Dear Mark and Richard,
I agree that the topic of counterfeit drugs is a most interesting one and
with its adverse effect on health should be addressed even more aggressively
than what is done at present. And as you rightly points out, Richard, it
should probably be divided they way you mentions. Since the time I worked in
Botswana, 1985-88 and experienced receiving drugs which might have been
deliberately substandard, it has been an area I have tried to follow. In
Botswana we had at that time no quality control facilities and it was by
coincidence that we discovered empty rifampicin capsules coming from Helm in
Germany. We also had many other problems with that company which I will not
list here.
Recently, I spent six weeks in Mongolia where they have quality control
facilities and have tried to control donations and all other import.
Although import is only allowed by the state wholesaler, many people arrive
at the border with drugs which are, when discovered by the custom, analysed.
I have no complete picture of what has happened and is happening as this was
not part of my TORs, but I was told by the chief inspector that the number
of substandard drugs found is increasing and they have recently had many
cases of substandard drugs (too little of the active ingredient) coming from
Vietnam. He said it was drugs having been donated to Vietnam then brought
into Mongolia via the Vietnamese embassy, thus avoiding customs.
Unfortunately I was only told this the last week, and had no chance to check
the manufacturer. So unfortunately I do not know if it is from Vietnam or
another country, but will try to find out later. The drugs mentioned were
biseptoli (cotrimoxazole), penicillin V and paracetamol. They have been very
careful in controlling donations, but in the early phases they received some
substandard donations made in Taiwan. As for donations, they say some drugs
arrive in "subquantity" i.e. boxes contain less than the stated number of
tablets. May be that's another way of conterfeiting? Companies mentioned
were Helm and Rivopharm.
To sum up I think there is a major problem and probably an increasing one of
substandard drugs containing less than the stated amount of active
ingredient. This can probably only be solved by improved quality control on
the recipient side which is easy to say but not so easy to solve except in
the former Soviet Union republics where at least they have the necessary
manpower and facilities. What they need is some retraining, awareness and
modern equipment.=20
Kirsten
Ms Kirsten Myhr
Bygd=F8y Alle 58B
0265 Oslo
Norway
Tel: +47 22 56 05 85 (h)
Fax: +47 22 24 90 17 (w) Tel: +47 22 24 90 12 (w)
E-mail: myhr@online.no