| Probe |
june-july, 2020 | The Health
15
What is in your fake drug?
The World Health Organisation (WHO) groups counterfeit medicines into six
categories
• Products without any active pharmaceutical ingredients.
For example, sugar pills, which are regularly used as placebos in clinical trials.
• Products with incorrect quantities of active pharmaceutical ingredients.
This can be too much, which could cause serious side effects, or too little, which
does not cure the illness.
• Products with the wrong pharmaceutical ingredients.
For example, in 2008, 150 people in Singapore were hospitalized for taking a
counterfeit erectile dysfunction drug that contained the diabetes drug glyburide
• Products with correct quantities of active pharmaceutical ingredients but with
fake packaging.
For example, traditional medicine sold as ubat kuat lelaki that contains the
erectile dysfunction drug sildenafil.
• Copies of an original product.
An identical drug that is not made by the original or licensed manufacturer.
• Products with high levels of impurities and contaminants.
For example:
– Pesticides – Heavy metals
– Arsenic – Chalk
– Plaster – Brick dust
– Printer ink – Leaded highway paint
– Floor wax
Sources: WHO & Pfizer
medicines are related to sexual stimulants,
slimming and beauty treatment drugs,”
said the president of Fomca.
How rampant is the fake
medicine trade?
According to the World Health
Organisation (WHO) estimates, 10 per cent
of the global pharmaceutical commerce
worth US$21 billion involved counterfeit
drugs.
The United Nations Office on Drugs and
Crime (UNODC) said the sale of fraudulent
medicines from East Asia and the Pacific to
Southeast Asia and Africa alone amounted
to some US$5 billion per year.
The common medicines targetted
for counterfeiting included various
chemotherapeutic drugs, antibiotics,
vaccines, erectile dysfunction drugs,
weight loss aids, hormones, analgesics,
steroids, antihistamines, antivirals and
anti-anxiety medication.
In August 2019, community pharmacist
and part-time blogger Zeff Tan warned in a
Facebook post on counterfeit Panadol that
the subtle differences between the fake
and real Panadol were not detectable to the
untrained eye.
There are some consumers who are
unaware of the issues of counterfeit
products in the market. Some over-thecounter
medicines are easily accessible
from street vendors , sundry shops and
on-line sellers where the origin of the
products may remain unknown.
"It’s not surprising that there will be
imitation products for some very famous
over-the-counter medicines such as fever
medicines and traditional cough syrups .
"For some sellers, they might be also
unaware which company is the actual
appointed distributor of the product and
may “accidentally” source the product
from an unofficial source," said Tan.
Most of the unregistered medicines
found in the Malaysian market are
traditional medicines.
“It means the particular medicines did
not go through all the stringent evaluation
and registration processes as stipulated
under the law. Hence, its safety, quality
and effectiveness were never evaluated
or tested,“ explained Datin Dr Faridah
Aryani Md Yusof, Senior Director of
Pharmaceutical Services, MoH.
Tests have shown most alternative
traditional or herbal medications have
active pharmaceutical ingredients in its
contents. And they are most likely to be
manufactured with unregulated quantity,
which could harm the body.
The WHO Western Pacific meeting
report published in 2001 estimated the
Malaysian traditional medicine market
was worth RM2 billion.
The increasing development and
production of the traditional and herbal
medications provide a platform for the
unregistered drugs industry to adulterate
these particular products with poison to
increase its efficacy.
Meanwhile, the emergence of the
internet opens up another can of worms.
Online e-commerce sites boost the
distribution of fake medicine worldwide
more rapidly as the WHO suggests that
the internet provides a key route for
counterfeit drugs to appear on the market.
Counterfeiters target specific consumers
by identifying the market needs and
demands of different regions perfectly.
Lifestyle medicines, such as weight loss
aids, anti-ageing products and steroids are
more in-demand in developed countries‘
market. Life-saving drugs, which are
used to treat serious diseases, such as
HIV, Malaria and Tuberculosis, are more
oriented towards less developed countries.
When quality of
medicines matter
Some people may think that consuming
fake medicines may render treatment
ineffective and prolong the sickness. But the
truth is such fakes may be contaminated
with toxic and poisonous substances and
cause deaths.
The World Health Organisation (WHO)
has stressed that medicines, including
vaccines, save lives and prevent diseases and
epidemics only if they are safe, efficient, of
good quality and used rationally.
The main concern of the prevalence of
counterfeit and substandard medicines is
dangerous health consequences.
Development of drug resistance is another
adverse repercussion on the rise. Common
diseases could become incurable with
standard treatments, thus increasing the
morbidity and mortality rate of the global
population.
Apart from the health consequences, it
also jeopardises the public confidence in drug
regulatory authorities, healthcare system
and professionals, suppliers and dealers as
well as pharmaceutical companies.
It cannot be denied that consumers
sometimes look to pricing and opt for the
cheaper products, which in all likelihood are
fake.
Malaysian Medical Association (MMA)
President Dr N Ganabaskaran said it
could be dangerous if consumers have a
habit of looking for cheap sources while
compromising safety, efficacy and
quality.
“This is something that we consume that
can be very harmful to our loved ones and
us.”
Duopharma Biotech Berhad Group MD
Leonard Ariff Abdul Shatar said the most
severe damage would be the loss of the
public’s confidence and trust in the company.
And possibly the pharmaceutical industry,
which may lead to clients switching to other
brands or stop buying the product altogether.
“This is why the measures taken by
the Ministry of Health (MoH) and other
enforcement agencies is important to ensure
that the issue is nipped in the bud,” he said.
Senior Director of Pharmaceutical
Services Datin Dr Faridah Aryani Md Yusof
said it was essential to understand that
unregistered medicines do not mean the
medication is counterfeit or fake medicines.
“It is just that the particular medicines did
not go through all the stringent evaluation
and registration processes as stipulated in
the law.”
Education also seems to be a vital issue.
Malaysian Pharmaceutical Society president
Amrahi Buang said society had always been
educating the public to get their medicines
from community pharmacists.
”MPS has also made known to the public
about the new hologram for registered
products in Malaysia called Farmatag.”
Federation of Malaysian Consumers
Associations (Fomca) President Datuk Dr
Paul Selvaraj agreed.
“Consumer education is needed to create
awareness of genuine and fake medicines.
There are not enough campaigns to warn
of the dangers of counterfeit drugs and
medicines.”
Community pharmacist and parttime
blogger Zeff Tan said some product
packaging are printed with fake registration
numbers when in fact they are not.
“Purchase only from trusted and
reputable pharmacies or healthcare stories,”
he advised.