Counterfeit Drugs Are A Public Menace In Bangladesh :Where We're Heading To?
By Avik Sengupta, Canada
New investigations reveal an estimated US $150 million worth of spurious drugs are posing a risk to public health at 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 counterfeit or of very poor quality. Significantly, these include many popular antibiotics and lifesaving drugs. Jolted into action, the health ministry's Drug Administration authorities have launched a drive against illegal and fake drug vendors in the country. Preliminary findings reveal Bangladesh boasts a whopping 80,000 unlicensed drugstores.
Drug administration officials express their helplessness in combating the menace, "There are so many illegal operators that we cannot cope. Our 25 branches across the country are staffed with just 40 drug superintendents and inspectors. We act when we 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 which is totally unmonitored. In the absence of quality controls, 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 100,000 strong industry produces drugs worth over US $500 million.
Worse, 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, stresses a pharmaceutical industry executive. 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 be causing 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 for strokes and brain hemorrhages - Cavinton - was being marketed minus its main chemical ingredients. "It is obvious that patients who used this counterfeit drug have either died or suffered an ordeal," they say. Ironically as the Bangladesh Pharmaceutical Industries Association remarks, "The presence of fake and illegal drugs in Bangladesh is itself surprising because we manufacture over 96 per cent of our requirements and even export drugs."
The value of fake and contraband drugs flooding the market is estimated to be between US $100 million and $150 million. According to him, these drugs are produced in hundreds of fly-by-night drug factories functioning along the borders of Bangladesh, India, Pakistan, China and Thailand. Paradoxically though, the Chemist and Druggist Association points out, the pharmaceutical industry is Bangladesh's second largest foreign exchange earner, boasting exports 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 outlets.
It alleges that apart from some three dozen leading allopathic drug manufacturers, the rest are involved in the production of fake and low quality drugs. The forum terms this cannibalistic marketing of competing companies. "Due to its high returns, businessmen with no commitment to health services have started investing in the pharmaceutical sector. Their companies thrive on faking popular brands and manufacturing drugs sans authentic ingredients. The low prices help their drugs to sell," it says. Many companies manufacture fake post-operative antibiotics like cephradine and hydrocortisone. Fungus-coated saline fluids and used syringes are also commonly found. In addition, most drug manufacturers lack suitable storage facilities and enclose tablets and capsules in such low quality foil that it is impossible for them to retain their potency. Health ministry says the local pharmaceutical industry meets nearly 96 percent of the country's drug demands. According to the ministry, it has ordered a crackdown on illegal drug networks in the country. "We are preparing to sue some 15 illegal and fake drug vendors in the capital Dhaka. We are currently inspecting other towns and cities as well."
If the above facts, no doubt that counterfeit drugs are a public menace in Bangladesh. They are mostly ineffective and can cause grievous injury or even death. The existence of spurious drugs in Bangladesh is well known, although not the precise extent. The Government has yet not decided to bring in legislation to hand out the serious penalty to those who manufacture or sell spurious drugs that cause grievous injury or death. Several newspapers have long opposed capital punishment but the point is that stern penalties are a necessary but insufficient condition for putting an end to the spurious drug industry. 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 does not suffice.
According to the WHO, counterfeit medicine is ‘one which is deliberately and fraudulently mislabelled with respect to identity and/or source. Counterfeiting can apply to both branded and generic products and counterfeit products may include products with the correct ingredients or with the wrong ingredients, with insufficient active ingredients or with fake packaging.' In the past, bogus pills used to be blank replicas of the originals. But counterfeiters nowadays often add other active ingredients, such as mild pain relievers such as acetaminophen into pills that might make patients temporarily feel better. This was the case with fake Tamiflu seized from UK pharmacies in 2007. In 2004, Médecins Sans Frontières (MSF) discovered counterfeits ARVs on markets in the Democratic Republic of Congo (DRC) containing anti-depressants and muscle relaxants. The addition of false active ingredients to counterfeit pharmaceuticals alarms health professionals. More worrisome is the substitution of real active ingredients with potentially life-threatening chemicals. The antifreeze component diethylene glycol has been used in place of glycerine in cough medicines, killing hundreds of people in Nigeria, Panama and Bangladesh in recent years.
