By Land, Thomas
Contemporary Review , Vol. 290, No. 1691
AN AFRICAN woman whose family has suffered the effect of the insidious trade in counterfeit pharmaceuticals has unleashed a global campaign against that deadly, multi-billion dollar enterprise. So far, she is winning. But she has barely survived an assassination attempt.
Probably the largest seizure of counterfeit drugs in Europe has just taken place at Brussels airport netting a consignment of more than two million fake painkiller and antimalarial pills from India, destined to West Africa. China has revoked the manufacturing licences of three pharmaceutical companies and fined 125 other businesses for involvement in the production or sale of illegal drugs. Tough new safety regulations are expected in the European Union (EU).
Further initiatives are being prepared by several other global and regional organizations in line with a resolution recently passed by the 61st World Health Assembly in Geneva - the highest authority on matters of public health - to thwart the trade in counterfeit drugs.
No-one is safe from it. The proportion of fakes dispensed by unsuspecting pharmacists is 30 per cent in large parts of Africa and Russia, 3 per cent in Central Europe, 1 per cent in the rich West. But change is on the way. This criminal enterprise has thrived for years with the multinational pharmaceutical industry and most governments looking the other way.
But the urgency of the issue burst on the consciousness of world leaders last year when Nigeria deployed hundreds of regular troops as well as policemen in a siege of the Bridge Head Drug Market at Omits. That exercise yielded more than 80 trucks of unregistered, counterfeit and stolen pharmaceuticals worth many millions of dollars. It probably saved many lives.
The raid was staged under the authority of Professor Dora Akunyili, aged 52 years, the director-general of the National Agency for Food and Drug Administration and Control (MAFDAC), She is a beautiful and hugely influential matriarch usually clad in colourful traditional robes, a pharmacologist and a mother of six who lost her diabetic sister to a treatment of fake insulin. Strangers affectionately call her 'Mommy', an expression of deference.
The operation began with a pre-dawn swoop on the sprawling market accommodating 2,500 dealers. They are mostly traditional traders lacking pharmaceutical qualifications and effectively controlling a huge West African drug distribution network. Such raids have led to more than a hundred public burnings of life threatening medical fakes and the public humiliation of organized criminals who profit by them.
Before Dr Akunyili was appointed to her present post in 2001, about 68 per cent of pharmaceutical products circulating in Nigeria had been unsafe, a proportion now down to less than 20 per cent, she told a recent regional conference in Johannesburg. That meeting of African regulatory heads of department and their top officials was the first called to seek collective strategies to confront the counterfeiters across the continent.
Modern medications are potent, dangerous, expensive and wrapped in mystery because the people dependent on them - almost all of us - mostly do not understand their content. The manufacture, distribution and sale of fakes are technically easy, vastly profitable and still relatively safe for the perpetrators.
The drug control agencies in all but the richest countries lack the means to identify sophisticated fakes in ordinary commerce. A global web of corruption also protects the counterfeiters. Laws are lax - swindlers caught in the act are fined only a few thousand dollars in most countries. And the human cost of the racket is estimated in the loss of perhaps half a million lives a year.
Most of the fakes originate from India and China. The United Nations World Health Organization (WHO) in Geneva reckons the annual financial cost of the world trade in counterfeit pharmaceutical at $36bn, a figure that could double within two years to represent perhaps a tenth of all pharmaceutical sales. …