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The Dangers of Counterfeit Drugs - 2002-04-09

An editorial in the British Medical Journal warns that counterfeit drugs being sold in developing countries can not only cripple, but kill those who take them. The editorial describes the trade in fake drugs as “murderous.”

Examples of counterfeit drugs include meningitis vaccine made of tap water, anti-malaria drugs and snake anti-venom containing no active ingredients, and pain relievers made of industrial solvents.

The International Federation of Pharmaceutical Manufacturers also says the fake drugs are deadly. It says 25-hundred people died in Nigeria in 1995 after being given a phony meningitis vaccine. Hundreds of children died in Bangladesh and 89 people died in Haiti after taking cough syrup made with a toxic chemical used in anti-freeze.

Dr. Paul Newton, a clinical lecturer at Oxford University, is one of the authors of the British Medical Journal editorial. He says it’s difficult for the average person to tell whether a drug is fake. That’s because counterfeiters go to great lengths to try to duplicate the packaging of the authentic product.

He says, "Fakes are often unexpectedly cheap. So, one should always beware of a pharmaceutical product that is surprisingly cheap. Because That can’t really be."

The editorial says the counterfeit drug trade is “probably linked to organized crime, corruption, the narcotics trade and unregulated pharmaceutical companies.”

DR. Newton says, "We’ve been trying to encourage more investigation of how this happens. That’s really not clear. We fear that it’s related to the trade in narcotics and drugs like amphetamines in Southeast Asia, where there are factories illegally producing large quantities of drugs of misuse. And it would be virtually easy to adapt those to make fake drugs. But we don’t know that. That’s speculation."

Another co-author of the editorial is Michael Green, a chemist with the U-S Centers for Disease Control and Prevention, the CDC. He developed a quick, simple test to spot counterfeit anti-malarial drugs. It involves dissolving a small part of the tablet and mixing it with chemicals. The color of the resulting mixture reveals whether or not the drug is authentic. He says his colleague, Paul Newton, proved it’s an effective means of testing malaria medications.

"Actually, Paul used the test in identifying the fake malaria tablets in Southeast Asia," he says. "He was very instrumental in field testing this test just to make sure it actually worked out in the field where it’s designed to work."

Mr. Green says simple tests could have a great impact on the counterfeit drug trade. "It’s important because in developing countries they lack the resources to get the materials to do the more sophisticated tests. It would be nice to come up with these simple tests that you don’t need the sophisticated instrumentation or expensive chemicals to perform the test. And it can be easily transferred to people at the local level," he says.

The authors of the British Medical Journal editorial recommend that rich nations provide the resources that developing countries need to tackle the problem of fake drugs. This includes better policing of the drug markets, educating the public about how to recognize them, and lowering the price of genuine medications to make counterfeiting less profitable. (Signed)