Substandard and counterfeit drugs can negatively impact the pharmaceutical industry and patients. Here, we investigate counterfeits in south-east Asia and possible solutions.
Counterfeit and falsified drugs can have a serious impact upon human health. These drugs can also influence microbial resistance as well as have an effect on pharmaceutical companies’ profits and branding. Tackling counterfeit drugs is therefore an important issue which companies and governments alike are looking to combat.
Although there is no international consensus of what makes a drug counterfeit, the World Health Organization (WHO) defines them as "drugs that are deliberately and fraudulently mislabelled with respect to identity and/or source." They explain that counterfeits are a type of substandard drug, which are "genuine medicines which have not passed the standards and quality testing protocols set for them."
In 2017, WHO analysed drug samples and found that 10.5 percent of pharmaceutical drugs in low and middle-income countries are fake or substandard.1 Many south-east Asian countries like China and India are developing nations so may have counterfeit drugs at these levels.2
WHO reported that according to the Pharmaceutical Security Institute, Asia accounts for the largest share of counterfeit drugs in the world.3 China and India are two of the biggest drug manufacturers4 so counterfeit drugs could potentially cause problems for this populous region.
Extent of the problem
The extent of the falsified drug problem is not limited to south-east Asia but is global. However, within the region, they present a difficulty.
In 2009, 20 million pills, bottles and sachets of counterfeit and illegal pharmaceuticals were seized by the International Criminal Police Organisation throughout China and seven other south-east Asian countries. A total of 33 people were arrested and 100 retail outlets closed.3 The drugs obtained included antibiotics, birth-control medicines and antimalarials. Although a successful operation, the volume of drugs indicates how many counterfeits are available to patients in Asia.
pharmaceuticals on the market present opportunities for fakes
"If there is insufficient product on the market, within days, the vacuum is filled with falsified versions," says Michael Deats, an expert on medicine safety and vigilance with WHO.
Pharmaceuticals on the market present opportunities for fakes and the WHO suggests that the internet provides a key route for counterfeit drugs to appear on the market.5 The organisation also says a self-diagnosing culture has contributed to counterfeit prospects.
In 2016, the WHO issued a warning for south-east Asia, after two falsified hepatitis C pharmaceuticals and a falsified yellow fever vaccination were discovered.4 The alert indicates that the problem is widespread throughout Asia and requires many governments and groups to work together.
Myanmar, Vietnam and Thailand were included within this region, but are also purported to be a part of the problem, as major transit points. The World Customs Organization (WCO) reports that 50-60 percent of illicit traffic is shipped via sea4 so the positions of these three countries makes them ideal locations for the transport of counterfeit drugs throughout the region.
India and China are major players within the world of counterfeit drugs. The countries manufacture large proportions of the world’s medicine and the extent of their reach means that counterfeit drugs can have a worldwide consumer base. Half of the deaths from the current opioid crisis in the US were from the synthetic heroin fentanyl, manufactured in China.6 The fentanyl was reported to contain counterfeit medications, highlighting the global impact of substandard drugs.
The manufacturing of drugs in Asia leads to other populations around the world being affected, meaning there is a knock-on impact.
Impact of counterfeits
Counterfeit drugs not only reduce profits for pharmaceutical companies. Once taken by patients, falsified drugs can cause health problems and even be fatal.
In 2011, approximately 200 people died after taking contaminated heart medication in Pakistan.7 Then in 2012, 60 people died in the country after drinking cough syrup to get high.8 Tests of the medicine revea...
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