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. Insisting on bills with the batch number of medicines clearly mentioned, staying clear of chemists who sell drugs at a discounted price, and destroying used containers bearing the manufacturer's name indelibly marked are simple ways of ensuring that the drugs being bought are genuine. Consumers need to be wary of doctors themselves providing drugs rather than prescriptions. Finally, drug testing carried out by some public service organizations enjoying wide consumer acceptance will go a long way in supplementing the government's efforts. 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.
http://newsfrombangladesh.net/view.php?hidRecord=323601
Drug administration officials express their helplessness in combating the menace, "There are so many illegal operators that we cannot cope. Our 25 branches across the country are staffed with just 40 drug superintendents and inspectors. We act when we 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 which is totally unmonitored. In the absence of quality controls, 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 100,000 strong industry produces drugs worth over US $500 million.
Worse, 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, stresses a pharmaceutical industry executive. 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 be causing 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 for strokes and brain hemorrhages - Cavinton - was being marketed minus its main chemical ingredients. "It is obvious that patients who used this counterfeit drug have either died or suffered an ordeal," they say. Ironically as the Bangladesh Pharmaceutical Industries Association remarks, "The presence of fake and illegal drugs in Bangladesh is itself surprising because we manufacture over 96 per cent of our requirements and even export drugs."
The value of fake and contraband drugs flooding the market is estimated to be between US $100 million and $150 million. According to him, these drugs are produced in hundreds of fly-by-night drug factories functioning along the borders of Bangladesh, India, Pakistan, China and Thailand. Paradoxically though, the Chemist and Druggist Association points out, the pharmaceutical industry is Bangladesh's second largest foreign exchange earner, boasting exports 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 outlets.
It alleges that apart from some three dozen leading allopathic drug manufacturers, the rest are involved in the production of fake and low quality drugs. The forum terms this cannibalistic marketing of competing companies. "Due to its high returns, businessmen with no commitment to health services have started investing in the pharmaceutical sector. Their companies thrive on faking popular brands and manufacturing drugs sans authentic ingredients. The low prices help their drugs to sell," it says. Many companies manufacture fake post-operative antibiotics like cephradine and hydrocortisone. Fungus-coated saline fluids and used syringes are also commonly found. In addition, most drug manufacturers lack suitable storage facilities and enclose tablets and capsules in such low quality foil that it is impossible for them to retain their potency. Health ministry says the local pharmaceutical industry meets nearly 96 percent of the country's drug demands. According to the ministry, it has ordered a crackdown on illegal drug networks in the country. "We are preparing to sue some 15 illegal and fake drug vendors in the capital Dhaka. We are currently inspecting other towns and cities as well."
If the above facts, no doubt that counterfeit drugs are a public menace in Bangladesh. They are mostly ineffective and can cause grievous injury or even death. The existence of spurious drugs in Bangladesh is well known, although not the precise extent. The Government has yet not decided to bring in legislation to hand out the serious penalty to those who manufacture or sell spurious drugs that cause grievous injury or death. Several newspapers have long opposed capital punishment but the point is that stern penalties are a necessary but insufficient condition for putting an end to the spurious drug industry. 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 does not suffice.
According to the WHO, counterfeit medicine is ‘one which is deliberately and fraudulently mislabelled with respect to identity and/or source. Counterfeiting can apply to both branded and generic products and counterfeit products may include products with the correct ingredients or with the wrong ingredients, with insufficient active ingredients or with fake packaging.' In the past, bogus pills used to be blank replicas of the originals. But counterfeiters nowadays often add other active ingredients, such as mild pain relievers such as acetaminophen into pills that might make patients temporarily feel better. This was the case with fake Tamiflu seized from UK pharmacies in 2007. In 2004, Médecins Sans Frontières (MSF) discovered counterfeits ARVs on markets in the Democratic Republic of Congo (DRC) containing anti-depressants and muscle relaxants. The addition of false active ingredients to counterfeit pharmaceuticals alarms health professionals. More worrisome is the substitution of real active ingredients with potentially life-threatening chemicals. The antifreeze component diethylene glycol has been used in place of glycerine in cough medicines, killing hundreds of people in Nigeria, Panama and Bangladesh in recent years.
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. Insisting on bills with the batch number of medicines clearly mentioned, staying clear of chemists who sell drugs at a discounted price, and destroying used containers bearing the manufacturer's name indelibly marked are simple ways of ensuring that the drugs being bought are genuine. Consumers need to be wary of doctors themselves providing drugs rather than prescriptions. Finally, drug testing carried out by some public service organizations enjoying wide consumer acceptance will go a long way in supplementing the government's efforts. 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.
http://newsfrombangladesh.net/view.php?hidRecord=323601
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