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.

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.