powder, sawdust, paint and an array of other toxic or inert substances. It thwarts efforts to cure disease and worsens illness.
While it is sometimes argued that “counterfeit” drugs and “substandard” drugs must not be spoken of together, in practice it can be extremely difficult to differentiate between the two as it is not always clear whether or not the actions leading to faulty drugs were made deliberately. Furthermore, the difference is of little concern to a patient harmed by bad medicine.
The main dangers to health posed by fake drugs are:
1. Failure to provide effective treatment
2. Drug resistance
3. Direct harm
IMANI (a non-profit, non-government organization based in Ghana) estimates that counterfeit drugs kill over 700,000 people every year.
Even near-perfect copies cause harm by competing with legitimate supplies of medicines. This can crowd out manufacturers of high quality generics as well as undermining incentives for future research and investment.
Fake medicines are most prevalent in poor countries and seem to be prevalent across all classes of drugs. Estimates suggest that counterfeits represent up to a third of medicines in some least developed countries (LDCs) – notably in Africa. With non-counterfeit substandard medicines also highly prevalent in poor countries, the picture is bleak.
The following studies reinforce this finding:
Sub Saharan Africa
- Senegal - of the 22 ampicillin drugs sampled, 21 were made of flour
- Angola, Burundi, and the Congo – 46 per cent of drugs are substandard
- Burkina Faso – 10.6 per cent of drugs procured from licensed sellers and 90 per cent purchased from unlicensed sellers were substandard
- Laos, Myanmar (Burma), Vietnam, Cambodia – 68 per cent of artesunate (anti-malaria) drugs did not contain the correct amount of active ingredient
- In some areas 30–50 per cent, or even more than 50 per cent, of drugs you buy randomly from pharmacies are actually fake (Report from Oxford University, Bangkok’s Mahidol University and the Wellcome Trust)
- Peru – according to the Association of Pharmaceutical Laboratories (ALAFARPE), the counterfeit medicines market in Peru is worth $66 million (up from $40 million in 2002)
- Dominican Repulblic – the Public Health Department reported that 10% of imported medicines were counterfeit
One set of figures from the European Commission showed 75 per cent of counterfeit drugs being imported from India. After India, China is the second largest source.