My name is Marie Lamy and I am conducting a doctoral study at the London School of Hygiene and Tropical Medicine.
I am researching the institutional mechanisms to regulate and prevent the availability of fake medicines in the Greater Mekong Region of Southeast Asia, comprised of Myanmar, Thailand, Lao, Cambodia, Vietnam and parts of China.
My interest in fake medicines began when I witnessed the inequalities in terms of access to healthcare in Southeast Asia. After working as a researcher on global health governance at the Lee Kuan Yew School of Public Policy and subsequently as a project officer at i+solutions, a foundation specialised in the supply chain management of essential medicines, I gained a greater understanding of global health challenges related to access to medicines.
Why the problem of fake medicines must be taken seriously
Fake medicines are a worldwide threat. The challenge of fake medicines goes beyond matters of intellectual property, as fake medicines may contain none/inadequate quantities of the active ingredient or may contain harmful ingredients. Fake medicines are therefore a genuine threat to global health.
The topic of fake medicines is very much under-researched from an institutional and governance perspective.
My project addresses the issue of fake antimalarial medicines through the lens of policy and regional governance, with a view to informing the development of more effective regional mechanisms to improve access to quality medicines. I am looking to see how countries in the Mekong Region can work together to prevent fake medicines from getting into the hands of patients.
A wide range of medicines are counterfeited worldwide – from lifestyle drugs to paediatric drugs and life-saving medicines like antimalarials, which are distributed on a wide scale and thus attract criminal groups looking to make the most profits. It is argued that 10% of all medicines worldwide are fake. This estimate rises to over 30% in developing countries including countries of the Mekong Region.
The impact of fake medicines upon the global fight against malaria
Fake medicines pose a direct challenge to the eradication of deadly infectious diseases such as malaria, in part due to the risk of antimicrobial resistance. The Mekong Region has been identified as the basin of resistance to antimalarial drugs.
A great deal of research has been done and is still underway to find new testing methods to verify the quality of medicines, and to measure the extent of the spread of resistance. Yet, more research is needed to understand the structural reasons of why fake medicines enter the market in the first place, as well as to find effective collaborative solutions to curb this trend.
The regional dimension of this problem requires particular attention
While the illicit trade of fake medicines has reached a global scale and impact, the availability and sale of fake drugs tends to be concentrated in specific regional contexts. In the Mekong Region, where there is a high mobility of labour and goods across borders, regional solutions are needed to protect the lives of innocent patients.
Fake medicines are a threat to the effective supply chain management activities that procurement, donor and recipient organisations want to avoid. It is a threat that is looming, hard to quantify due to the fact that it stems from underground criminality, and difficult to eliminate due to the trans-border nature of the challenge and the lack of regulations and enforcement measures at the national, regional and global levels.
Large medical aid agencies, central medical stores, or any stakeholder at any point of the supply chain are at risk of getting their stocks stolen or diverted. At the same time, fake medicines are threatening to enter market illegally.
The question we must ask is what effective regional regulations and policies prevent incidents like these from happening?
Nayyar GML et al. (2012). Poor-quality antimalarial drugs in Southeast Asia and sub-Saharan Africa. Lancet Infect Dis 12: 488-96.
Newton PN et al. (2006) Counterfeit anti-infective drugs. Lancet Infect Dis 6(9): 602-13.
The Lee Kuan Yew School of Public Policy is part of the National University of Singapore; not-for-profit foundation i+solutions is based in Woerden, the Netherlands.