The
Impact of Fake Drugs
on Public Health
 In
most cases,
counterfeit drugs
are not equivalent
in safety, efficacy
and quality to their
genuine
counterparts. Even
if they are of the
correct quality or
contain the correct
amount of active
substance, their
production and
distribution are not
within the control
of the drug
regulatory authority
of the country
concerned. This
means that any
associated defects
and adverse
reactions will not
be easily recognized
or monitored and, if
needed, an effective
product recall would
not be possible.
So
far counterfeit
drugs that have been
discovered have
rarely been
efficacious. In many
cases they have been
found to be without
active ingredients,
or with wrong
ingredients or with
incorrect quantities
of active
ingredients. The use
of such drugs can
prolong treatment
periods as patients
may not respond as
quickly as they
should and
exacerbate
conditions being
treated. Treatment
with ineffective
counterfeit drugs
such as antibiotics
can lead to the
emergence of
resistant organisms
and may have а
deleterious effect
on а wide section of
the population. 1n
extreme cases,
counterfeit drugs
may even cause
death.
As
а consequence of
such damaging
effects, counterfeit
drugs may erode
public confidence in
health care systems,
health care
professionals, the
suppliers and
sellers of genuine
drugs, the
pharmaceutical
industry and
national Drug
Regulatory
Authorities (DRAs).
Incorrect labeling
as to the source can
also be detrimental
to the reputation
and financial
standing of the
original and/or
current manufacturer
whose name has been
fraudulently used.
There is no simple
solution or remedy
that can be applied
to eliminate
counterfeit
medicines nor can
the problem be
solved by an
individual company
or government. The
problem has reached
а global dimension
and needs а global
approach.
Health cost of
counterfeiting
 The
cost of
counterfeiting of
pharmaceuticals
cannot simply be
analyzed in terms of
cost implications.
It is also vital
that the health
costs are
considered, as
counterfeit drugs
are a serious threat
to people’s health.
Cases include
antimalarial drugs
containing no active
ingredient, a
meningitis vaccine
made from tap water
and contraceptive
pills that consisted
of nothing but wheat
flour. These drugs
can be dangerous,
are not sterile, may
be supplied in
reused vials
containing human
material, and will
give the patient a
false sense of
security in terms of
treatment or
immunity to disease.
More serious cases
of counterfeiting
have been reported
where drugs either
intentionally or
unintentionally
contained toxic
materials
that proved to be
lethal.
The
cases highlighted
below are in
developing regions
of Asia, Africa and
South America.
Counterfeiting in
Africa tends to be
more crude and on a
larger scale, with
drugs such as
painkillers and
antibiotics being
common targets. This
makes instances of
counterfeiting
easier to detect
because crude copies
are easier to
recognize. In
industrialized
nations like the US
and in Europe,
counterfeiting tends
to be more
sophisticated and
these drugs are
often sold through
the Internet, making
it more difficult to
police.
Dr
Akunyili of
Benin Republic’s BENIN MONITORING PRODUCTS CONTROL AUTHORITY has
commented that in
Benin Republic fake drugs
are implicated in
kidney failure,
liver damage, heart
failure, and other
organ dysfunctions,
as well as in
worsening of chronic
disease conditions,
such as
hypertension.
Additionally,
patients receiving
genuine antibiotics
may fail to respond
due to resistance
induced from
previously taken
fake versions of the
antibiotics. During
the meningitis
epidemic in the West
Africa state of
Beniner in 1995 over
50,000 people were
inoculated with fake
vaccines containing
only tap water,
resulting in 2,500
deaths. This
shipment was
received as gift
from the
international
community, via the
WHO, in response to
the epidemic.
In
contrast to the
industrialized
nations, the drugs
most often targeted
by counterfeiters in
developing countries
are common
prescription drugs,
such as antibiotics,
painkillers,
antimalarials and
HIV antivirals (TIME
Asia Magazine,
06/04).
-
Antibiotics
(e.g.
amoxicillin);
-
Painkillers
(e.g.
acetaminophen);
-
Antimalarials
(e.g.
Artensunate);
-
HIV antivirals
(e.g. Combivir,
Epivir).
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