[Ip-health] Roger Bate in WSJ: India's Fake Drugs Are a Real Problem

Thiru Balasubramaniam thiru at keionline.org
Wed May 19 12:34:00 PDT 2010

The timing of Roger Bate's op-ed in the Wall Street Journal on  
'India's Fake Drugs' is more than just mere coincidence.  Today, The  
the World Health Assembly witnessed contentious discussions on WHO's  
work on counterfeit medical products. In particular, WHO's Project  
IMPACT took a beating as many member states called for the divorce of  

KEI has profiled Roger Bate (http://keionline.org/node/672) as a  
corporate shill for work on tobacco, climate change skeptics and the  
ivory trade.



India's Fake Drugs Are a Real Problem

Global trade in counterfeits is huge and penalties are minimal.
    * MAY 19, 2010


The Food and Drug Administration of the Indian State of Uttar Pradesh
recently conducted a series of raids throughout its region to uncover
counterfeit drugs. The raids yielded large quantities of substandard
medicines and resulted in several arrests.

This evidence of India's fake drug trade jibes with what I've found in
several surveys. In 2009, I looked at five important medicines being
sold at 52 different pharmacies in Delhi and Chennai, using covert
shoppers. In Dehli, 12% of the pills were substandard, as were 5% in
Chennai. About 2% of the pills contained no active ingredient. The
others did but it had degraded, probably because the pills had expired
and been repackaged with new labels; some may have degraded through poor

According to an investigation I just conducted with the Legatum
Institute and the International Policy Network, the situation is as bad
with at least some of Delhi's wholesalers. We found that 7% of all
tested samples were substandard and 3.6% were likely counterfeit. It's
probable that the drug supply in poorer areas is even more contaminated.

A strong majority of Indian pharmacists interviewed in our investigation
admit that fellow pharmacists knowingly profit from the sale of
counterfeit drugs. Nearly all of the pharmacists interviewed claimed to
have been propositioned by counterfeiters at one time or another. Last
year alone, counterfeit drugs were seized by authorities in Bangalore,
Mumbai, Delhi, Jaipur and many other Indian cities. In 2008, about half
of the medical products that were confiscated by European Union customs
officials originated in India.
[BATE] Zuma Press

Bad medicines don't just threaten lives, they undermine the entire
medical system.

Since drugs made in India are sold around the world, the country's
substandard drug trade represents a grave public health threat that
extends far beyond the subcontinent. Unless serious steps are taken to
improve the quality of the Indian drug supply, the global spread of
unsafe pharmaceuticals will persist.

It's no wonder the counterfeit drug trade thrives in India. The profits
are enormous. The global trade runs into the tens of billions of
dollars. Meanwhile, the penalties for making and selling knock-off
medicines are minimal. Those fake drug offenses that are prosecuted
spend years winding their way through the Indian legal system. According
to the Confederation of Indian Industry, "counterfeiting rarely produces
dire consequences in terms of incarceration or redress."

By way of comparison, the penalties for selling narcotics such as
cocaine and opium are incredibly steep. India has a separate law
enforcement agency—the Narcotics Control Bureau—for crimes of this sort.

The public-health consequences of the counterfeit drug trade are
serious. These products, often adulterated with road paint and chalk,
look identical to the antibiotics they pretend to be. Thousands of
people probably die every year either because they're poisoned by bad
ingredients in counterfeits or because the counterfeit doesn't treat the
victim's malady. Estimates of substandard drugs reach as high as 30% of
all medicines sold in parts of Africa, Asia and Latin America. But the
truth is we don't really how bad the problem has become.

These bad drugs don't just threaten lives. They undermine the legitimacy
of the entire Indian medical system, discourage patients from using
life-saving pharmaceuticals, and threaten the economic livelihood of
legitimate pharmacists and drug makers.

To counteract the spread of counterfeit drugs around the globe, several
steps must be taken. First, Indian officials need to be more honest
about the extent to which bad medicines have contaminated their drug
supply. In a 2003 report, India's Ministry of Health and Family Welfare
stated that between 8% and 10% of India's pharmaceuticals are
"substandard." Yet recent media reports quote unpublished government
studies claiming the rate is far below 1%. No one I've spoken with
believes these figures.

India's leaders must also do more to enforce the anticounterfeit laws
already on the books. The penalties for making and distributing bad
drugs should be serious and perpetrators should be brought to justice

New technologies also have a role to play in ensuring the safety of
India's pharmaceuticals. Some drug companies have begun assigning
packages—and even individual pills—unique serial numbers. Consumers can
check the legitimacy of their medicine by text messaging these serial
numbers to a central database and getting a quick and accurate answer.

Other quality control solutions involving bar codes also show promise.
But any technology will prove effective only if part of a broader
political effort to rid India of substandard medicines. Action is
urgently required or thousands of annual avoidable deaths around the
globe will continue.

Mr. Bate is a fellow at the American Enterprise Institute.


Thiru Balasubramaniam
Geneva Representative
Knowledge Ecology International (KEI)
thiru at keionline.org

Tel: +41 22 791 6727
Mobile: +41 76 508 0997

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