There are some remarkably evil people in this world. They come in all kinds. Some would probably seem relatively ordinary or perhaps respectable (like some of the leaders of the US government). There's the recent example of the unlamented murderer al-Zarqawi, whose passing is a net plus for the world, although the reveling was more than a bit unseemly. And then there's these guys.
Counterfeit malaria drugs are increasing in number and will continue to claim lives unless more action is taken, say researchers.The percentage of over-the-counter artesunate tablets containing no active ingredient increased from 38% to 52% in mainland Southeast Asia between 1999 and 2004, says Paul Newton at the University of Oxford, UK, whose team has been analysing the problem.
[snip]
Evidence suggests that criminals are using production on an industrial scale to make the counterfeit drugs. Newton says that one large pharmacy, for example, inadvertently sold 100,000 counterfeit artesunate tablets.
"We make no apology for the use of the term manslaughter to describe this lethal criminal trade. Indeed, some might call it murder," says Newton, in a policy analysis published this week in PLoS Medicine.
"The criminals are making these fakes in the full knowledge that their ineffective product might kill people who would otherwise survive their malaria infection."Newton points to the case of a 23-year-old Burmese man who died in February 2005 after being diagnosed with a straightforward case of malaria. Doctors prescribed him tablets thought to contain artesunate, but later tests revealed the medication as counterfeit.
A further investigation showed that the hospital's entire stock of the drug, which it had purchased in good faith, was fake. (New Scientist)
One of the makers of genuine artesunate, Guilin Pharmaceutical Company, Ltd., started to put special hologram labels on its products to distinguish them from the fakes. Shortly thereafter counterfeit holograms adorned the fake tablets (you can see an example of a counterfeit hologram here). More details on the counterfeit drug problem can be found in an informative article by Cockburn, Newton, et al. in Public Library of Science (PLoS).
Is this really murder? Yes.
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Lest readers think this is a third-world problem: "In North America, counterfeit atorvastatin [41], erythropoietin [41], growth hormone [33], filgrastim [33,41], gemcitabine [36,37], and paclitaxel [36,37] have been reported recently." from the PLoS article. The first drug, atorvastatin, is the best-selling cholesterol drug Lipitor. Erythropoetin (Epogen), and figastrim (Neupogen) are products used to treat anemia, blood disorders, and side-effects from chemotherapy. Gemcitabine (Gemzar) and paclitaxel (Taxol) are used to treat cancer.
Not very nice people.
I think it was last Sunday that NBC aired a long segment on this problem, which probably included the dreaded John Stossel. The mind can only boggle at the likely counterfeiting going on with tamiflu and what will likely happen if things gets worse. Revere, you've said several times that tamiflu is good for prophylaxis, and I agree with that. What I disagree with is that most health authorities have set the dosage too low ... about 75 mg daily. That's a waiting scenario for H5N1 developing resistance, should it spread and become more infectious. Counterfeit tamiflu could only make that situation worse.
Hell, there was a pharmacist in the midwest who was diluting chemo infusions by 90%. There's big bucks in that.
On the other hand, there are quite a few drugs, big sellers, that are better counterfeit than real. I would put antidepressants in that category for most people who receive them, along with amphetamines for kids who don't sit still in class.
Marissa: I am guessing (aren't we all!) that you are right about the Tamiflu prophylaxis dose. And if you bump it up to 150 then you also increase side effects. No free lunch.
Cervantes: LOL (but wryly). These guys are the Don Rumsfelds of the drug world. Some of the graft is more harmful than others. The Rumsfelds are at the top. Plenty of other defense conract grafters further down.
What I find baffling is that some counterfeiters apparently put at least some correct active ingredients in their drugs. Why would they bother to do that if all they're out for is the money? This is not a rhetorical question; I'd be interested in answers.
annodeus: Don't know the answer but I would speculate that there are all sorts of degrees of dishonesty. Bad doctors cut corners but also deliver some medical care, just substandard care.
annodeus - I looked at the example of the fake hologram (link in main post) and it mentioned that some of the fake drugs have traces of the active ingredient so that they'll test positive on one of the quick tests that are mention to discern counterfeit drugs. It's amazing how clever the counterfeiters get.
In other news, over on FluWiki the Reveres are still being accused of promoting genocide. It's kind of funny to see a dead horse beaten for so long.
Also, please excuse the horrible grammar. Should have been: "...so that they're test positive used on one of the quick tests designed to discern counterfeit drugs."
I would have liked a warning that the link to the counterfeit images was a .pdf.
Does anyone have a building they need demolished? I'm so angry the steam coming out of my ears could do the job on the cheap.
Lisa: I generally do warn readers and I apologize for the lapse. I'll try not to let it happen again.
I certainly agree with you about how evil this is, but I'd include manufacturers of homeopathic products in that category - as well as a lot of naturopathic ones.
Lisa: If you're using Firefox, there's an extension called target alert that you might find useful. (And no, I have no affiliation with them beyond 'user'.)
The real crime is that Viagra I bought over the internet turned out to be impotent...
jw: Too bad. Mine works fine. Except I took it with my iron pills and now I just point north all the time.
Fake anti-malarials made of in the form of common drugs like Artesunate are truely shocked. In relatively well-off Afircan countries like Nigeria, Malaria is something you are essentially gaurenetted to get at least once in your life. All you do is go to the pharmacists, get a quick blood test, and you are given an antiparasitic. This isn't like fake viagra, this is people who should almost certainly survive, being killed directly buy greed.
We know the fake Tamiflu's as well.
Sometimes they catch the murderers of malice prepense.
http://www.nytimes.com/2006/08/31/world/asia/31briefs-006.html?_r=1&ore…
Somewhere, Harry Lime is laughing.
(Hint: IMDb.)
Counterfeit birth control pills usually have a bit of the hormone so you feel like they're working but not enough to actually stop ovulation. There are times when the human race just enrages me.
Tests on internet viagra showed that they were mostly floor sweepings and mold.
"there are quite a few drugs, big sellers, that are better counterfeit than real. I would put antidepressants in that category for most people who receive them"
I take it you mean people not diagnosed with clinical depression, which is a very real and very dangerous mental disorder...