Counterfeit medicines boost resistant strains of disease and endanger lives, say researchers

IRD / Arnaud Luce

[WINDHOEK] Up to a quarter of what governments spend on medicines each year is lost to fraud, bribery and diversion of pharmaceuticals, says the World Health Organization.

The organisation this week (30 October) launched an initiative to help governments fight corruption by promoting greater transparency in medicines, regulation and procurement.

"Countries need to deal with this problem and ensure that the precious resources devoted to health are being well spent," said Howard Zucker, assistant director-general for health technology and pharmaceuticals at the World Health Organization (WHO).

Apart from the loss of resources and the danger posed to patients' lives, corrupt practices also allow the entry of counterfeit and substandard products into the medicines chain, further endangering the health of communities.

Fake medicines now account for a quarter of all drugs in circulation in the least developed countries (LDCs), according to the WHO. They are not only ineffective at treating illness, but they cause hundreds of thousands of deaths every year.

Now the WHO plans to form a group of independent experts and advocates to work on strengthening regulatory authorities and procurement practices by stimulating legislative reforms that will establish laws against corruption.

It will promote standardised systems of checks and balances to limit or prevent abuse and encourage ethical practices through behaviour change activities and staff training.

The organisation also plans to compile a database of best practices and successful experiences already tried and tested in countries to promote good governance in the public pharmaceutical sector.

The WHO announcement follows a report published in May this year, in which researchers warned that counterfeit medicines are a serious problem in LDCs but will not be stopped until countries change their legal systems and enforce intellectual property rights regulations.

Counterfeit medicines aid new, drug resistant strains of viruses, parasites and bacteria to develop, currently a major worry for HIV/AIDS and malaria, according to the report by the London-based International Policy Network.

By often containing too little active ingredients, fake drugs do not kill all of the targeted disease agents, allowing resistant strains to multiply.

A field survey in a range of South East Asian countries in 2004 found that 53 per cent of artemisinin-based antimalarial drugs contained incorrect levels of active ingredient.

The report called for supply side issues to be addressed, with LDCs enforcing the rule of law, defining and enforcing intellectual property rights and patent systems.

"If the least developed countries were to improve their intellectual property regimes — especially the ability to obtain and enforce trademarks — then companies would be able to take action privately to protect themselves, and by consequence their consumers, from these counterfeits," Julian Morris, one of the report's authors told Scidev.Net.

Morris said attempts to use bilateral deals to improve the enforcement of intellectual property rights have been criticised by activists who claim that they will raise medicine prices.

But, he added, "the real effect would be to make real medicines more widely available at lower prices, while massively reducing the availability of counterfeit medicines".

This week (30-31 October), health experts, and representatives from governments and the pharmaceutical industry met at the WHO headquarters in Switzerland to set up a global advisory group — made up of experts from international organisations as well as government officials — to promote good governance in drugs procurement.