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Health and law enforcement organisations must work together to stop the spread of counterfeit medicines, says Aline Plançon.

Counterfeit medical products have long been a threat to public health and patient safety. But counterfeiters are now using more sophisticated methods and the Internet to broaden the availability of fake medicines to unsuspecting patients and increase the amount of counterfeit products crossing borders.

In response, Interpol has been involved in combating the trade in counterfeit drugs and medical devices since 2005.

A series of successful operations shows that stemming the tide of fake, dangerous and diverted medical products requires close collaboration between the health sector, law enforcement agencies, international bodies and nongovernmental organisations.

Organised crime

Counterfeit medical products are a highly lucrative form of crime — they are more profitable to criminals than drug trafficking.

Producing expensive or cheap medicines does not require significant infrastructure or facilities. The ingredients are cheap, and counterfeiters incur none of the costs associated with quality assurance or safe manufacturing standards. And substitutes for the active ingredient are often dangerous for health.

International and sophisticated organised-crime groups traffic counterfeit drugs by exploiting weaknesses and loopholes in health systems around the world.

They infiltrate the legal medical supply chain with fake products that cannot be distinguished from genuine ones without laboratory testing.

So, to disrupt their activities, the international community needs to ensure adequate health legislation, joint actions between stakeholders, and appropriate law enforcement practices.

To do this, the WHO launched the International Medical Products Anti-Counterfeiting Taskforce (IMPACT) in 2006.

Making an impact

IMPACT aims to raise awareness about counterfeit drugs among international organisations and other stakeholders to improve cooperation between them and between anti-counterfeiting initiatives.

It calls on authorities and decision-makers to produce effective legislative measures, to establish efficient systems for exchanging information, and to develop technical and administrative tools to support international, national and regional initiatives against the trade in fake drugs.

Interpol has made its global law enforcement capacity available to IMPACT by developing an innovative cross-sector approach, integrating and coordinating the activities of partners from the health, police, customs, scientific and private sectors around regional enforcement projects.

It has also created a unit dedicated to combating counterfeit medical products and other pharmaceutical crimes. The Medical Product Counterfeiting and Pharmaceutical Crime (MPCPC) unit, which is independent from its Intellectual Property crime unit, has developed a package of measures aimed at increasing the capacity of countries to combat counterfeit medical products.

These measures include intelligence gathering, enforcement training, raising awareness and coordinating enforcement actions on the ground.

The MPCPC unit is helping countries improve the exchange of information between agencies and the operational entities that intervene to identify criminal networks, disrupt illegal activities and supply chains, and seize illegal pharmaceutical products.

Working together

The creation of IMPACT was a formal international recognition that tackling counterfeit medicines cannot be achieved by individual stakeholders working independently.

Although more concerted action is required, its results bear out the need for the various sectors and stakeholders to work together.

For example, an international operation that took place across East Africa in July and August 2010 — Operation Mamba III — resulted in the seizure of more than 10 tonnes of counterfeit and illicit medical products.

Law enforcement officials arrested about 80 individuals suspected of involvement in the illegal manufacture, trafficking or sale of counterfeit or diverted medical products.

The operation involved police, customs and drug regulatory authorities across Burundi, Kenya, Rwanda, Tanzania, Uganda and Zanzibar. It was coordinated by Interpol and carried out under the umbrella of IMPACT.

The laboratories of Singapore's Health Sciences Authority and CODFIN (Counterfeit Drug Forensic Investigation Network) helped with forensics, and the World Customs Organization provided support.

Operation Mamba III was the third such operation in as many years in East Africa.

Building on its success, Interpol continues to encourage more systematic exchange of information to pool expertise, experience, resources, intelligence and technical assistance.

By working together, countries can take concrete action on the ground to curb a crime that remains low-risk and high-profit for the criminals involved but poses a serious health threat to the public.

With counterfeit and unregulated medical products becoming increasingly prevalent, sophisticated operations such as Mamba III play a vital role in enhancing the awareness, resources and educational efforts that, in coming years, will play an important role in efforts to fight counterfeiters.

Aline Plançon is project manager and head of Interpol's Medical Product Counterfeiting and Pharmaceutical Crime unit, a partner of WHO's International Medical Products Anti-Counterfeiting Taskforce (IMPACT).

This article is part of a Spotlight on Detecting counterfeit drugs.

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