Counterfeit medicines are part of the broader phenomenon of substandard pharmaceuticals – medicines manufactured below established standards of quality and therefore dangerous to patients’ health and ineffective for the treatment of diseases. The difference is that counterfeits are deliberately and fraudulently mislabeled with respect to identity or source. Counterfeiting occurs both with branded and generic products and counterfeit medicines may include products with the correct ingredients but fake packaging, with the wrong ingredients, without active ingredients or with insufficient active ingredients.

Counterfeit medicines range from random mixtures of harmful toxic substances to inactive, useless preparations. Occasionally, there can be “high quality” fakes that do contain the declared active ingredient. In all cases, contents of counterfeits are unreliable because their source is unknown or vague and always illegal. Fake drugs can cause harm to patients and sometimes lead to death.

Any kind of product can be and has been counterfeited: expensive lifestyle and anti-cancer medicines, antibiotics, medicines for hypertension and cholesterol lowering drugs, hormones, steroids and inexpensive generic versions of simple pain killers and antihistamines. In developing countries the most disturbing issue is the common availability of counterfeited medicines for the treatment of life-threatening conditions such as malaria, tuberculosis and HIV/AIDS.

FIP is the global federation of national associations of pharmacists and pharmaceutical scientists, and is a non-governmental organization in official relations with the World Health Organization. Through its 132 member organizations, it represents over three million practitioners and scientists around the world.

The federation has been actively engaged in combating the threat fake medicines pose to public health for over 20 years. As increasing globalization augments the risk of fake medicines in each country, pharmacists are critical to ensuring patients receive genuine treatments.

“Our focus on counterfeit medicines is driven by our commitment to protect patient safety when using medicines. We continue our activities in advocacy, support of local activities and providing technical expertise on the issue, and through leadership, special projects such as the .pharmacy web domain, and collaborations such as Fight the Fakes,” said Luc Besançon, FIP CEO and general secretary.

Fight the Fakes is the latest of FIP’s collaborations. “The answers to the threat of counterfeit medicines cannot be solved by only one group or profession. A coalition of concerned parties is needed to ensure that solutions are implemented. Solutions to counterfeit medicines imply a series of measures — no single measure can by itself solve the problem,” Mr Besançon said.

International Collaboration against Counterfeit Medicine

In 2003 the Council of Europe established an ad hoc group to fight counterfeit medicines and, since 2004, FIP has worked within this group. In 2008, the group became the Committee of Experts on Minimising Public Health Risks posed by Counterfeiting Medical Products and Related Crimes. In 2006, the World Health Organization established an international medical products anti-counterfeiting taskforce, IMPACT, which was a voluntary grouping of governments, organisations, institutions, agencies and associations from developing and developed countries aimed at sharing expertise, identifying problems, seeking solutions, coordinating activities and working towards the common goal of fighting counterfeit medical products. IMPACT aimed to ensure appropriate regional representation, including from developing countries. FIP developed a framework for communication and also contributed to a practical handbook. This project has now been completed.

Since the inception of IMPACT, FIP represented the World Health Professions Alliance (WHPA), leading its Working Group on Communications. A series of advocacy activities, including the development of materials, such as a WHPA toolkit on counterfeit medicines for health professionals and patients, have been undertaken.

In 2014, FIP became an official partner of Fight the Fakes. This is a campaign that aims to raise awareness about the dangers of counterfeit medicines through giving a voice to those who have been personally impacted by counterfeit medicines and sharing the stories of those working to put a stop to this threat to public health.

There is an official website for Fight the Fakes in which certified educational data is released to inform public about counterfeit medicines. It designed to raise awareness about the risk or jeopardy of counterfeit medicines.

Facts about fake medicine:

-UNODC (United Nations Office on Drugs and Crime) estimates the market value of fake anti malarials at over US$ 400 million in West Africa alone.  -Both branded and generic products are subject to counterfeiting. -Every therapeutic class of pharmaceutical product has been the subject of counterfeiting. -Fake medicines could be to 15% of medicines in circulation worldwide. -1 out of 4 counterfeit products intercepted by EU customs in 2011 were fake meds. -700,000 people die because of fake meds to treat malaria and TB each year. -Fake medicines can contain no active ingredients at all, so they are a direct threat to patients that need treatment.   -123 countries are impacted by fake meds so far. -95% of online pharmacies operate illegally. -Up to 30% of medicines in developing countries are fake meds. -The US based Centre for Medicines in the Public Interest predicts that counterfeit drug sales will reach US$ 75 billion globally in 2010, an increase of more than 90% from 2005. -1 medicine in 2 purchased on Internet sites that conceal their physical address is a fake med.

A checklist designed to help health professionals carry out a visual inspection of medicines for signs of counterfeiting, such as improper packaging, labeling or description of dose, has been produced by the International Council of Nurses in partnership with the United States Pharmacopoeia and modified by FIP’s Military and Emergency Pharmacists Section.

Dr. Shima Naghavi, Director of International Affairs

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