Murder by fake drugs

BMJ 2002; 324 doi: http://dx.doi.org/10.1136/bmj.324.7341.800 (Published 6 April 2002)
Cite this as: BMJ 2002;324:800

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Time for international action

  1. Paul N Newton, clinical lecturer (newtonpaul100@hotmail.com),
  2. Nicholas J White, professor of tropical medicine (fnnjw@diamond.mahidol.ac.th),
  3. Jan A Rozendaal, malaria control adviser,
  4. Michael D Green, chemist
  1. Centre for Tropical Medicine and Infectious Disease, Nuffield Department of Clinical Medicine, Oxford University, Oxford OX3 9DU
  2. Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
  3. Asian Development Bank - Intensified Communicable Disease Control Project, Ministry of Health, Jakarta, Indonesia
  4. Division of Parasitic Diseases, Center for Disease Control and Prevention, Atlanta, GA 30333, USA

    Until recently the most infamous internationally known example of fake drug dealing was Graham Greene's fictional account of a British fake penicillin peddler who was eliminated in the sewers of postwar Vienna in The Third Man.1 Unfortunately, malevolent dealings in counterfeit drugs are very much a contemporary reality. Notorious recent real examples include neomycin eye drops and meningococcal vaccine made of tap water; paracetamol syrup made of industrial solvent; ampicillin consisting of turmeric; contraceptive pills made of wheat flour; and antimalarials, antibiotics, and snake antivenom containing no active ingredients.2 3 4 5 6 7 8 9

    In a recent survey of pharmacies in the Philippines, 8% of drugs bought were fake (quoted by Wondemagegnehu2). A countrywide survey in Cambodia in 1999 showed that 60% of 133 drug vendors sampled sold, as the antimalarial mefloquine, tablets that contained the ineffective but much cheaper sulphadoxine-pyrimethamine, obtained from stocks that should have been destroyed, or fakes that contained no drug at all. 3 4 In another recent survey, 38% of tablets sold in five countries in mainland South East Asia as the new antimalarial artesunate were fake.5 Artesunate is …

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