Chapter 8 2. Counterfeit drugs, a public hazard sweeping the world

The pharmaceutical industry experts of the World Health Organization believe that the proliferation of counterfeit drugs in many countries has reached an unprecedented level.What is even more worrying is that although international organizations and governments have taken measures to crack down on counterfeit medicines, all indications show that counterfeit medicines around the world have not decreased, but are on the contrary growing. Public and secret reports received by the World Health Organization show that in the past 15 years, there have been more than 700 major counterfeit drug incidents in at least 28 countries, of which 65% occurred in developing countries.Most of the counterfeit medicines have no effect on the disease, and some counterfeit medicines are toxic and cause the death of those who take them.Therefore, people angrily call counterfeiters "super murderers".

In many third-world countries, patients have no trouble finding a wide variety of European or North American-labeled medicines that may be nothing more than starch or sawdust, or perhaps even poisonous substances, in fancy packaging.From Lagos, Nigeria, to Bamako, Mali, there is a thriving counterfeit drug business.Africa's counterfeit drug market, worth more than $8 billion a year, is estimated to kill more people than Ebola.In developing countries, untold numbers of children die each year from taking counterfeit medicines. In 1990, in a Nigerian hospital, 109 children died immediately after drinking cough syrup, which was mixed with a deadly solution-car antifreeze oil; They died of kidney failure after using toxic antipyretics; in the spring of 1995, the French "Doctors Without Borders" warned that some fake meningitis vaccines appeared in Niger, and it is unknown how many were injected into children who knew nothing ...

In Uganda, where talcum powder was sold as penicillin and injected into patients, four people died after eating tablets mixed with sawdust and dye; in Myanmar, many villagers fell ill after taking fake medicines supposed to treat malaria. It’s even worse; most of the popular counterfeit medicines in the Philippines are anti-infective antibiotics, mainly containing cornstarch. Although they do not directly harm patients, they delay treatment; fake burn ointments have been found in Mexico, which are full of sawdust, coffee or ash powder. Putting these messy things on the wounds of burn patients will cause large-scale ulceration of the wounds; the relevant departments of Cameroon have inspected 248 kinds of medicines commonly used in the pharmaceutical market, and found that half of them are below the quality standard, and the real ingredients of 48 kinds of medicines are the same. Its name is irrelevant...

In the vast developing countries, counterfeit medicines are rampant, and in developed European and American countries, there are also many scammers selling counterfeit medicines.In many hospitals and pharmacies, many cardiotonic drugs with insufficient doses were found, and some of them only had half the efficacy. In April 1994, a well-known British fitness club was found to have sold a large number of impotence and anti-aging drugs to club members without exception; the French "Doctor Daily" reported that many drugs marketed in the French pharmaceutical market Among them, about 5% are fake products; there is a famous and expensive medicine for treating bronchitis in the German pharmaceutical market. It is indicated on the label that this medicine contains 18 kinds of precious medicinal materials, but after testing, it was found that it contained a large amount of cortisone; The United States found that many counterfeit medicines for arthritis were made of lactose and common aspirin, and the United States lost $16.002 million a year due to counterfeit medicines.

