Spurious drugs pose risk to public health
Saturday, 26 June 2010
Avik Sengupta
New investigations have revealed that spurious drugs worth an estimated US $150 million are posing a risk to public health in Bangladesh. In its annual testing of 5000 drug samples this year, the Public Health and Drug Testing Laboratory (PHDTL) detected 300 drugs that are either fake or of very poor quality. Significantly, these include many popular antibiotics and lifesaving drugs. The health ministry's Drug Administration authorities have launched a drive against illegal and fake drug vendors in the country. Preliminary findings reveal that Bangladesh has 80,000 unlicensed drugstores.
Drug administration officials express their helplessness in combating the menace saying there are so many illegal operators that we cannot cope. Some 25 branches across the country are staffed with just 40 drug superintendents and inspectors. The officials act when they get specific complaints. But this set up is hopelessly inadequate. They point out that smuggled drugs are the biggest threat, as this is a grey area. In the absence of quality control, any dishonest importer can smuggle in fake drugs at a takeaway price and sell them at a higher price, experts remark.
The rampant growth of contraband drugs is blamed on the poor quality of health services and cutthroat competition between drug manufacturers. The industry produces drugs worth over US $500 million a year.
The acute shortage of doctors and clinics in rural areas forces patients to purchase off-the-counter drugs sans a prescription. This helps fake drug vendors to thrive. A large percentage of patients also travel to neighboring India for treatment, returning with prescriptions of Indian drugs. To cater to them, dozens of unauthorized pharmaceutical establishments have mushroomed on the Bangladesh border.
These units either smuggle in Indian drugs or manufacture fake ones that threaten the lives of thousands of patients, experts observe. Although doctors warn these drugs could cause deaths, no survey has so far been conducted to assess their negative impact on public health. Recently, the Drug Testing Laboratory found that a popular drug used to treat patients suffered from strokes and brain hemorrhages -- Cavinton -- was being marketed minus its main chemical ingredients.
The value of fake and contraband drugs flooding the market is estimated to be between US $100 million and $150 million. These drugs are produced by unauthorised factories functioning along the borders of Bangladesh, India, Pakistan, China and Thailand. Paradoxically though Bangladesh exports drugs to 52 countries. The industry comprises over 800 drug-manufacturing companies, 230 of which manufacture allopathic drugs, 255 producing traditional herbal drugs, 300 engaged in the manufacture of modern herbal drugs and 80 homeopathic drug producing units.
Health ministry says the local pharmaceutical industry meets nearly 96 percent of the country's drug demands. However, it has ordered a crackdown on illegal drug networks in the country. It is preparing to sue some 15 illegal and fake drug vendors in the capital Dhaka.
The existence of spurious drugs in Bangladesh is well known. The government has not yet decided to bring in legislation to hand out penalty to those who manufacture or sell spurious drugs that cause grievous injury or death. The present system has serious shortcomings that need to be overcome before any tangible results can be seen. The top priority must be to strengthen the drug control machinery and give enforcement teeth. The fact that not a single prosecution has resulted in life imprisonment since the Drugs Act has amended to provide for this enhanced punishment shows that legislation alone is not enough.
Although the government shares the responsibility for keeping a check on spurious drugs, the pharmaceutical industry cannot disown responsibility. The weakest link here is the distribution network. No amount of policing by the government will help unless the companies beef up their distribution networks. While some manufacturers have their own clearing and forwarding agents to handle certain drugs, the need for a well established distribution network for all drugs cannot be ignored. Educating wholesalers and retailers to identify spurious drugs is another suggestion; this is a challenging task as the packaging is close to perfect and even experts find it difficult to tell the genuine from the fake. One of the ways to beat the counterfeiters is to use advanced packing technology. This will become a reality only if the government makes it mandatory for at least antibiotics and life saving drugs.
Consumers have a crucial role to play in arresting the proliferation of spurious drugs. Being the least equipped to tell genuine from spurious drugs, they should be advised to buy drugs only from reputed and well-established chemists. Educating the public on the circulation of spurious drugs and the dangers they pose should be high on the agenda of the government, the pharmaceutical industry, and the media.
