Before a drug is deemed suitable for human use it has to undergo rigorous testing, which can take up to 12 years. However, counterfeit and poor-quality medicines have surged the global pharmaceutical market and are thought to be responsible for the deaths of over 250,000 children each year.  

Many falsified medicines include anti-malaria drugs, cancer drugs and antimicrobials, exposure to which can cause drug resistance in certain cases.

The American Journal of Tropical Medicine and Hygiene stated that falsified and substandard medicines now make up ten percent of all medicines in developing countries.

The producers of counterfeit drugs target low and middle income countries, usually with high medicine demand and absence of effective systems for pharmaceutical regulation and governance.  

Many of these developing countries lack the technology and policies needed to fight against this counterfeit infiltration. Weakness in drug quality assurance protocol will ultimately jeopardise a country’s ability to protect patients from substandard products and cause distrust in the health system.

This surge, with an estimated economic cost of up to US $200 bn, is thought to have been fuelled by the increase in global internet access and rise in online pharmacies.  

The Centre for Safe Internet Pharmacies (CSIP) stated in 2016 that there were up to 35,000 illicit online pharmacies, 96 percent of which failed to adhere to legal requirements. Online pharmacies and IT companies have been identified in fuelling the current US opioid epidemic, responsible for up to 130 deaths every day.

Many organisations are striving to address this global crisis with the key players including: WHO, UN Office of Drugs and Crime, and INTERPOL. All working to aid in the surveillance, control and criminal justice tied to the fake drug trade.

INTERPOL’s Operation Pangea has seized tens of thousands of fake drug products but the threat from the internet still requires a system for prohibition. Research suggests there is a need for organisations, like INTERPOL, to cooperate and share their data with each other in order to combat this issue.

There is a growing threat that terrorist organisations play within the pharmaceutical industry and a ‘war through pharmaceuticals’ which ‘current international framework is ill-equipped to proactively handle’, according to the Case Western Reserve Journal of International Law.

Urgent international effort, as well as development in low-cost quality assurance and digital technology that allows manufacturer-to-patient security, is required to actively combat this growing issue, where life-saving medicine turns life-threatening.


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