On November 20, 1998, a serious medical accident occurred in Bangladesh, killing eight people, including a 5-year-old child.That night, medical staff at the Affiliated Hospital of Rangpur City, northwestern Meng, administered intravenous saline to 23 patients. A few minutes later, eight patients had a strong reaction and then stopped breathing.Other patients have also reacted, with high fevers but not life-threatening ones.According to preliminary analysis, these saline for injection are either counterfeit products or expired products. According to estimates by the World Health Organization, the annual output value of counterfeit drugs in the world is as high as 80 billion francs. The International Chamber of Commerce estimates that counterfeit drugs account for 6% to 7% of the global pharmaceutical market, and the pharmaceutical industry loses 36 billion marks every year due to counterfeit drugs— — This is equivalent to three times the annual sales of Merck & Co., the world's largest drugmaker.It is estimated that 20% to 30% of the drugs sold on the Brazilian market are counterfeit; in Lebanon and Pakistan, 30% to 50%; in Indonesia, at least half; In African countries where counterfeiting has always been allowed, the proportion is as high as 60%, and in some counterfeit medicine "hardest hit areas", such as Nigeria, the proportion is even as high as 70%!There are three main types of counterfeit medicines: the first one is that the ingredients of the medicine are not fake, but the ingredients are substandard, or the dosage is seriously insufficient. Taking it for a long time will lead to a serious shortage of the dosage and affect the curative effect; the second is that the ingredients of the fake medicine are the same. The corresponding disease of the medicine has nothing to do with it, so it has no curative effect; the third is that the substance contained in the fake medicine is poisonous, and the light medicine will leave serious consequences, and the severe one will die.Regardless of what the fake medicines "contain", their packaging is "original and genuine", because it is a breeze to imitate the packaging of genuine medicines with modern technology.These "original products", whose prices are much lower than the original drugs, are continuously on the counters, standing shoulder to shoulder with the original drugs, and may even squeeze the original drugs out of the shelves.In this way, fake medicines brought a lot of ill-gotten gains stained with blood to the manufacturers.

The pharmaceutical industry is a high-tech industry.So, what kind of conditions do counterfeit drug manufacturers need to have?According to Silverman, an expert at the San Francisco Institute for Health Policy, "What is needed is: a person with access to a small laboratory, a little understanding of medicine and chemistry, plus a completely devoid of humanity and the temperament of a thief." For those concocted For counterfeiters of counterfeit drugs with authentic ingredients but jerry-built materials, getting a formula of a brand-name drug is a top priority, and it is not difficult to get a formula of a brand-name drug-"money can make money".As for those criminals who use flour, sawdust, and even antifreeze oil to make counterfeit medicines, they even save money on buying formulas.

After the almost genuine fake drugs are produced, the remaining problem is to transport these fake drugs to the destination country and successfully market them.Today, when international trade is so developed, it is almost impossible to find clues about the circulation of counterfeit medicines. Well-known figures in the international pharmaceutical industry pointed out that counterfeiters have set up special networks, and those engaged in the trading of raw materials are all large organizations.These groups distribute the raw materials to small networks that move around and let them produce counterfeit medicines.About half a year later, it switched to another product.It's hard for these guys to invent a drug, but it's not that hard to counterfeit it because they've hired some really good people.London's "Observer" also reported that manufacturers of counterfeit drugs are not completely isolated from each other, and they even have direct or indirect links with international drug trafficking groups.

Several experts at the World Health Organization, led by Hamm, the head of the drug safety department, are fighting the counterfeit drug problem with all their might.He said that the situation has not changed in the past few years. At that time, everyone believed that action should be taken on the problem of counterfeit medicines. Today, people are still at this stage, and the problem of counterfeit medicines is getting worse.In the face of the flood of counterfeit medicines, although all institutions are shouting "mobilize to fight against counterfeit medicines", very few of them have actually taken solid action, and very few counterfeiters of counterfeit medicines have been prosecuted and sanctioned by law.François Goly believes that in order to avoid a greater disaster, the political world should respond strongly to this.In his view, it is not enough to rely solely on industry experts in the fight against counterfeit medicines.The International Federation of Pharmaceutical Manufacturers Associations and the World Health Organization hope to strengthen cooperation with Interpol and the customs of various countries to establish an international cooperation system for searching for counterfeit drugs.

