The Counterfeit Medicine Problem in Developing Countries
The prevalence of counterfeit medicine in developing countries is causing a widespread health concern in low-income communities. Data from a November 2017 World Health Organization (WHO) study, obtained from analysing 100 studies over a nine-year period from 2007 to 2016, suggest that approximately 10.5% of drugs distributed in low- and middle-income countries are fake or substandard.
Threats from Fake Medicine
Falsified and substandard drugs are produced without sufficient oversight, and as such, they may contain the incorrect or wrong amount of ingredients. In some instances, these drugs may not even contain any active ingredients.
Aside from that, manufacturers of fake medicines, vaccines and antibiotics may also struggle to achieve quality standards. On the distribution front, issues such as improper storage could impact the efficacy of the drugs.
These factors could harm patients and cause additional economic demands on segments of the population that are already struggling to meet the cost of medicine. Beyond that, the widespread use of fake antibiotics could trigger microbial resistance across whole communities. One study by the University of Edinburgh estimated that the use of antibiotics with reduced to no activity may have caused between 72,000 and 169,000 deaths from childhood pneumonia.
Reasons Behind the Spread of Falsified Drugs
The chief factor believed to be behind the spread of substandard and falsified medical products in developing countries is the lack of governance. While developed regions can rely on bodies like the Food and Drug Administration (FDA), European Medicines Agency (EMA), or Canadian Food Inspection Agency (CFIA) to conduct stringent quality control across the entire manufacturing process of pharmaceuticals, some developing nations do not have specialist regulatory bodies, equipment and manpower capable of performing a similar task.
In addition, developing countries frequently lack comprehensive legislation and judicial resources to regulate the pharmaceutical trade effectively. WHO noted that many developing countries are not even able to perform basic due diligence, such as verifying the details of manufacturers and wholesalers of imported drugs, owing to the absence of itemized registers.
Trafficking of Falsified Drugs in South East Asia
The prevalence of substandard and falsified medical products is particularly alarming in South East Asia. Between 2013 and 2017, WHO received over 1,500 reports of compromised drugs from around the world, with the majority of reports coming from sub-Saharan Africa (42%), Europe (21%) and the Americas (21%). However, reports originating from South East Asia only accounted for 2% of the total, strongly suggesting that most of the falsified products distributed in the region remain undetected.
Free trade agreements and lax import controls between South East Asian nations are seen as what is possibly facilitating the flow of illicit drugs in the region. Thailand, Myanmar and Vietnam are identified as major transit points – particularly in the wake of massive police crackdowns in China and India in 2012.
Reports indicate that the issue remains largely unaddressed, however, owing to limited judicial follow-ups on suspected criminals. Enforcements are also constrained owing to limited testing capabilities, as well as inaccuracies and delays. To tackle the issue effectively, assistance must be provided to governments in the region to help strengthen criminal legislation and create their own accredited testing facilities.