According to a recent World Health Organisation (WHO) report, one in ten medicines majorly in middle and low-income countries is sub-standard.
The words Substandard, counterfeit or falsified medicines mean that the medicines may be expired, contaminated or have substituted or inappropriate quantities of active ingredients, or comes with misleading packaging and labels.
The most common counterfeit drugs are antimalarials, cough syrups, pain-killers, birth control pills and antibiotics. The share of counterfeits seized in the European Union suggests that these drugs are mainly sourced from India, China and the UAE. The market share of counterfeit drugs is expected to increase by 30% in Asia, Africa and Latin America.
According to a WHO factsheet, counterfeit drugs easily reach developing nations because of poor governance, technical incapacities and access to quality pharmaceuticals.
India being the world’s largest producer of generic drugs, it is a key player in counterfeit pharmaceutical manufacturing. A few years back, an incident broke out in Paraguay and Pakistan concerning an illness due to consumption of a cough syrup.
After extensive research, it was found out that the syrup’s active ingredient, Dextromethorphan, was imported from India and contaminated with levomethorphan, a drug five times stronger than morphine. Since its molecular formula was the same as dextromethorphan, it was difficult to detect.
The report further puts light on how complex supply chains could be an obstacle to ensuring quality control. For example, a tablet taken in Germany may be made in Egypt and ingredients may be imported from India, Brazil and Spain, packaged in foil that came from China, inserted into a box designed for the United Kingdom of Great Britain and Northern Ireland, and shipped to Liverpool by way of Dubai.
Another example is when an Indian company came in the spotlight when an individual suffering from HIV in Africa was given mouldy tablets by an NGO. On investigation, it was observed that the medicine was genuine but the packaging was not. The tablets were bought by an American organisation and shipped to a foundation in East Africa for charity, which had unexpectedly repackaged the anti-retroviral to show false expiry dates. This foundation then diverted sale through a string of companies, one of which resold the medicine to NGOs that gave the drugs for free.
There are many other incidents and cases in the WHO report.
With counterfeit drugs taking lives of many and putting the others in danger, it is important for India to fix the loopholes in the supply chain and bring transparency in the distribution of pharmaceutical products.