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Internet laws are weak

Online pharmacies are now a norm. There are several online pharmacies that are legal, safe and protect your privacy, offering convenience and safeguards for purchasing medicines. However, there are several ‘rogue’ websites that offer to sell drugs that are potentially dangerous and have not been checked for safety or effectiveness. However professional they look, it could actually be an illegal operation. Such websites do well in developing countries due to the poor pre-existing legal drug trade avenues that are beset by problems such as corruption. This makes the desperate population easily exploitable and extremely vulnerable to the counterfeit drug trade. Steps must be taken to prevent people from ever needing to rely on such sites. However, attempting to assert control over internet based entities regardless of legality is an incredibly difficult and fruitless endeavor. Internet laws in general are extremely weak in most countries and this allows a massive network of illegal websites to thrive.Let’s take Silk Road for example. The pseudonymous founder had carried out active operation for a good two years before the FBI had a reason to arrest him and pull the website down. However, despite the arrest, a Silk Road 2.0 was started up by the administrators of the original Silk Road, and it was fully functional in no time, with no laws to govern them from doing so otherwise. Perhaps the crisis caused by the counterfeit drug trade can urge Governments to pass laws that more strictly govern illegal online activity, and make access to such websites restricted.

From Ms Simran Sampat

Medical student based in Hungary

Labels and packaging are imitated perfectly

The global counterfeit drug trade, a multibillion-dollar industry, is flourishing in Africa and other developing countries. The concern with counterfeit medicines is that their labels and packaging are often imitated to perfection. The markets are engulfed with fake and poor-quality drugs. If you pick the wrong box, it could be a health hazard, even fatal. According to the World Health Organisation (WHO), about 100,000 deaths a year in Africa are linked to the counterfeit drug trade. The organisation International Policy Network, reports that globally, 700,000 deaths a year are caused by fake malaria and tuberculosis drugs. The detection of counterfeit medicines has become extremely difficult over the years, because of technology has made it extremely easy to reproduce holograms using sophisticated printing techniques. Many counterfeiters add active ingredients that pass quality test controls but are not beneficial to the consumer. Regrettably, the penalties for selling and possessing fake drugs are not strong enough to deter criminals. Government agencies in charge of licensing and regulating drugs often lack of training and have insufficient manpower. In developing countries, corruption often plagues such regulatory bodies. The WHO is helping countries develop the expertise needed to regulate drugs. Regulatory bodies in every country need to ensure drug registration, or marketing authorization also known as product licensing. This procedure focuses on thorough evaluation to ensure a drug is safe for consumption. A major factor that contributes the thriving fake drug industry is the cost of medicines. This is a determining factor for consumers in developing and under-developed countries. Products sold in licensed pharmacies remain out of reach for a large part of the population in such countries. A joint study by the WHO and Health Action International found that “duties, taxes, mark-ups, distribution costs and dispensing fees are often high, regularly constituting between 30% to 40% of retail prices, but occasionally up to 80% or more of the total.” People will continue to patronize drug outlets like open drug markets for first-line treatments, because they’re cheaper.

From Mr Trevor David

Professor of Pharmacology based in Ukraine


International political resolution is required

The international nature of the fake-drug trade is what makes it such a difficult problem to manage. There needs to be a worldwide system that penalizes countries that don’t enforce medicinal quality controls. Much of the counterfeit drug trade is often linked to organised criminal gangs, corrupt regulatory authorities, the narcotics trade, unregulated pharmaceutical companies, and the business interests of unscrupulous politicians. To eliminate the problem an international political resolution is required. Information on fake drug identity and distribution needs to be shared nationally and internationally. Government drug regulatory authorities, customs officials and port authorities, pharmaceutical companies and consumers need to be aware of the seriousness of this issue. In many countries, the only check on the authenticity of the tablets will be by the patients buying the medicine, who don’t always have enough awareness of the difference between potentially beneficial from the fake lethal. With a more technologically advanced world, it is actually easier to conduct social media campaigns about pre-packaged drugs that can help consumers recognise the fakes. Cambodia used an effective strategy of improving the availability of quality assured drugs and public warnings describing fakes, a poster and radio education campaign has educated patients to distinguish fake tablets and has driven the sale of counterfeit anti-malarial further underground. Strict measures that reduce the profit margins for manufacturing fakes, such as reducing the price and increasing the availability of genuine, quality assured drugs, will make counterfeiting a less attractive criminal activity. Uncompromised international police action against the factories and distribution networks needs vigourous attention as does the hunt of narcotic peddling.

From Ms. Liza B.

Nurse based in Maldives

Counterfeit medicine and the war against it

The need for research and development in the field of medicine is growing as the world population rises and newer and tougher strains of bacteria evolve to counter our current forms of medicine. This ever-growing demand for medicine has also given rise to the counterfeit medicine industry. Counterfeit medicines have become a global crisis with regulatory authorities fighting battles in both the developing countries and the developed ones. Counterfeit medicine in simple words is fake medicine. It can contain the right active ingredient in the wrong dosage or the wrong active ingredient or in some cases no active ingredient at all. It can also sometimes contain hazardous, adulterated or substituted ingredients. With the sale of medications on the rise, the market is evolving almost every year with no medicinal quality controls. And among it, the sale of the counterfeit medicines is increasing to about 13 per cent annually, according to the Centre for Medicine in the Public Interest, a non-profit medical research group based in New York, US. In order to combat such a market, countries must strictly watch the global drug supply chain of under-regulated wholesalers and repackagers.According to the US department of Commerce, in 2004, US Customs seized over $138 million (Dh507.8 million) in counterfeit products. International pharmaceutical companies are thus being targeted and losing out on billions of dollars due to the counterfeit medication, which are hijacking the brands and in turn infringing the patent and trademark rights of legitimate pharmaceutical manufacturers. In order to fight back, pharmaceutical companies, consumers and global governments play a vital role and hence must not relax their regulations. In order to optimise their regulation standards, various channels of drug distributing, including the consumers, must be brought into awareness about the penalties for selling or buying counterfeit drugs.

From Ms Ayesha Khan

Pharmacist based in Sharjah

The industry is growing in scale and physical proximity

Illicit online pharmacies offer a gateway for criminals to sell counterfeit drugs under the pretext of legitimacy. 80% of purported online pharmacies still do not require a valid prescription for any medicine. According to the Pharmaceutical Security Institute, more than 2,000 incidents involving counterfeit drugs were reported worldwide by police and customs authorities in 2009 – up nine per cent in 2008 – but the true scale remains unknown since many cases go unreported. India and Brazil are big producers of generic medicines. Experts warn that the manufacture and sale of counterfeit medicines is growing in complexity, scale and geographic proximity, since many of them are being bought over the internet. Counterfeit medicines are often stashed in cargos that go out of their way to disguise their country of origin. Pharmaceutical companies and governments are reluctant to publicize the problem to medical and health staff and the consumers. They may be demotivated to do so due to possibility that this will create negative publicity and will harm the sales of their brand-name and products in an industry that is largely competitive. The Food and Drug Administration (FDA) estimates that up to 15% of all sold drugs are counterfeit, and in parts of Africa and Asia this figure exceeds 50%. A new study conducted by the National Association of Boards of Pharmacies (NABP) has found that nearly 80% of claimed online pharmacies still do not require a valid prescription for any medicine. The report also finds that 96% don’t meet the necessary certification established by the Verified Internet Pharmacy Practice Sites. These illegal online drug sellers have infiltrated the social media space. They use any and every opportunity to make illicit sales, and there is little if any regulatory means to address related safety and health risks.

From Rohit Awasthi

Operations executive in an online store based in Delhi, India