By Melaku Mulualem
Starting from the 1980s up to now, fake medicines are becoming serious health threat to the peoples of the world. According to the United Nations Office on Drugs and Crime (UNODC) report in 2013, “In parts of Asia, Africa and Latin America, fraudulent medicines are thought to amount to as much as 30 per cent of the market”. The World Health Organization has also stated, “Counterfeit drugs are found everywhere, but sub-Saharan Africa is particularly affected”. Lack of strong regulatory mechanisms, weaknesses in capacity, corruption of officials are good opportunities to such drug dealers in getting market to their fake products.
The spread of falsified and substandard drugs have had disastrous consequences on the healthy life of people. Even if medicines are expected to bring treatment and relief, fake drugs bring to patients suffering and death, which is a crime against humanity. Such drugs also lead to “the rise in drug-resistant strains of diseases like tuberculosis”. Unlike the underdeveloped countries the impacts of counterfeit drugs in developed countries are minimal. This is because developed countries have better mechanisms in protecting imports of fake medicines from other countries. They have also the capacity to produce their own high standard medicines.
According to researchers on the issue “the problem was first noticed by the pharmaceutical industry. They saw that their own products were being copied”. Since fake medicines are being produced with similar package and colour of genuine medicines it is very difficult to identify them easily. Let alone to ordinary persons, even medical doctors cannot recognize the fraudulent medicines. As well known counterfeit medicine fails to cure patients from their illness.
According to the World Health Organization, some medicines can also have ingredients such as chalk, and even dangerous chemicals and can be toxic that may kill persons who are in poor health. Other source also shows that “a piece of chalk or some flour or starch can be shaped into a tablet or pill”. When there is a suspect that a drug is fake, the process of checking through laboratory is slow and expensive to underdeveloped countries. It also increases the cost towards health care. In addition to fake products, expired medicines are being exported to the underdeveloped countries after repackaging them as new products. It is a pity that patients would die as a result of another person’s greed- especially the producers and “government inspectors frequently accept bribes and kickbacks to allow the fake drugs to pass borders.” This is a serious challenge to poor countries and the entire international community at large.
The Millennium Development Goals (MDGs) were adopted in the year 2000.The deadline for the achievement of these goals is set to be the year 2015. Out of eight goals three of them focused directly on health issues. These three are: reducing child mortality rates; improving maternal health; and combating HIV/AIDS, malaria and other diseases. From this point it is clear that 37.5 per cent of the MDGs cover only health issue.
On the contrary, however, some “pharmaceutical companies” are producing fake medicines that would negatively impact on the MDGs goals. It is sad to be rich at the expense of the lives of patients who are dying as a result of fake medicines. The international community should work hand in hand to counter the spread of fake medicines in the world so that poor countries can meet the target of the MDGs in health issues.
In my opinion, fake medicine is a “silent form of terrorism” in our world. As well known international terrorist groups kill innocent peoples in the world. By the same token, fake medicines manufacturers also kill innocent peoples in different parts of the world. International terrorists are violent in their action, where as “silent form of terrorism” kill peoples through non-violent action. It is common knowledge that international terrorism mostly target against the developed Western countries. However, “silent form of terrorism” is mostly targeting poor countries that have no developed mechanisms in controlling them.
In my opinion “silent form of terrorism” kills many people in the world than the violent terrorism. The World Health Organization has reported that “fake anti-malaria drugs kill 100,000 Africans a year”. Violent terrorism kills many people in one place, where as “silent form of terrorism” kill many people at different places. Both types of terrorisms are being done deliberately. The action of violent terrorists gets vast media coverage in the world. But nobody counts the death of innocent peoples as a result of fake medicine producers. Moreover the families of the victims of violent terrorists know who killed their beloved ones. On the other hand the families of the victims of the “silent form of terrorism” do not know who killed their beloved ones.
I would also like to argue that both forms of terrorism create fear among people. “Silent form of terrorism” can create fear among million patients in the underdeveloped countries. Considering the presence of 30% of fake medicine in many underdeveloped countries, it is possible to say that sooner or later patients can feel panic in buying medicine due to suspecting the quality, safety and efficacy of pharmaceutical products. The panic is in terms of a loss of confidence by the general public regarding the genuineness of the product.
The main objective of violent terrorism can be getting attention to their political, religious or other causes. However the main objective of “silent form of terrorism” is to get money. Unlike the violent terrorism, the latter do not need media coverage on their immoral acts. This multi-billion dollar illicit business has attracted many criminals to produce more fake products. In the year 2010 the UNODC estimated that “the annual market for fraudulent medicines, exported from Asia to South East Asia and Africa, was worth US$1.6 billion”. According to BBC report of October 2011 “counterfeit drugs are a $200bn industry worldwide”.
As well known there are various definitions to the word “terrorism”. In a general terms most of the definition focuses only on the violent action of terrorists against non combatant peoples in the world. For instance Encyclopedia Britannica has defined terrorism as “the systematic use of violence to create a general climate of fear in a population and thereby to bring about a particular political objective…”
I would also like to argue that the definition of terrorism should incorporate the concept of “silent form of terrorism”. This is because both forms of terrorism are killers of innocent peoples. Even if violent international terrorism is mainly targets against the Western and developed countries, both developed and underdeveloped countries are not completely free from the impact of both types of terrorism. So far governments and peoples of the underdeveloped countries are fighting against the international terrorism. In similar manner developed countries should also support the underdeveloped countries in fighting the “silent form of terrorism”.
According to various sources, “focus has been given to the health and regulatory aspect of this problem [fake medicine], it appears that less attention has been given to the issue from a criminal justice perspective”. It is unfortunate that the punishment against fake drug dealers is not strong enough to discourage criminals.
From the view of international law states have the right to punish foreign individuals based on different principles. One of the principles is called universality jurisdiction principle. This principle includes punishing foreign individuals who are involved in piracy, crime against humanity, genocide and breeches of laws of war. This is to mean that a pirate from Somalia or master minds of the Al Qaida terrorist group can be tried in any part of the world. I would also like to propose that fake medicine producers or company owners who practice “silent form of terrorism” should also be tried under the universal jurisdiction principle. This would help states to prevent, combat and control fake medicine in the world.
Fraudulent medicine is a global problem that necessitates a global solution. Identification of sources of fake medicine is a half solution to the problem. I am also witness for watching the BBC programme on this issue some years back. The programme was identified as the best story of the year. Such identification of countries that produce fake medicine will definitely help to break the chain of the market in different parts of the world. The collaboration among governments; regional, continental and international organizations and institutions as well as civil society organizations will also help in controlling the illicit manufacture and trafficking of fraudulent medicines. Such coordinated endeavour can restore trust in the medicines that keep people healthy.
Melaku Mulualem is training department head at the Ethiopian International Institute for Peace and Development (EIIPD). He can be reached at email@example.com