(The writer can be reached at email: avik.sengupta@mail.mcgill.ca)
New investigations have revealed that spurious drugs worth an estimated US $150 million are posing a risk to public health in Bangladesh. In its annual testing of 5000 drug samples this year, the Public Health and Drug Testing Laboratory (PHDTL) detected 300 drugs that are either fake or of very poor quality. Significantly, these include many popular antibiotics and lifesaving drugs. The health ministry's Drug Administration authorities have launched a drive against illegal and fake drug vendors in the country. Preliminary findings reveal that Bangladesh has 80,000 unlicensed drugstores.
Drug administration officials express their helplessness in combating the menace saying there are so many illegal operators that we cannot cope. Some 25 branches across the country are staffed with just 40 drug superintendents and inspectors. The officials act when they get specific complaints. But this set up is hopelessly inadequate. They point out that smuggled drugs are the biggest threat, as this is a grey area. In the absence of quality control, any dishonest importer can smuggle in fake drugs at a takeaway price and sell them at a higher price, experts remark.
The rampant growth of contraband drugs is blamed on the poor quality of health services and cutthroat competition between drug manufacturers. The industry produces drugs worth over US $500 million a year.
The acute shortage of doctors and clinics in rural areas forces patients to purchase off-the-counter drugs sans a prescription. This helps fake drug vendors to thrive. A large percentage of patients also travel to neighboring India for treatment, returning with prescriptions of Indian drugs. To cater to them, dozens of unauthorized pharmaceutical establishments have mushroomed on the Bangladesh border.
These units either smuggle in Indian drugs or manufacture fake ones that threaten the lives of thousands of patients, experts observe. Although doctors warn these drugs could cause deaths, no survey has so far been conducted to assess their negative impact on public health. Recently, the Drug Testing Laboratory found that a popular drug used to treat patients suffered from strokes and brain hemorrhages -- Cavinton -- was being marketed minus its main chemical ingredients.
The value of fake and contraband drugs flooding the market is estimated to be between US $100 million and $150 million. These drugs are produced by unauthorised factories functioning along the borders of Bangladesh, India, Pakistan, China and Thailand. Paradoxically though Bangladesh exports drugs to 52 countries. The industry comprises over 800 drug-manufacturing companies, 230 of which manufacture allopathic drugs, 255 producing traditional herbal drugs, 300 engaged in the manufacture of modern herbal drugs and 80 homeopathic drug producing units.
Health ministry says the local pharmaceutical industry meets nearly 96 percent of the country's drug demands. However, it has ordered a crackdown on illegal drug networks in the country. It is preparing to sue some 15 illegal and fake drug vendors in the capital Dhaka.
The existence of spurious drugs in Bangladesh is well known. The government has not yet decided to bring in legislation to hand out penalty to those who manufacture or sell spurious drugs that cause grievous injury or death. The present system has serious shortcomings that need to be overcome before any tangible results can be seen. The top priority must be to strengthen the drug control machinery and give enforcement teeth. The fact that not a single prosecution has resulted in life imprisonment since the Drugs Act has amended to provide for this enhanced punishment shows that legislation alone is not enough.
Although the government shares the responsibility for keeping a check on spurious drugs, the pharmaceutical industry cannot disown responsibility. The weakest link here is the distribution network. No amount of policing by the government will help unless the companies beef up their distribution networks. While some manufacturers have their own clearing and forwarding agents to handle certain drugs, the need for a well established distribution network for all drugs cannot be ignored. Educating wholesalers and retailers to identify spurious drugs is another suggestion; this is a challenging task as the packaging is close to perfect and even experts find it difficult to tell the genuine from the fake. One of the ways to beat the counterfeiters is to use advanced packing technology. This will become a reality only if the government makes it mandatory for at least antibiotics and life saving drugs.
Consumers have a crucial role to play in arresting the proliferation of spurious drugs. Being the least equipped to tell genuine from spurious drugs, they should be advised to buy drugs only from reputed and well-established chemists. Educating the public on the circulation of spurious drugs and the dangers they pose should be high on the agenda of the government, the pharmaceutical industry, and the media.
(The writer can be reached at email: avik.sengupta@mail.mcgill.ca)