The report by the International Policy Network (IPN) raises the point that until the rule of law is fully established and enforced in LDCs World Health Organization (WHO) proposals for stiffer penalties will be ineffective.
Instead of just increasing penalties the report proposes that local institutions, in particular the rule of law should be strengthened; governments should interfere less in pharma markets; and technologies for identity preservation should be used more.
The “lack of a functioning rule of law” is cited in the report as the main reason manufacturers in LDCs cannot protect the identity of their products and this is regarded as “the most fundamental cause of the spread of fake drugs”.
Strengthening the rule of law is “a long-term and uncertain process” though and consequently the report recommends that manufacturers take advantage of the technological deterrents on the market.
For the rule of law to improve government action will be required but in other areas the report recommends a hands off approach from those in power.
The report states that “existing licensing systems for pharmaceuticals in LDCs serve practically no purpose other than to restrict the sale of legitimate products manufactured by foreign companies”.
Furthermore, “many government interventions in the pharmaceutical market have restricted supplies of quality medicines, driving up prices and simply leading to gaps in the market”.
Cost of counterfeits
The report also deals with the human cost of counterfeiting, citing failure to provide effective treatment, direct harm and drug resistance as the three main problems.
Dealing with the first issue, a case of counterfeit antimalarials with an active ingredient that temporarily lowered fevers was distributed in South East Asia. This gave the impression that the malaria was being treated but provided only short-term relief.
In cases, such as the heparin contamination, where a harmful substance is substituted into the drug patients can die after taking counterfeits and others, which contain insufficient quantities of the active pharmaceutical ingredient, can result in resistance being formed.
This is of particular in LDCs, where cases of resistance to tuberculosis, malaria and HIV have been identified in recent years.
The complete report can be found here.