Black MEDICINE by Marv Shepherd
When you’re sick, taking the right medi- cine is almost as important as finding a good doctor. But what if the medicine is fake? A black market in counterfeit or low-quality drugs is fast becoming
the world’s newest health hazard.
Although the extent of drug counterfeiting is very
difficult to assess, in 2005 Peter Pitts of the Center for
Medicines in the Public Interest, a pharmacy industry-funded research organization, estimated that the size
of the global counterfeit drug trade will approach $75
billion this year, more than double what it was eight
years ago. An even more startling estimate by the World
Customs Organization claims the number of fake medications on the market soared by 600 percent between
2007 and 2008, and its trade is currently valued at $200
billion a year.
It’s no surprise that black market statistics are hard
to pin down. But there is little doubt about the global
reach of black market medicine. Last year, counterfeit
or fake drugs were found in over 100 different countries.
Latin America currently ranks second behind Asia
as having the highest number of counterfeit drug “
incidents,” report professional associations like the Pharmaceutical Security Institute (PSI), a nonprofit group
made up of the world’s leading pharmaceutical companies. Fake medications have been identified in Argentina, Mexico, Brazil, Panama, Peru, Ecuador, Bolivia,
Paraguay, Uruguay, Venezuela, Colombia, and Belize. In
Mexico alone, the fake drug market was estimated to
be $1.5 billion in 2008, or a disturbing 12 percent of the
Mexican prescription drug market .
Just as worrying, even developed nations have been
caught napping by the rise of black medicine. In Europe
alone, according to a 2010 Pfizer-funded study, the counterfeit drug trade is estimated to be $14.3 billion, from
Internet purchases. The U.S. Food and Drug Agency reported it was investigating 56 drug counterfeiting cases
illustration by shane harrison
in 2008, which may only be the tip of the iceberg. A key
problem is the lack of international coordination in identifying and going after counterfeit drug traffickers. The
problem has been complicated by disagreements over
whether the use of generic versions of drugs still under patent protection should be regarded as part of the
counterfeit industry. Addressing it demands both a serious commitment by national governments and multilateral cooperation.
Generic Does Not Equal Fraud
Few would disagree that the counterfeit trade has been driven by consumer demand for af- fordable medications. But this is a health is- sue that goes well beyond the patent debate and cost. Fake medications can cause death.
Although no worldwide estimates exist as to the extent
of the harm, there are plenty of cases to support the argument that fake drugs are often deadly.
In Haiti, Bangladesh, India, and Argentina, more than
500 patients, many of them children, died in 2007 from
medications that used the toxin diethylene glycol (
antifreeze) as a solvent for cough syrup. The World Health
Organization ( WHO) estimates that up to 20 percent of
the deaths due to malaria are the result of counterfeit
antimalaria drugs that lack the effective active ingredient. Deaths from counterfeit drugs in the last decade
have also been reported in the United States and Canada.
Even when they do not cause death, counterfeit medications represent a threat to the health of individual
patients and to the delivery of good health care. When
a patient’s condition deteriorates even though he or she
claims to be taking the prescribed medication, physicians are likely to misdiagnose the problem. With both
sides unaware that the cause is fake drugs, a doctor could
either increase the dose or switch to another form of
drug therapy that is unnecessary or more costly.