The findings of the investigation disclosed by the Italian police recently shocked the international community: the counterfeit medicine manufactured by an international criminal gang was sold well on three continents, Europe, Asia and Africa.The 12,000 independent clinics in the UK alone have imported counterfeit anti-ulcer medicines worth tens of millions of pounds! The British Ministry of Health later confirmed that the UK's Drug Control Agency, with the assistance of Italian police, seized fake medicines worth £7 million from a barn in Italy.Among the eight criminals arrested, Italian Aureli Rizzo Hikari, who has close ties to the Russian Mafia, delivered 5,000 cases of anti-ulcer drugs to the UK's largest drug import and export company "Medi Health" in one trip last April. medicine.When Medicare doubted the authenticity of the first batch of medicines, the British police immediately confiscated all the medicines.Investigators in Italy and the UK, however, are convinced that more counterfeit drugs have been smuggled into the UK because the gang has very close business ties to six UK drug companies.Lieutenant Colonel Antonio Melnila of the Anti-Counterfeiting Detachment of the Italian Gendarmerie said: "We found a whole 304 barrels of raw materials for making fake medicines. As for the safety of the medicines, all I can say is that the barn was dirty and damp. There are all kinds of insects everywhere. Some medicines have been there for more than two years."

When the Italian police arrested the residence of the counterfeiting gang, they seized the names and addresses of drug suppliers and buyers in the United Kingdom, Ireland, Cyprus, Tunisia and Pakistan from Rizzo's home.This Italian gang not only manufactures and sells counterfeit goods, but also sells stolen medicines.All of their counterfeit materials are made by crushing some generic drugs and then processing them.As for the stolen medicines, they changed the packaging dates and labels of the medicines.Regarding the harmfulness of these counterfeit medicines, experts have assessed that patients who have taken counterfeit medicines may miss their illness at least, or be poisoned as a result.

