Fake drugs causing real problems

Written by Christopher Shay and Khoun Leakhana

Monday, 24 November 2008 Phnom Penh Post

The govt's two-pronged attack on counterfeit medicines hopes to educate local pharmacists and consumers, while working with regional officials to crack down on fake suppliers Photo by: CHRISTOPHER SHAY A pharmacist at the busy Sok Serey Pharmacy near Central Market pauses for a moment before getting medicine for a customer. PHANTOM DRUGS? Chroeng Sokhan, vice director of the Department of Drugs and Food, said that two of the three "ghost manufacturers" - companies that produce fake drugs - that make the majority of the counterfeits in Cambodia are located in China. WITH a fever, an upset stomach and a splitting headache, Chheth Sokha, 52, did what she always did when she felt sick - she went to the grocery store and bought some cheap medicine. "Whenever I am sick, I always buy medicine at grocery stores because it is cheaper than at big pharmacies," she said. She bought the same medicine she had purchased the last time she was sick, but this time instead of making her feel better, the medicine landed her in the hospital. "The doctor told me that I was poisoned by the medicine. I thought by buying cheap medicines I could save money, but it was the opposite. Fake medicine cost me even more when I got worse and had to go to the hospital," she said. The medicine that Chheth Sokha bought was almost certainly counterfeit. The problem of fake medicine in Cambodia is a long-standing one, and despite efforts from the World Health Organisation, Interpol and the Cambodian government, it is a problem not easily cured. Efforts to minimise the problem have focused on enforcement and education and have seen some success. WHO estimates that around 10 percent of the drugs in Cambodia are counterfeit, a decline of about three percent since 2002. Prevalence decreasing "The prevalence of counterfeit drugs has decreased. We have done a lot of education about counterfeited items, and the items have started to disappear in the markets," said Chroeng Sokhan, the vice director at the government's Department of Drugs and Food. But he admitted that due to the global nature of the problem, there is only so much that can be done locally. "Counterfeiters have a lot of money, so they can do many things. They can adapt. It's a difficult problem to solve locally. We need Interpol support for cross-border help," he said. Counterfeiters have a lot of money so ... it is a difficult problem to solve. The government says it is working with its neighbours to decrease the number of fake drugs smuggled across borders of Southeast Asia. "We are taking measures to crack down on the illegal trafficking of fake medicine. This is being done with the cooperation of authorities in neighbouring countries," Deputy Prime Minister Sar Kheng said in a meeting last week. The other part of Cambodia's war against counterfeits is to educate Cambodians about the dangers of fake pharmaceuticals. The government as well as drug producers have focused on educating pharmacists, hoping to create a front line against the distribution of counterfeits in the Kingdom. Has Aun, a pharmacist who sells medicine near Central Market, said: "It is difficult for us to know whether a drug is fake or good because they really look the same. But we have been trained on how to detect fake drugs by the drug producers and the Ministry of Health." Sok Serey, another pharmacist, said: "The ministry's agents examine our pharmacy at least two or three times a year. They train us how to check for expired drugs and how to check the brand names of drugs." The sophistication of some of the counterfeit drugs have made it nearly impossible to tell if a drug is authentic or not. For the last five years, counterfeit malaria medicine with holograms nearly indistinguishable from the real medicine have been found in Cambodia, according to a report authored by top malaria researchers. Detection difficult Tey Sovannarith, the deputy director of the Technology Office in the Drug Quality Experimentation and Examination Department, said that when a visual inspection is inconclusive, he needs to resort to checking the melting time of the pills in order to know for sure if a drug is counterfeit. The counterfeit drug market has hurt the reputation of overseas drug companies in Cambodia, especially ones from China. Sok Serey said that her pharmacy did not carry any medicine made in China because of the danger of counterfeits. "I don't like Chinese medicine. Sometimes it works; sometimes it doesn't," she said. What can Cambodian consumers do? According to William Mfuko, the officer responsible for essential medicines at WHO in Cambodia, because of public education efforts, all Cambodians need to is "watch TV, listen to their radio and look out for posters that warn against counterfeit drugs". Most importantly, he said "they should develop habits of consulting medical professionals for their drug needs". "Self-medication is often the driving force behind counterfeit drug markets," he said. Through continued education and better enforcement, the government hopes that Cambodians will become more discerning drug consumers and will learn what Chheth Sokha had to figure out the hard way. "From now on, I will remember the doctor's advice not to use medicines which do not have clear or proper brand names," she said. "Moreover, I will be really careful taking medicine because they are double-edged swords. They are good for us only if we use them properly. But if we do not use them properly, they could kill us," she added.