International Action Needed to Fight Fake Drugs
By Catherine Cheney, on , Trend Lines
Some countries have laws prohibiting the sale of fake medicines, but, as the BBC reports, the lack of an international treaty allows organized criminal networks to sell fake drugs out of countries with weak laws. There have been multiple instances of mass deaths due to fake drugs, including in 2008, when the U.S. Food and Drug Administration documented 81 deaths and 600 allergic reactions (.pdf) to counterfeit heparin, a drug that prevents blood clotting .
Amir Attaran, an associate professor at the University of Ottawa and the lead author of the British Medical Journal article calling for a treaty, told Trend Lines that international action is needed to address the public health problem of counterfeit medicines.
“International law opens our markets to foreign medicines and yet does not criminalize those who abuse those open markets,” he said. “Foreigners can take advantage of this, and if they are in a country that protects them, that is a haven, they will get away with it.”
The fake drug trade is worth as much as $75 billion annually, according to the Center for Medicine in the Public Interest.
“If you have a Canadian Internet pharmacy selling garbage medicines to Americans, and [such pharmacies] exist, Canada turns a blind eye,” Attaran said. “The U.S. suffers the consequences. In previous cases, the U.S. has asked Canada, ‘Would your police please investigate and arrest somebody?’ But Canada just won’t do it because there is money to be made.”
An international treaty, he continued, would provide a “legal backbone” that would force “unwilling countries” to act. In the past, Attaran explained, medicines were produced locally, but in an increasingly globalized medical market, where he said the U.S. imports 80 percent of medicine ingredients, there is a need for international regulation.
“Centuries ago, apothecaries made fake potions, so it is not a new problem, but it is a very much larger problem than it has been in the past,” he said. “When [a fake drug] doesn't kill, at the very best it doesn't treat you, so even the best outcome is a lousy outcome.”
One big challenge for progress on this issue is the controversy over intellectual property rights, he said. India, for example, resists any steps toward international regulations in part because of a belief that the real aim would be to curb competition for large multinational pharmaceutical companies while pushing smaller local and generic producers out of the way. But Attaran emphasized the need to distinguish between public health law and intellectual property law. The sale of imitation products for a cheaper price than the original is an economic issue, he explained, but a pill that does not contain what it is supposed to contain or is unsafe becomes a public health issue. An international treaty on fake drugs would provide protections against the latter, not the former.
“You have to build a very strong and tall wall between intellectual property and public health,” Attaran said. “We do not need to be concerned about creating law in [patents or trademarks], because those laws exist. But there is not a public health law that deals with this.” In practice, he added, “the tools that the police and prosecutors have to solve the problem are weirdly distorted.”
The United States, France, the United Kingdom, Singapore and Nigeria are leading on this issue, he said. “The countries that are preaching to do something on this are doing it both out of their own experience and also because they really want to exercise leadership,” he added. Other countries are reticent about international regulations, with some even actively working against it.
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