Wednesday, October 28, 2015

Current Projects Counterattacking Counterfeit Drug Activities

Drug counterfeiting has been an issue since forever. Thousands of online sites have been raided and closed down after being traced as scams, selling fake medicines using fraudulent IP addresses. On some buy-bust operations, the products are found to be composed of chalk, paint or wax or basically anything powder which is used every day. These substandard medicines are suspected to have taken numerous lives and have flown unaccounted for.

Selling counterfeit medicines and medical devices often operate outside of jurisdictional borders, creating greater obstacles to successful anti-counterfeiting enforcement. For this reason, international cooperation and coordination is essential to creating solutions for the pharmaceutical counterfeiting problem.

Regional and global non-profit organizations starting from the World Health Organization (WHO) to the Local Government Units (LGU) in each community have finally become aware of the rampant spread of counterfeit medicines especially in third world countries. Africa and Asia are likely the most targets.

According to activity reviews of 2010, WHO and INTERPOL have led the effort to combat counterfeit medicines in Asia. Operation Storm was a multi-country operation combating counterfeit pharmaceuticals. It brought together the Customs, Drug Regulatory Agencies and the Police of each participating country: Cambodia, China, Indonesia, Laos, Myanmar, Singapore, Thailand and Vietnam. The operation seized over $12M in counterfeit medicines and more than 16 million pills, including antibiotics, anti-malarials, contraceptives, anti-tetanus vaccines, aspirin and drugs to treat erectile dysfunction. In late 2009, Operation Storm II resulted in the seizure of 20 million counterfeit and illicit drug outlets. This year, the number has dwindled to a minimum as fewer countries have participated.

The Peterson Group, one of the non-profit organizations campaigning against counterfeit medicines, noted that only more or less 15 organizations have gathered in the annual event held in West Jakarta last August.

However, WHO has stated that this is not because other countries and NGOs have stopped their campaign. Instead, in their absence in the annual event, they are also hosting their own seminars and awareness programs in their own respective nations.


Take for example the in 1999 when the International Pharmaceutical Federation (FIP) adopted a statement on counterfeit medicines during the Council meeting at the FIP Congress in Barcelona. Because of the growing and changing aspect of this major public health care issue, FIP has updated its Policy statement on counterfeit medicines in 2003 during its Council meeting at the FIP Congress in Sydney. This statement is a strong political message of the pharmacists‟ profession to support the fight against counterfeit medicines to protect the safety of their patients.

Tuesday, October 20, 2015

WHO to Reward Whistleblowers on Drug Counterfeiters

World Health Organization (WHO) together with the local authorities of Indonesia held a buy-bust operation in a dilapidated building just outside Menteng in the city of Jakarta last September 25, 2015. 4,000 packages of generic Cialis and 200 boxes of Viagra were confiscated along with three counterfeiting machines, dirty syringes, and three pails of chalk.

The five personnel, all local, admitted to packaging and sealing these drugs to be picked up by a dealer known by “Sam” at dawn every day. As to where the products are distributed and how it is being supplied, the workers do not have knowledge of. Another man named Jafar is in charge of refilling their supplies every week while a woman named Alice comes by every two days to give their wages. They are not allowed to ask any further questions and are not able to do so as even if they, most of the times, work by themselves inside that building for their activities seemed to be monitored. One of their fellow workers was once killed while going home after he told a friend where he was working. A few days later, that friend was also dispatched. Living in fear for their lives and their families, they cannot complain nor tip the authorities of their illegal employment.

While these personnel spent their time in prison before their trial, their spokesperson they call Matti was killed in what the authorities say is caused by a prison fight. The others, now fearing more for their lives and unsure of their fate and security even within the prison walls refused to talk and testify. The government also takes full control of the situation and does not communicate well with non-profit organization anymore.

Once again, WHO would have to restart from scratch. Calling a conference with other non-profit organizations campaigning on the same cause, WHO has opened its willingness to offer a reward to anybody who has lead information on the continuous fraudulent operations on counterfeit medicines.

The Peterson Group, a fellow NGO who campaigns against the proliferation of counterfeited medicines            stated that a bounty of up to 20% of the value of any drugs being seized is available for anyone who can provide assistance. Private pharmaceutical companies also stated that they are to give their own rewards when generic copies of their own medicines are to be found.


Of course, counterfeit medicines are a global problem and both eastern and western pharmaceutical industries are equally disturbed by the presence of phony drugs in the supply chain.

