TRADE in fake prescription medicines is a cruel and expanding racket. Globally, it now probably isn鈥檛 a lot less lucrative than dealing in hard drugs, yet it has received nothing like the attention. While in rich nations there has been a trend towards faking 鈥渓ifestyle drugs鈥� such as Viagra, in developing countries the counterfeits replace life-saving medicines, and are estimated to kill thousands every year.
Fake drugs kill either directly, because they contain toxic substances, or indirectly because the pills contain no effective ingredient and so fail to treat potentially fatal conditions such as malaria, tuberculosis and typhoid. People who watch others die this way will ultimately lose faith in the real medicines and miss out on their benefits. Worse, some fakes contain just a little active ingredient to fool inspectors, and these diluted concoctions encourage the emergence of resistance among both bacteria and parasites. This, in turn, undermines the effectiveness of the genuine drugs.
A lack of research makes it difficult to gauge the precise scale of the problem, but estimates suggest that in parts of south-east Asia as many as half the drugs on sale are forgeries. And the problem is growing fast. Recent targets include drugs based on artemisinin, which are opening a new front against malaria. In south-east Asia the incidence of fakes in sales of artesunate, a drug derived from artemisinin, increased from 38 to 53 per cent between 1999 and 2004. Fears are growing that the fakes will now follow the real drugs into the African market.
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The WHO is setting up a new agency, the International Medical Products Anti-Counterfeiting Taskforce (IMPACT), which will bring together all parties hoping to tackle the problem, from Interpol and drugs companies to regulatory agencies, customs authorities and charitable donors. There is a new recognition that progress cannot be made unless regulation, and most of all the agencies needed to enforce it, are strengthened everywhere. A third of countries have virtually no such enforcement, allowing criminals to infiltrate markets, bribe officials and move fakes across borders with impunity.
IMPACT deserves wholehearted support. Governments must wake up to the scale of the misery caused by counterfeiters. Ominously, evidence is emerging that these criminals have turned their attention to the anti-retroviral drugs vital for combating HIV and AIDS. With political will building in rich nations to supply genuine anti-retrovirals to those who need them in Africa, it would be a cruel blow if this move were undermined by a new generation of forgeries.
