In 2009, 20 million pills, bottles and sachets of counterfeit and illegal medicines were seized in a five-month operation coordinated by the International Criminal Police Organization (Interpol) across China and seven of its south-east Asian neighbours; 33 people were arrested and 100 retail outlets closed.
Also last year, a series of raids in Egypt found counterfeit medicines worth hundreds of millions of dollars and exposed a criminal network feeding consumers across the Middle East. And in Europe, customs officers seized 34 million counterfeit pills in just two months in 2009, a haul that the European Union's industry commissioner Guenter Verheugen said "exceeded our worst fears".
Results from this string of law enforcement operations around the world arc slowly building a profile of the trade that shocks even regulators familiar with the issue. Health experts believe such operations have only scratched the surface of a flourishing industry in counterfeit medicines that poses a growing threat to public health around the world.
Asia accounts for the biggest share of the trade in counterfeit medicines, according to the industry-funded organization, the Pharmaceutical Security Institute. But, according to Interpol officer Aline Plancon, there are counterfeit medicine cases in every part of the world. "There is a flow of products coming from everywhere and going to everywhere, there are so many hubs," she says.
The threat from counterfeit pharmaceutical products is hardly new; many national authorities have long waged their own struggle against counterfeit medicines. Although WHO has been working actively on this complex, politically sensitive issue since it was first discussed in May 1998 at the World Health Assembly, enforcement efforts stepped up a notch in 2006 when it launched the International Medical Products Anti-Counterfeiting Task Force (IMPACT), drawing members from international organizations, enforcement agencies, industry and nongovernmental organizations.
Since then, IMPACT members have been collaborating closely oh international criminal investigations, assisting countries in strengthening their own detection and enforcement systems, and working with industry to develop such measures as secure, high-tech pharmaceuticals packaging.
Worldwide sales of counterfeit medicines could top US$ 75 billion this year, a 90% rise in five years, according to an estimate published by the Center for Medicine in the Public Interest in the United States of America (USA). It is difficult to measure the extent of the problem when there are so many sources of information and different definitions of "counterfeit". Sabine Kopp, IMPACT's interim executive secretary and manager of WHO'S anti-counterfeiting programme, says that WHO is currently conducting a survey to compare legislation and terminology used to combat counterfeiting of medical products in different countries.
"Studies really only give a snapshot of the situation as counterfeiters are extremely flexible in the way they mimic products and avoid detection," says Kopp.
There are no accurate data that accurately measure the scale of this vast, sophisticated and lucrative business, but "we're talking about big quantities seized and sophisticated criminal networks," says Interpol's Plancon, who co-chairs IMPACT's working group on enforcement.
The range of counterfeit products reaching markets has also broadened with the increased commercial use of the Internet to provide a dizzying array of both branded and generic drugs. In more than 50% of cases, medicines purchased over the Internet from illegal sites that conceal their physical address have been found to be counterfeit, according to WHO.
"In a shocking development, it was discovered relatively recently that counterfeit versions of lifesaving prescription medicines for cancer and serious cardiovascular diseases are also being sold to consumers online," the European Alliance for Access to Safe Medicines reports. …