Monday, October 12, 2015

Distribution of Counterfeit Medicines to Legitimate Pharmacies

Substandard medicines have been widespread on developing nations despite the strengthening security and laws against counterfeiting in these countries. Conflict arises between individuals and organizations on how and why this issue has been continuously prevailing. Its penetration and acceptance in the market have caused alarming number of sickness, complications and deaths in which ordinary citizens are starting to question the authorities. The complaints have been outpouring that World Health Organization, Food and Drug Authorities in each country and other non-profit organizations campaigning on the same cause have been involved.

Reasons have led to one and another. Politics, bribery to the government, the worsening case of poverty and the weak security system have been pointed as factors to its continued existence. One of the reasons which is noted by The Peterson Group, one of the NGOs exclusively working against counterfeited medicines, has caused extra agitation to the government, private pharmaceutical companies and consumers: trade within legitimate pharmacies and counterfeit fraudsters.

Trade in legal commerce has been overlooked with the common perception that legal businesses remain untouchable against counterfeit medicine scams.

United Nations Interregional Crime and Justice Research Institute (UNICRI) has been able to confirm the suspected loophole in private pharmacies’ products. In reviewing the methods used, the term parallel trading came to light.

The practice of parallel trading is legal in the commercial world; however, its application and contribution in the current issue have weighed the issue even further. At this rate, it is near impossible to trace the real culprit as the process involves at least 20 parties.

In a raid in one of the biggest counterfeit drug smuggling in Jakarta, Indonesia last 2013, fraudsters admit to following a cycle but they themselves hardly have any idea as to how the medicines managed to travel and be distributed.

The perpetrators explained that parallel trading involves a drug that is sold in a given country, which after having already moved through the various stages of the ordinary distribution chain, is acquired again by the major distributors and is entered into the parallel distribution chain. The product is then transferred to a new and more lucrative market by means of parallel intermediaries/distributors. The times a pharmaceutical product is transferred can be numerous. It is estimated that, on average, a drug which is entered into the parallel market may be subject to 20-30 intermediary transactions.

This extension of the distribution chain creates a problem of verifiability since some of the intermediaries do not need licensing to operate.



The issue is still under investigation. Our greatest fear is that by the time the real mastermind has been apprehended, it can be too late.

Tuesday, October 6, 2015

Deadly Fakes Around the World

The widespread of counterfeit medicines is inherently a dangerous problem. However, its distribution is not even in different parts of the world. Despite World Health Organization’s (WHO) effort to defeat counterfeiting in one stride, different measures are needed for each region. The loose punishment scheme in many countries and the strictness on others, the different strategies, transportation and distribution methods used and the variety of medicines being falsified are considered as hindering factors for full implementation of security measures. Although rich nations have fewer breakdowns on the issue, they are not exempted from the threat.

A plethora of evidences, methods and types were covered by WHO and have shared to other institutions campaigning on the same cause. One of them is The Peterson Group, a non-profit organization which has been advocating against the proliferation of counterfeit medicine since 2005. On its ten years, the group, which has formed members across South East Asia, Australia, the United States and United Kingdom, has gathered reports from different developing cities and nations. The following is the summary of each region’s brief background on counterfeiting medicines:

North America

Counterfeit medication is a recognized and well documented problem in the United States. One case in 1937 has featured more than a hundred deaths after consuming medicines containing the dangerous solvent diethylene glycol.

Some counterfeiters in the United States are even found to be using fraudulent connections to terrorism. WHO has also found that the profit from counterfeit medicines have been used to fund the famous terrorist group Hezbollah.

Europe

There are few fake and substandard drugs in most European countries for reasons similar to those articulated above for the United Sates: quality producers dominate the market, supply chains are generally well regulated, and officials provide strong oversight and strict enforcement when pharmaceutical standards are violated. Still, preventing fakes from entering or travelling through the two dozen European territories is a constant challenge for enforcement officials.

Cambodia

Cambodian Ministry of Health has released a statement stating that 13% of the nation’s medicines are fraudulent. Warnings on health precautions are already released by local government units and private pharmaceutical companies as most counterfeit medicines are found in informal and unlicensed units.

Indonesia


Counterfeiting in Indonesia has grown despite the warnings of death penalty as punishment. By 2008, 44% of medicines in the market are counterfeited, even sold in legitimate pharmacies. 11 men were arrested in the capital city, Jakarta for refilling syringes with water, forging expiration dates and repackaging.