Low cost, low quality, high risk

The National (UAE)
May 29, 2008

It is an illegal trade that could soon be more lucrative than dealing in narcotics and is fast becoming one of the Government’s most serious concerns. They look and feel like typical medicines but counterfeit medicines landing on some pharmacy shelves can be ineffective or even dangerous.

The Ministry of Justice and various health bodies are finalising proposals for a new law that will see the maximum penalties for those caught making or selling counterfeit drugs increase by as much as ten-fold.

The fake medicines often make their way into pharmacies because agents offer them at a much lower price, said Dr Mohammed Abuelkhair, the head of the drug-control department at the Health Authority Abu Dhabi (HAAD).

“We need pharmacies to buy their products only from registered sellers,” said Dr Abuelkhair, who was a pharmacist for more than 25 years. “They may be making more money by buying cheaper fakes, but the punishments will be very harsh if they are caught.

“It is not worth it for them. Their pharmacy may be closed and their licence could be at risk.”

In December, HAAD helped to produce a declaration calling for a national action plan.

The declaration recommended the “standardisation of regulations addressing counterfeiting of medicines, and extending its scope to cover all the products, even if not intended for treatment and prevention of diseases, including health and medical equipments”.

It also called for tougher penalties to be imposed for violations of these recommendations, and suggested a committee should be formed with representatives from the Ministries of Health, Economy and Justice, local health authorities, customs, police, general municipalities and food control authorities.

A lot of the counterfeit medicines that ended up on UAE shelves, or passed through the country, were traced back to India or China and were often made in “dirty old warehouses”, Dr Abuelkhair said.

Experts say counterfeiters are becoming more and more sophisticated, which is why tougher regulations need to be brought in.

Some have equipped themselves with the same machinery as the genuine pharmaceutical manufacturers. Without performing laboratory tests, it takes an expert eye to spot some of the replica drugs because every last detail, including holograms, has often been copied.

The production of counterfeit medicines has increased so much that the World Health Organisation now has a steering group of organisations called the International Medical Products Anti-Counterfeiting task force. Its mandate is to establish the most reliable, specific and sensitive ways to detect fake products.

The US Center for Medicine in the Public Interest recently predicted that global counterfeit drug sales would reach US$75 billion (Dh275bn) within two years.

The internet also poses a huge threat. It is estimated that more than 70 per cent of Viagra sold online is fake.

Dr Moutaz Zakkar, an inspector at HAAD who is trained to find counterfeits, said it could be a minute detail such as the print quality of the instruction leaflet that was the only giveaway.

“Some are very easy to find, others are very difficult,” he said.

“Counterfeiters are now targeting high-value, high-demand medicines. They want to make a lot of money.

“The penalties do not match the crime in a lot of places around the world. This is why the new law is being drafted. Dh10,000 is nothing to some criminals.

“But counterfeiting is a complicated thing. It does not just have to be fake medicines. It can be medicines that do not correctly list the ingredients.”

A recent example was Phytoshape, a popular slimming drug that claimed to be a herbal product. It was licensed and sold legally in large quantities.

However, tests showed it contained sibutramine, a non-herbal ingredient found in Reductil, a powerful prescription-only anti-obesity drug, and it was removed from the market.

Other products HAAD has investigated include Viagra fakes, medicines with unsafe levels of mercury, hormone treatments and birth-control methods.

Last summer, in one of the largest hauls in the region, Dubai customs officers recovered five million tablets, including a Viagra-style pill and sedatives, worth Dh20 million, from a warehouse.

Saeed al Marri, the deputy director general of the Federal Customs Authority, said: “We need co-operation between different departments, like customs and the Ministry of Health. We are in touch with the ministry and local customs department and, whenever we find something, we act straight away.

“Sometimes you can tell the difference between the counterfeit and the real thing, but other times you cannot.

“Sometimes, the medicines are just passing through the country and confiscating the goods is very complicated. We have to watch the ports and airports closely.”

HAAD is also in the process of setting up a quality control laboratory to test drugs quickly and efficiently. Work is expected to start by the end of the year.

The authority urges people to contact the Poison and Drug Information Centre on 800 424 if they suspect a medicine is counterfeit.

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