Advice and Information On Counterfeit Medicines Abroad

On your gap year you're going to be exposed to counterfeit medicines. That's the truth. In some countries, such as India, you can buy pretty much anything over the counter without a prescription, including class A drugs such a ketamine. In India you can even get your rabies jabs over the counter.

One of the offshoots of counterfeit medicines is drug tourism. Drug tourists often travel to places with lax laws, such as countries in Central or South East Asia, to specifically pick up prescription drugs that they wouldn't be able to get in their own country. A benefit of counterfeit medicines is saving money and obtaining drugs that would otherwise be hard to get. However, there are a number of detriments of counterfeit medicines too.

Dr Geoff Lewis carries on his series of what to look out for on your gap year and in this article he's looking at counterfeit medicines and spuriously labelled medicines...

What is counterfeit medicine?

Counterfeit medicines are quite simply medicines which are not 'what they say on the label'. They may contain the wrong drug altogether, not enough of the correct drug, a dangerous additive or dilutant, or they be mislabelled as to where they were made. In most cases the source is unknown.

They may produce problems ranging from non-effectiveness, to failure of essentials medicines (for example for diabetes or epilepsy), to incomplete treatment, or even to death.

Counterfeit medicines should not be confused with 'generic' medicines which are correctly made by other pharmaceutical companies once the original company has lost its exclusive license to manufacture them. They are mostly made abroad because of fewer regulations; up to 75% being estimated to come from India, 7% from Egypt and 6% from China.

Why do counterfeit medicines exist?

In many countries medicines are very expensive and not available through a nationalised system so families can cut costs by buying from non-regulated suppliers. The supply of properly made medicines can be limited in some countries forcing people to seek an alternative source.

Also, there is a lot of money to be made by manufacturers who can sell cheaply made counterfeit medicines as if they are the more expensive brand by falsely labelling them.

What is the extent of the problem?

Most medicines have been counterfeited at some point, from simple painkillers and antihistamines, to more important medicines for HIV, malaria, diabetes and epilepsy. