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‘Rx or in the name of God!’ – that is what doctors have taken to writing on patients’ prescriptions. Sardonically, a patient does need all the blessings he can manage, for both the government and the judicial system have so far been unable to ensure that the medicine a patient pops is a genuine healer and not a fake. Drug counterfeiting has grown in scale and capabilities over the years. A counterfeit drug is a medication which is produced and sold with the intention of deceptively representing its original, authenticity or effectiveness. The common street term for counterfeit drug is “beat bag” or “bunk bag”.

Anyone, anywhere in the world can come across medicines seemingly packaged in the right way, in the form of tablets or capsules that look right, but which do not contain the correct ingredients and, in the worst case scenario – may be filled with highly toxic substances. In some countries, this is a rare occurrence, in others, it is an everyday reality. Modern medicines have increased life expectancy, revolutionized the way doctors treat patients and for many have improved the quality of life. Pharmaceuticals are a $150 billion business. And thanks to tawdry facets of the human mind, the fake drugs industry takes up the rear with a flourishing $50 billion turnover. With such credentials, the modern definition of medicines must read – the potentially curative and the cryptically lethal.

Imagine the outcry if a thousand odd people in a developed country such as the US or the UK died after being administered fake medicines. Then consider that in the year 2000, a similar number of infants died of kidney failure in India and Bangladesh after taking “industrial solvent” guised as “paracetamol syrup”. In 2003, seven children in Nigeria died after “water” instead of “adrenalin” was injected into them to restart their hearts. In 2004, toxic counterfeits of “iron injections” led to a death trail in Argentina. In 2005, one hundred HIV patients succumbed to AIDS after being unwittingly administered with a drug to prevent the disease. These deaths represent just a few documented cases of a trade in illicit pharmaceuticals that claims countless lives every year.

Contraceptive pills made of flour, animal medicines “redesigned” for human use, capsules filled with yellow paint, syrup bottles filled with furniture polish, eye drops made of tap water. The gross simplicity of these pernicious deceptions would make any sane human reflect upon 2 things – Firstly, the petty value of life and secondly, the Dante’s Inferno. With household inputs as capital and ease of production, there is much water in the WHO’s belief that the manufacture of fake medicines is largely a cottage industry, with most production taking place in a family’s backyard rather than in cold warehouses. The most grotesque picture of family life one has seen in years.

Fake medicines pose an international health emergency. The International Narcotics Control Board (the UN Drugs watchdog) has sent out a warning that 70% of prescription medicines in developing and 40% in developed countries are counterfeit. India is the 2nd largest phoney medicines exporter to the EU and the US with 35% of the total fake drugs seized. Although it has forfeited the 1st position it held in 2006 to Switzerland – the statistics may not give India much reason to cheer. Seventy five percent of fake drugs supplied world over have origins in India, followed by seven from Egypt and six percent from China. In addition to the motif, four Indians have been found guilty of masterminding a multi-million Euro-global racket of selling counterfeit Viagra over the Internet after procuring them from India and China.

The biggest counterfeit drugs bust in the British History – a stigma to the country. India has eventually evolved as the hub of fake drug manufacturing. The lucrative (Rs. 4,000 crore) industry is even attracting illegal drug manufacturers because of the low penalties and huge profits of over 200%. Owing to the lack of export regulation and the blessing of Globalisation and reduced trade barriers – India ensures that patients everywhere are now potentially at risk. The country appears to be demanding pay-off for its lost battles against colonialism. But in this era of intellectual agility, one could have expected the uncouth crusaders to do better than that. New Delhi is the hub of the thriving fake drugs market. According to Intelligence sources, a large number of “tourists” from Uzbekistan, Russia and other CIS countries visit India, take up accommodation in “tourist hotels” in the congested Paharganj and Karol bagh areas, only to return with fake drugs which are now flooding the international markets. Investigations have revealed that Bhagirath Palace is the nerve centre of the fake drug business in Delhi, which accumulates counterfeits produced in Ghaziabad, Noida, Aligarh, Bhiwadi, Ballabhgarg, Sonepat, Hisar, Punjab, Andhra Pradesh, Orissa and Madhya Pradesh. With such activities prolific in the heart of the country’s democracy, the irony is not lost.

Corollary, one can’t help but applaud the well-oiled links of the lethal trade, fuelled by lack of deterrent legislations. Fake medicines are an open secret today. And yet, no one can be sure of how many fake drugs are sold. The pharmaceutical industry first raised the alarm 20 years ago, but law enforcement agencies, governments and charities that donate medicines have paid scant attention – as have researchers. Alarmingly, just 60 academic papers have been published on fake drugs, only five of which have used scientifically acceptable methods. What’s more, a survey conducted in India revealed that 2 out of 3 pharmacists and 4 out of 5 consumers didn’t even realise fake drugs existed. Along with measures to subsidise genuine, quality-assured drugs and uncompromising policies – the call of the hour is some big-time “ethical polishing” and “moral awakening”.

Counterfeit drugs are murder. They are the highest form of terrorism against public health because they kill a mass. Deaths due to counterfeit drugs are neither documented issues nor local newspaper tit-bits. They are blatant signals that at the moment, the counterfeiters are winning and they can steal our lives any second. It’s not a game of blind man’s buff; it’s a pest permeating morbidity. Slay it. Else tune yourself to think twice before popping a pill ….if not quacks then spurious drugs will kill you.

Bhavna Triphathy

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