More than 10 percent of the medicines on sale in the developing world may be counterfeit, according to World Health Organization estimates, and medicines in the European Union are now the leading illegitimate product seized at the border, increasing by 700 percent from 2010 to 2011.
The fake or faulty meds circulate through the globalized drug trade, originating sometimes from organized crime groups and other times from middling laboratories that make careless errors, according to Amir Attaran, a health researcher at the University of Ottawa.
The consequences can be dire, as evidenced by the death of more than 100 people in Pakistan earlier this year after faulty drugs were given to up to 40,000 cardiac patients. In 2008, the blood thinner Heparin was found to have counterfeit active ingredients sourced from China and caused 81 deaths. Past research has shown that up to a third of malaria drugs are counterfeit.
In spite of that, nearly a third of countries have little or no medicine regulation, according to the WHO.
Now, Attaran and a group of health researchers are saying that a global crackdown can help.
In a new paper in the British Journal of Medicine, the researchers call for a global framework, similar to the one now used to control tobacco, to stop the spread of fake drugs. The paper comes a week before the WHO plans to meet on the subject of counterfeit medicines in Buenos Aires.
"If you’re going to globalize trade, you have to globalize the law also," Attaran said in an interview.
The report's authors say that a confusion over the definition of "counterfeit," as well as secrecy on the part of the pharmaceutical industry, has led to a lack of international standards on drug safety.
Global treaties have helped governments cooperate internationally to clamp down on other worldwide problems, such as money laundering or human trafficking, Attaran argues. Under their proposed framework, governments would define different types of illegitimate medicines, codify public health crimes in international law and mandate intergovernmental cooperation on the issue.
The WHO provides country and regional support for strengthening medical regulation, and it would be up to the organization's 194 member states to vote on such a treaty.
The most common source countries for counterfeit drugs are India and China, and past WHO research has shown that the most commonly counterfeited medicines are genitourinary (37 percent of law enforcement seizures), followed by anti-infectives (12 percent) and central nervous system drugs (12 percent).
Attaran said he was told on Monday by the World Health Organisation (WHO) that he and other non-governmental representatives could not attend the upcoming meeting, following an objection by India.