“Substandard and fake medicines harm and kill patients and there is an urgent need to tackle this scandal. A global treaty is needed to combat this deadly trade,” say leading experts in a paper titled “How to achieve international action on falsified and substandard medicines” published in the British Medical Journal .

The paper was submitted by an international group of experts led by Prof. Amir Attaran from the University of Ottawa in Canada in association with the World Federation of Public Health Associations, the International Pharmaceutical Federation and the International Council of Nurses.

Stating that despite years of debate no agreement on how best to tackle this scandal has been reached, Prof. Attaran speaking to The Hindu over phone from Canada said: “Progress on the twin challenges of safeguarding the quality of genuine medicine and criminalising falsified ones has been held back by controversy over intellectual property rights and confusion over terms. We believe that to move forward several challenges must first be overcome.”

Presenting that argument about how countries have to move forward to ensure that their citizens are not given fake or substandard drugs, Prof. Attaran said: “For example, anti-counterfeiting laws must shift from protecting commercial interests to protecting public health interests; there must be clear, internationally agreed definitions for different types of illegitimate medicines; and more transparent surveillance and research to measure the global scale of the problem.”

“In our paper we argue that tackling the challenges of poor quality of unsafe medicines requires a comprehensive global strategy on which all stakeholders agree,” says the author.

The paper also points out that other global treaties “have helped governments strengthen their laws and cooperate internationally to clamp down on the havens”.

The experts have urged the World Health Organisation to help governments across the world bring in policies that will “avoid unnecessary controversy and can better enable them, companies, advocates, and the health professions to protect the public’s health”.

“This appeal comes days before WHO member-States will hold their first meeting to discuss the problem and we hope that this meeting will lead to some concrete action,” said Prof. Attaran.

In poor countries, WHO estimates that over 10 per cent of medicines may be “counterfeit” and although medicine safety is better in rich countries, fake drugs still cause thousands of adverse reactions and some deaths.

“The lethal meningitis outbreak in the US due to contaminated steroid injections had highlighted the serious consequences of this global problem. Other recent examples include a heart medicine containing a toxic overdose of a malaria drug which led to 125 deaths in Pakistan, and a fake cancer medicine containing starch and acetone trafficked to Canada and the US. The extent of harm is still unknown,” said Prof. Attaran.

Editor of Monthly Index of Medical Specialities Dr. C. M. Gulati said: “There is no significant evidence of fake medicines in India and there is a difference between fake and counterfeit depending on how we choose to define counterfeit. In the Western world anything in violation of the patents held there is deemed as fake. This is a deliberate attempt to downgrade the reputation of Indian medicine.”