Brazil is a land of counterfeit medicines.Not long ago, Anna, who was 10 months old, was admitted to a hospital in Rio de Janeiro due to pneumonia. Doctors treated her with a new third-generation antibiotic drug produced by Brazil's United Pharmaceutical Factory.However, little Anna's condition worsened day by day.On the tenth day, little Anna responded softly to her mother's urgent call and left the world.The doctors discovered afterwards that the antibiotics given to Anna were counterfeit medicines without any pharmacological ingredients.Little Anna's father was very sad and shouted angrily: "The gangsters who sell counterfeit medicines took away my only daughter. Don't they think that what they are doing is also endangering their own family?" In recent years, incidents of counterfeit medicines in Brazil have intensified, posing a serious threat to social stability and public health.A 78-year-old man in Belo Horizonte was suffering from prostate cancer and had stabilized his condition with medication for eight years.In the past five months, he switched to the anticancer drugs provided by the contract hospital of Xilin Pharmaceutical Factory.Unexpectedly, this anti-cancer drug was a counterfeit drug produced by criminals, which caused the old man to relapse and die. In May 1998, Antonio, the former mayor of Timoteo, also died of counterfeit drugs.The spread of counterfeit medicines has caused a strong shock in Brazilian society, and many people dare not buy and take medicines easily.Many pharmacies have also experienced a decline in business due to the bad influence of counterfeit drugs.Sales at 1,500 pharmacies in Rio de Janeiro alone have plummeted by 40%. Some experts pointed out that since Brazil's economy has stabilized since 1995, people's income has generally increased, and the demand for medical treatment has continued to grow.At the same time, the difficulty of seeing a doctor and the high cost of consultation have also prompted many low-income families to purchase medicines and treat diseases on their own. In 1997, the sales of various medicines in Brazil reached 10.3 billion US dollars, becoming the fourth largest medicine consumption market in the world.As a result, greedy criminals take advantage of the increased demand for medicines, the lack of medical knowledge of many consumers and the desire for cheap, and the imperfect supervision mechanism of drug production and sales to use various means to produce and sell counterfeit medicines.Some tamper with the packaging and resell expired medicines; some illegally manufacture medicines in an environment without sanitation and technical conditions; what's more, some people even use water instead of injections and flour as tablets to pretend to be medicines. Really, entrap consumers. According to the estimate of the Drug Inspection Center of the Brazilian Ministry of Health, at least 5% of the drugs in the Brazilian drug market are counterfeit, counterfeit and pirated drugs each year, with sales of more than 500 million US dollars.However, the views of non-governmental organizations are far from being so optimistic, and they believe that the proportion of counterfeit medicines in Brazil has reached 20-30%. In 1997, the Brazilian Health Inspection Center seized 61 varieties of counterfeit drugs, most of which were painkillers and anti-inflammatory drugs, as well as counterfeit new drugs and nutritional medicines for the treatment of AIDS and cancer. three times as many years. The Brazilian government attaches great importance to the chaos in the drug market, the prevalence of counterfeit drugs and the serious harm caused by counterfeit drugs to consumers' physical and mental health.Minister of Health Sierra pointed out: "The production and sale of counterfeit drugs is the most serious crime. Because in the face of counterfeit drugs, victims lose any ability to defend themselves." In July 1998, relevant Brazilian departments and representatives of the Pharmaceutical Industry Association, Representatives of drug distributors met together and decided to take a series of measures to crack down on the criminal activities of illegal production and sales of fake drugs. Drug wholesale is a key link for counterfeit drugs to enter the market.Some wholesalers aim at the lucrative profits of public hospitals and hospitals contracted by medical insurance to purchase medicines in bulk, regardless of the quality and source of medicines, and resell counterfeit medicines from criminals to hospitals.Therefore, the Brazilian government has made stricter regulations on the sales of drugs: when purchasing drugs, all public hospitals and contract hospitals must require wholesalers and importers to provide drug quality certificates provided by nine quality inspection centers designated by the federal government , otherwise it will cancel its contract hospital qualification and revoke its business license, and the person in charge of the hospital will be punished by law.When public hospitals and contract hospitals purchase directly from pharmaceutical factories, they should have the drug quality certificates provided by the manufacturers.In order to cancel the underground drug trading market, pharmaceutical manufacturers must send the list of wholesalers and retailers who distribute their drugs to the Ministry of Health for record. Ministry of Health records.The Ministry of Health also agreed with the Brazilian Pharmaceutical Industry Association that in the future, technologically advanced holographic anti-counterfeiting marks and safety seals will be uniformly used on drug packaging.Each pharmacy must indicate the production batch number and serial number of the drug on the invoice when selling the drug.The Health Inspection Center has also launched a hotline so that consumers can check drug information at any time and report and expose criminal activities of counterfeit drugs. Medicines are special commodities, which are directly related to consumers' physical and mental health and family happiness.Brazilian President Cardoso emphasized that the use of counterfeit medicines to seek wealth and death is an extremely serious crime that must not be condoned.In order to allow patients to use safe medicines, the Brazilian government has also launched a massive anti-counterfeiting campaign in the drug markets of major cities across the country, severely punishing the crimes of illegal manufacturers manufacturing and distributing counterfeit and inferior drugs.In order to crack down on lawbreakers, the Brazilian Congress recently passed a decree that severely punishes manufacturers of counterfeit and shoddy medicines.According to the decree, anyone who produces and sells counterfeit and inferior drugs will be sentenced to 10 to 15 years in prison. If the counterfeit and inferior drugs cause the death of the user, the crime will be increased and sentenced to 30 years in prison.The Brazilian government has also decided to set up a special police department to organize forces to combat counterfeit drug crimes.Over the past few days, the police authorities, with the cooperation of the health department, have successively cracked down on some black dens for manufacturing counterfeit medicines and sealed up shops selling counterfeit medicines.Not long ago, the Brazilian Ministry of Health ordered the Xilin multinational pharmaceutical factory in Sao Paulo to suspend production for rectification because more than a dozen women of childbearing age who failed to use the contraceptive pills produced by the factory sued the factory for manufacturing and selling counterfeit and inferior drugs to harm consumers.The Brazilian Ministry of Justice imposed a fine of US$ 2.9 million on the pharmaceutical company in accordance with the relevant provisions of the national consumer protection law. The proliferation of counterfeit medicines around the world is undoubtedly a major threat to China.Now, many foreign medicines enter China. Although our country has a strict testing system, it is inevitable that counterfeit and inferior medicines will flow in.Recently, the drug management department has successively announced that several imported drugs have quality problems and are prohibited from being sold in China. This is enough to remind the Chinese that the phenomenon of counterfeit and shoddy foreign drugs is equally serious, and we must not be careless.