Drug giants accused of ignoring fake medicines that kill
By Saeed Shah
Published: 13 April 2007
The world's major drug companies have been accused of turning a blind
eye to the multibillion-dollar trade in fake medicine that has
resulted in an explosion of child malaria deaths in developing
Governments have not tackled the problem and pharmaceutical companies
are burying the issue, afraid that any publicity given to their
medicines being faked will lead to a fall in the sale of the genuine
product, according to a documentary.
The problem has been particularly acute with the treatment of malaria
in Africa, with anti-malaria drugs faked on an industrial scale.
Professor Nick White, of Oxford University, one of the world's leading
experts on malaria, said: "We estimate that there are more than
one million deaths each year - which is the equivalent of seven jumbo
jets going down every day. And 90 per cent of those deaths are in
Professor White said that counterfeit medicine was a major reason why
malaria had become, over the past 30 years, Africa's biggest child
killer, from an illness that used to be easily treated with
Some of the fake drugs contain no medicine at all, but others have
tiny traces of the real ingredients - which leads to another,
potentially bigger problem: it allows the malaria parasite to build up
resistance to the drug.
Nigeria's campaigning drugs regulator, Dora Akunyili, described
counterfeiting as "mass murder". She told the documentary,
which will be aired today on The Business Channel, a satellite
station: "The fake drug racket and the silence associated with it
have led to the resurgence of malaria... The companies kept quiet. The
regulators were paid off and everybody was helpless. Drug
counterfeiters operated in this country and in most developing
countries for almost three decades, unchallenged."
There is now just one family of drugs left that malaria has not built
up resistance to, Artemisinins - which are also being faked. Professor
White said: "Resistance to the Artemisinins would be an absolute
catastrophe for our current attempts to try to control
It is estimated that the global fake drug racket is worth $40bn
(£20bn) a year, and between 50 and 90 per cent of medicine in some
African and Asian countries is counterfeit. Graham Satchwell, the
former head of security at GlaxoSmithKline, the British-based global
pharmaceutical giant, told The Independent: "Each therapy area is
highly competitive, so if one person's drug is undermined, their
market share will suffer. It takes a brave company to say they have a
Mr Satchwell said that the "majority of the industry are sitting
on their hands", rather than tackling the problem - for instance
through radio tracking of their products. He also pointed out that the
figures from the industry's own organisation, the Pharmaceutical
Security Institute, showed many cases of counterfeiting in the US, but
hardly any in China or Africa - despite firm evidence from other
sources that tens of thousands die each year in China and Africa as a
result of fake medicines each year.
Dr Akunyili said: "If the companies had risen up to their
responsibilities early enough, the issue of the preponderance of fake
drugs would not have gotten to the level it got in Nigeria. It is this
silence that is actually largely encouraging drug
Dr Martin Meremikwu, of Calabar University Hospital, in southern
Nigeria, said that he had seen child malaria deaths soar. He said
that, by the time children who had been treated with fake drugs got to
the hospitals, it was often too late to save them.
"Malaria should not kill people. It's a curable disease. But if
the patient uses the wrong drug - either because they are fake or they
are ineffective because of higher resistance - then they are lying
here with complications.
"And in children, young children, the time between a mild disease
and a severe disease can be as little as eight hours, or 24 hours or
12 hours. So time is of the huge essence here. You really cannot
afford to try some other drug before trying a good one. You can't.
Because you don't have that time."
The drugs don't work
* Counterfeit medicines are swamping unregulated markets in developing
nations with unknown and sometimes fatal results. Not only are
thousands dying needlessly, but patients are also becoming immune to
the effects of the real thing. Counterfeit drugs occasionally contain
small doses of the active ingredient - enough to induce resistance
* The UN World Health Organisation estimates the incidence of
counterfeit medicines is about 10 per cent in developing countries,
with prevalence higher where regulatory control is weakest. But in
many parts of Africa, according to the WHO, as well as in some
countries in Latin America and South Asia, prevalence sits at around
30 per cent. The patients hit are the sickest and the poorest.
* WHO estimates that 200,000 of the one million malaria deaths every
year would be prevented if all the drugs taken were genuine. The
popularity of combination malaria drugs - which are more expensive
than other treatments - has seen counterfeit peddlers cash in on the
opportunity to boost sales. In Cambodia, Tanzania and Cameroon, up to
90 per cent of such drugs on sale in local markets are believed to
contain nothing but chalk or maize flour.
* As recently as 2001, about 68 per cent of medicines in circulation
in Nigeria were unregistered, and as much as 41 per cent were believed
to be fake.