The illicit trade in counterfeit goods is a multi-billion-dollar global industry in which counterfeit medicines play a hefty role. The World Health Organization (WHO) has reported that counterfeit medicines potentially make up more than 50% of the global drugs market, with a significant proportion of these fake products being encountered in developing countries.
WHO defines “Substandard/Spurious/Falsely-labelled/Falsified/Counterfeit medical products” as medicines that are outside of specifications, which includes intentional, reckless or negligent errors, false packaging, and those intended to deliberately deceive and imitate a genuine product.
Asia is no stranger to counterfeiting and is a well-known hub, taking advantage of the region’s infrastructure of seaports and free trade zones. India and China are reportedly the major sources of the world’s counterfeit drugs. In 2016, counterfeit medicines worth US$ 7 million were seized by the International Criminal Police Organisation (INTERPOL) across Asia. Medication including antibiotics, anti-hypertension pills and rabies vaccines were confiscated from hundreds of pharmacies and markets.
A Cure Bringing more Harm than Good
According to a 2019 report by the United Nations Office on Drugs and Crime (UNODC), the amount spent by consumers in Southeast Asia for counterfeit medicines is estimated to range between US$ 520 million and US$ 2.6 billion per year.
Moreover, of the reported 460 incidents in the illegal distribution of counterfeit pharmaceutical products from 2013 to 2017, 193 occurred in the Philippines, 110 in Thailand, 93 in Indonesia, and 49 in Vietnam.
The transnational crime of fake medicines appears most rampant in the Philippines where counterfeit over-the-counter drugs like paracetamol, as well as anti-tuberculosis medicines and anti-rabies vaccines are a growing threat. In 2018, fake medicines worth almost US$ 58, 960 were seized during a raid in the capital, Manila. In Thailand, the sale of unlicensed medicine is punishable by a fine and/or maximum imprisonment of three years. But this doesn’t stop counterfeiters from doing what they do best – just this year, a total of 2 million pills worth US$ 165,535 were confiscated in Prawet district of Bangkok. In Indonesia, major pharmaceutical counterfeiting gangs coordinate much of the manufacture and traffic in illicit medicines in the country, with a large share of the trade conducted via the internet. But such a crime isn’t limited to counterfeiters alone; the former general director of Vietnamese pharmaceutical firm VN Pharma was sentenced to 17 years in prison for importing and distributing counterfeit cancer medicines.
A WHO study on the public health and socioeconomic impact of substandard and falsified medical products shows how counterfeit medicines not only reduce profits and affect the reputation of pharmaceutical companies, but also pose risks for the whole of society:
- Adverse effects (for example toxicity or lack of efficacy) from incorrect active ingredients
- Failure to cure or prevent future disease, increasing mortality, morbidity and the prevalence of disease
- Progression of antimicrobial resistance and drug-resistant infections
- Increased out-of-pocket and health system spending on health care
- Economic loss for patients, their families, health systems and manufacturers (and other actors in the supply chain) of quality medical products
- Waste of human effort and financial outlay across the health system, further straining resources, staff and infrastructure
- Increased burden for health care professionals, national medicine regulatory authorities, law enforcement and criminal justice systems
- Lost income due to prolonged illness or death
- Lost productivity costs to patients and households when seeking additional medical care, the effects of which are felt by businesses and the wider economy
- Lack of social mobility and increased poverty
Prevention is Key
Counterfeit medicines may contain unsafe levels of dangerous substances or low-quality ingredients of unknown origin that are difficult for consumers to verify or authenticate. And while the challenge of counterfeit medicines is more rampant in developing countries, it is an uphill battle for pharmaceutical companies and consumers worldwide. To fight back, major companies such as Merck, Novartis, Roche and Johnson & Johnson have implemented anti-counterfeiting programmes to reduce the risks of counterfeit drugs entering the supply chain and to keep the legitimate drug system safe and secure.