Americas Quarterly - Summer 2010

ished pharmaceutical goods are scattered across the globe, which makes fraudulent products harder to track. India and China, for example, are not only emerging as the leading exporters of medicinal products—but as the leading producers and distributors of counterfeit drugs.

Fake drugs are similar to fake money. Counterfeit currency is deliberately intended to fool people into thinking they are in possession of the real thing when in fact they are not. In the same way, drug counterfeiters try to match the brand-name product’s color, shape, size, weight, and even the tablet or capsule engraving. They also copy the packaging and labeling of the brand name so skillfully that it is very difficult to tell the difference bet ween the fake medication and the authentic product.

Would the measures countries now use to go after money forgers, including methods of marking bills to establish their authenticity and preventing forgery, work? The only real difference between a counterfeit $100 bill and fake medicine is that a bogus $100 bill never killed anyone.

Because of the sophisticated global network of various counterfeit operations, the only way to combat this crime is through international cooperation. In 2006, the WHO assembled an International Medical Products Anti-Counterfeiting Task Force (IMPACT). The task force develops coordinated efforts among countries to fight the manufacturing and distribution of fake drugs. IMPACT has acquired drug regulatory, enforcement, manufacturing, and distribution expertise along with assistance from experts from the private sector to develop plans and strategies to combat the problem.

But addressing the problem at the root requires better cooperation from national governments. The first step is agreeing on a clear definition that recognizes the health risk posed by counterfeit medicine. The second is a greater commitment to tracking the manufacture and sale of counterfeit medicine—including through the Internet—and enforcing laws against local producers. The manufacturing and distribution of counterfeit medicines to patients is a serious criminal offense. It is up to national governments to treat it as one.

Marv Shepherd is a professor at the College of Pharmacy, director of the Center for Pharmacoeconomic Studies, University of Texas and president of the Partnership for Safe Medicines, an industry-supported organization dedicated to fighting drug counterfeiting.

Pfizer Colombia

by Jason Alcorn

Cardiovascular disease
“is the most prevalent
and costly disease in
Colombia,” says Pau-
lina Ramírez, country
director of health pro-
grams for Pfizer. Ac-
cording to the World
Health Organization,
heart ailments in Co-
lombia account for 239
deaths per 100,000
people. Like infectious
diseases, cardiovas-
cular disease most af-
fects the poor; unlike
infectious dis-
eases, though,
there is no sim-
ple vaccine or
treatment.

To address the problem, Pfizer partnered with a pub-licly-funded health maintenance organization (HMO), Mutual Ser, and Universidad Nacional de Colombia in a program known as De Todo Corazón (With All Our Heart). The for-profit partnership reaches 30,000 patients in eight departments and 84 small towns along Colombia’s Atlantic Coast.

It began in 2004,
when Pfizer looked at
the health care market
in Colombia and iden-
tified two central chal-
lenges: the high overall
cost of health care and
the high incidence of
cardiovascular disease
among the very poor.
The company ap-
proached Mutual Ser,
which receives govern-
ment funds to serve
low-income patients,
with a plan for disease
management through

education campaigns, physical fitness and increased medical attention for high-risk groups.

Today, each participant in the De Todo Corazón program is enrolled in a personalized program to improve cardiac health. By providing preventative care, the program reduces costs for Mutual Ser.

But the health benefits for patients themselves are also significant, according to Ramírez. “They don’t just receive quality care from good doctors,” she says, “They also receive education about how to self-manage their disease and participate in exercise activities.” The teaching materials that go to patients are the product of another Pfizer partnership—this one with educators from the Universidad Nacional.

In 2009, a study conducted by Mutual Ser-Universidad Nacional-Pfizer discovered that enrollment in the program reduced blood pressure and cholesterol levels in low-, middle- and high-risk patients. The effect was also to reduce the number of high-risk patients by 9 percent over three years.