Almost a third of medicines sold in developing countries may be counterfeit, according to the Centers for Disease Control and Prevention, making efforts to combat serious diseases such as malaria even tougher.
Some experts say that percentage could actually be higher. In comparison, fewer than 1 percent of drugs sold in industrialized countries such as the U.S., Australia, Japan, Canada, New Zealand and the European Union are fake.
Counterfeit drugs have a substantial effect on global public health. Fake drugs can set back advances in combating serious diseases such as malaria, which kills about 1.2 million people a year, experts say.
"Fake drugs may contain a small amount of active ingredients, no active ingredients or substituted active ingredients," Michael D. Green, a research chemist with the CDC's Center For Global Health, told TakePart. "People may have severe allergic reactions to the substitutes in fakes, such as sulfa drugs."
Some fakes have acetaminophen. People may think they are getting better because it reduces the fever, but the infection is still there, he says.
"We don't know what the real content of a falsified medicine is," says Jose Luis Castro, an advisor for the World Health Organization. "The content can be dangerous or lacking active ingredients, and its use can result in treatment failure or even death."
Falsified antibiotics, he says, can also contribute to increased resistance to the bugs they are designed to fight.
So serious is the potential impact on public health that the World Health Organization in 2006 set up its International Medical Products Anti-Counterfeiting Taskforce. The group is building coordinated networks so countries can work together to halt the production and selling of fake medicines worldwide.
Earlier this year, researchers funded by the National Institutes of Health looked at the effects of fake anti-malarial drugs alone and reported their findings in the journal Lancet Infectious Diseases. They analyzed more than 1,400 samples from seven countries and found 36 percent were falsified.
Even seasoned travelers can fall prey to fake drugs, as a recent case report published in The Lancet shows. Spanish doctors reported on a well-traveled woman, 28, who bought Artesunat, an anti-malarial drug, from local traders in Bata, Guinea, after being diagnosed at a local health center.
Despite taking the medicine as directed, she got progressively worse. She flew home to Spain, where doctors sent the unused pills to a lab for analysis. The lab found no Artesunat at all in the pills she had been taking nor any active pharmaceutical ingredients at all. The woman was treated with real Artesunat and recovered in three days.
Until more regulation is in place in more locales, travelers can protect themselves in a number of ways, according to WHO and CDC experts:
· Get all the medicine you will need for your trip from your regular pharmacy or healthcare provider before departing.
· Avoid buying medicines from street sellers.
· Inspect drug packages. In the case of the fake Artesunate bought by the Spanish woman, the name of the drug company that supposedly made the drug and the word 'malignant' were misspelled.
· Check to see if the medicine has a strange smell, taste or color or if it breaks apart very easily.
· Be suspicious if the medication costs very little compared to the normal price.
Travelers who suspect a counterfeit drug can report it to local authorities, Green says. "But due to poor regulatory practices in many countries," he adds, "this may be a useless endeavor."
What more do you think should be done to combat counterfeit prescription drugs? Let us know in the comments.