Note: This was originally posted on August 26th 2010. It is being reposted for research blogging.org.

For this one article I’m going to postpone the normal dark humor and cheesy puns. This topic is just too sad for jokes. All sources for this piece are linked at the bottom.

A multi-billion dollar underground industry is in existence across the globe that is so heinous it makes the illegal drugs problem look like a playground squabble, yet it is not even explicitly illegal in most countries. This is the counterfeit drugs industry which produces sugar pills complete with packets and leaflets and sells them to unknowing pharmacies in the third world to treat conditions including Aids and Malaria. To date the database containing the details of the circulation of counterfeits is maintained by the drugs industry but is kept secret even from the WHO, the FSA and the FDA, let alone the public.

Fake drugs make up an estimated 20% of sales in the former Soviet Union and 30% of sales in Africa and South America. When it comes to online pharmacies that conceal their addresses, the drugs are more likely to be fake than not wherever you are in the world. (WHO) In one bust of fake drugs in 2000, 43 tons of 17 brands of drugs from seven international pharmaceutical companies were found being prepared for export from China to Nigeria after an investigation by Belgian customs. This would be classed as one incident on the following a graph of incidents, over half of these incidents was classed as an incident on a commercial scale, that means hauls of thousands of pills:

“The fake drugs market is valued by the US Food and Drug Administration to be worth in excess of US$35,000,000,000.” That was in 2004. Many would say that was an understatement then. The problem has only got worse, nothing has changed for the better. Update: 10 tonnes of antimalarials, vaccines and antibiotics seized in East Africa on Thursday The main reason for this situation is the high prices of the original drugs that has forced the third world to buy their drugs from companies operating illegally manufacturing generic pills. They have no other choice. Genuine Malaria and Aids tablets cost the equivalent of weeks of wages of the people that need these drugs. There are plenty of legitimate underground labs all over the world making generic versions of these same medicines for a fraction of the costs charged by BigPharma, mainly in India where patent law isn’t worth the paper it’s written on. The sad situation we’re in now is that these robin hood labs have resulted in an opportunity for criminals to make counterfeits on the back of the underground pill industry. Pills have even been discovered that are designed to fake side effects so the patient comes back for more. They are sold in honest chemists across Africa and elsewhere by chemists who do not even know what they are selling. These fakes are mainly of expensive Aids and malaria Drugs. These sugar pills invariably harm or kill everyone who takes them, they are far more devastating to humanity than any wrap of illegal drugs.

“192,000 patients killed by fake drugs in China alone in 2001”

Big Pharma is complicit in this Genocide. It would be all too easy to create a secure tracking system for all medicines, similar to how the movie industry protects its content and would probably cost a fraction of their marketing budget. It is done for every other high value product we consume. We have known about this problem for years yet the industry is still nowhere near this point. Furthermore the industry actively blocks free flow of information about the fakes themselves.

“Most data on the epidemiology of counterfeit drugs are kept secret by the pharmaceutical industry and by governmental agencies…”

And just like illegal drugs…

“There are no reliable accessible databases whereby health workers or the public can access current details of which products are being faked in a locality.”

Despite desperate calls for this by the World Health Organisation, this still has not happened, we are powerless against these companies, they are bigger than our governments. The drugs companies are terrified of what it would do to their business if such a database were to go online. Of course, BigPharma has this database, it is owned by the Pharmaceutical Security Institute (PSI), set up by the 15 largest drugs companies but in the name of security it is kept secret even from the WHO and the FDA. BigPharma openly admits that this is simply because it would be bad for business. Business is more important than the freedom to publish the database of the wherabouts and batch numbers of certified death pills. The companies main concern appears to be that patients will abandon brand names entirely once they find out that the branded pills they buy are no more effective or necessarily any more likely to be genuine than their generic counterparts.

If this is not horrifying enough, consider that it could also be because it is not really in the financial interest of Big Pharma to stop this problem at all. Counterfeits are a necessary evil for Big Pharma to maintain it’s position over non branded labels. The need for trade names is entirely dependent on the existence of counterfeits. Genuine branded drugs are no different from non branded “generic” drugs. (Just like neurofen is no different to ibuprofen.) Furthermore these are the dealers of disease, spread of disease is the best thing that could happen for business, it results in more prospective customers. This is no conspiracy theory, there is no reason at all to believe the pharmaceutical industry is any different to any other industry and would act in a way that would damage it’s own sales of its own volition. It is well known that most of the worlds fake drugs are sold in Africa, where the market is controlled in rural areas by chemists and street vendors who don’t have the ability to test their product. This activity may be second only to the Catholic churches ban on condoms in the cause of the spread of aids in Africa. Sadly however, you can practically count on one hand the number of busts of counterfeits in Africa in the past year. Some experts now believe the majority of AIDS drugs being sold in Africa right now could well be fake. There is no way in hell there were 863 hauls in Asia (where most of the pills are made) and only 67 hauls made it to Africa, the main destination. It’s not exactly hard to get sugar across a border, especially if that border is Africa.

As I said before, this is no conspiracy theory, all that drives corporations is profit and as long as unregulatable pharmaceutical corps run riot and governments continue to turn a blind eye nothing will change. Despite all of this, the interminable and irrelevant drone of the war on illegal drugs is all we hear in the media. Wake up world, this is all kinds of fucked up.

Sources: WHO fact sheet, WHO report (2008), Report by National Centre for Biotechnology Information. Figures taken from the little data that the clandestine PSI has actually made public. An interesting article on the FDA.

Cockburn, R., Newton, P., Agyarko, E., Akunyili, D., & White, N. (2005). The Global Threat of Counterfeit Drugs: Why Industry and Governments Must Communicate the Dangers PLoS Medicine, 2 (4) DOI: 10.1371/journal.pmed.0020100

Update: Now the EU, instead of fighting the fakes is trying to block cheap generic producers that already provide 80% of Africa’s supply of antiretroviral drugs. Sign the petition to stop this here: https://action.msf.org/en_GB/action/index/

Update: US has now announced it will attack vendors of generic pills. If the illegal drugs market is anything to go by this will rapidly and severely worsen the problem. An underground generic market will be 100% unregulated and will therefore widen the opening for fly-by-night sugar pill vendors to fill the place of the few reputable dealers of generics. The planned censorship of generic pharmacy websites will also likely put (relevant reference) websites like mine in danger.

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