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The on going battle against counterfeit anti-malaria drugs in South East Asia

In February this year, it was revealed that the International Criminal Police Organisation (INTERPOL) with the help of scientists and health workers from the World Health Organization (WHO) and Wellcome-Trust University of Oxford Tropical Medicine Research Programme, and the co-operation of Chinese authorities have uncovered a massive counterfeit anti- malaria drug syndicate, based in southern China, that is selling these drugs in South East Asia.

The Operation dubbed Operation Jupiter, resulted in the seizure of 24, 000 “blister packs” of the fake drug and the arrest of a suspect who is alleged to have traded 240,000 “blister packs” of the counterfeit anti-malaria drug artesunate. The fake drugs are allegedly being sold in South East Asia particularly Vietnam, Cambodia Laos and Myanmar and the Thai/Myanmar Border where Malaria is a common menace.

Counterfeit anti-malaria drugs begun appearing in South East Asia in 1998 and pose a serious threat to lives. In 1999, counterfeit anti-malarial drugs were said to be responsible for the deaths of at least 30 people in Cambodia. Since then hundreds of lives have been lost.

The problem is particularly severe in the poorer regions of South East Asia such as rural Cambodia where people are poor and there is a lack of education and information. In addition, the pharmaceutical distribution system shares part of the blame for example in rural Cambodia, where the drugs are often sold by unlicensed distributors who purchase the drugs from travelling salesmen based on their recommendations.

In a research project conducted by the Cambodian Government in 2003, it was discovered that 27 % of malaria drugs purchased at rural pharmacies in Cambodia were fakes. WHO estimates that approximately 25% of the drugs sold to developing countries are counterfeits.

Initially, the counterfeits were easily identifiable from their inferior packaging, spelling errors and odd shaped pills but lately, counterfeits have become more and more difficult to spot with the holograms on packaging, which was introduced to identify the genuine product also being copied with such sophistication that it has become virtually impossible to distinguish. Full laboratory tests have become necessary to determine fakes hence the assistance of scientists to analyse the composition of the drugs and packaging in Operation Jupiter.

The contents of the counterfeit drugs range from some containing no active drug at all to drugs containing toxic ingredients, banned pharmaceuticals and even raw materials used in the party drug ecstasy. Some tablets contain very small traces of artesunate to enable it to pass the screening test. The dosage however is too small to be effective and has the opposite effect of contributing to the resistance of the malaria parasite.

WHO estimates that out of every one million Malaria deaths a year, 200,000 could be prevented if all drugs were genuine.

The loss of lives due to fake drugs has resulted in more awareness in South East Asian nations in developing, protecting and enforcing intellectual property rights. Stricter laws and better enforcement have become necessary to stop the illegal trade of counterfeit goods through out the region.

Countries such as Vietnam, Laos and Cambodia, with the assistance and corporation with numerous international organisations, have been putting into farce various measures to put a stop to the counterfeit drug trade. Steps are being taken to increase awareness through better communication and education programmes, workshops with manufactures, retailers and health care authorities with the collaboration of the police and local authorities. There have also been better enforcement measures through investigations inspecting distribution chains, confiscating fakes and initiating legal action.

Cambodia, one of the nations whose people are badly affected by the counterfeit drug trade has shown its seriousness in its commitment in battling the problem of counterfeit medicine by creating a specific office to deal with the crime of counterfeit drugs. The Cambodian government also has pledged support to a joint initiative between INTERPOL, the World Health Organization (WHO) and the World Customs Organization (WCO) during a visit by its deputy prime minister to INTERPOL in April this year. The project specifically targeting illegal trade in South East Asia is expected to be launched soon and is expected to have a positive effect in the fight against counterfeits in the region.

The unique collaboration of scientist and law enforcement agencies in Operation Jupiter may have only apprehended one of the many players in the counterfeit drug trade but is an indication of the seriousness of authorities in stamping out counterfeit drugs.