Counterfeit drugs have ballooned into a $431 billion market since 2000, affecting nearly two billion people worldwide, but governments have underestimated the dangers they pose to unwitting patients, according to a report in the Review of Business & Finance Studies.
Often hard even for licensed distributors to detect, fake medications have flooded markets of both developed and underdeveloped countries as a consequence of high medical costs, corruption, and weak or nonexistent legislative measures to contain them—and the threat is likely to get worse unless authorities develop “harsher sanctions,” said the report, published online this month.
“Each year, about 100,000 million people worldwide may succumb to these fraudulent medicines,” the report said. “Counterfeit pharmaceuticals sometimes contain chalk, brick dust, paint, and even pesticides. Some of them even contain the remains of human fetuses. Others contain no active ingredients at all.”
However, authorities around the world have done little to curb the trade, charge the authors of the study, Brian Gurney, Gary Amundson and Salem L. Boumediene, all of Montana State University Billings.
“Governments seem to underestimate the importance of the issue,” the study said.
The authors cite figures from the World Health Organization (WHO), showing an estimated 100,000 deaths per year in Africa linked to counterfeit drugs; and from the London-based International Policy Network (IPN), attributing 700,000 fatalities annually to fake malaria and tuberculosis medicines.
The underground pharma market is a lucrative business for a range of international crime groups, including post-Soviet mafia, Colombian drug cartels, Chinese triads, and Mexican drug gangs, Hezbollah and Al-Qaida are also believed to be involved.
However, the authors note, licensed pharmacists, private entrepreneurs and state officials throughout the world have been identified as “facilitators” of the trade.
According to the study, counterfeit drugs currently account for approximately 30 percent of the medicines distributed in developing African nations. During a nine-month period in 2012, China exported $1.5 billion worth of medical products to Africa which in some cases had few or no active ingredients at all.
Control of the trade is complicated by the fact that an increasing number of fake pharma products are marketed online, said the authors.
Online outlets called “rogue pharmacies”—most of them located outside the U.S.—distribute drugs to consumers without a prescription, and “are harder to track by regulatory bodies because they are not registered anywhere,” said the study.
“Given the light penalties and the time lag for regulators or law enforcement to shut down these Internet websites, operators simply take down the website and relocate to another region of the country or perhaps to another country,” the study said.
“From a business perspective, this is merely a relocation of a distribution center. “
A recent study, cited by the authors, found nearly 10,000 websites out of compliance with U.S. federal and state regulations, of which 2,274 have physical addresses located outside the U.S. and 3,708 maintain servers in foreign countries.
Moreover, criminal organizations have discovered that there is less risk and penalties associated with counterfeit pharmaceuticals than with human trafficking and illegal drugs. Just 1,300 people worldwide were arrested over the past five years.
Combating the trade will require both the use of more sophisticated technology to detect counterfeit drugs in shipments and stronger enforcement of laws already on the books, wrote the authors.
“Illegal drug dealers face a harsher sentence compared to medicine counterfeiters,” the study said. “The government has to make it clear that they are not facing a few months of incarceration but more like a couple of years.”
But equally important is to address the root causes of why people turn to fake pharmaceuticals, the authors said.
“One of the major reasons is poverty,” said the study. “People hold on to the tiniest bit of hope, which, in this case is what usually hurts them more.
“But (fake medication) is the only alternative they can afford, without having a prescription. If medical care (were) cheaper, no one would look into buying a medicine that can possible hurt them in any way, and usually hurts them more.”
The full report can be downloaded here.
This summary was produced by Brian Edsall, a news intern with TCR. Readers’ comments are welcome.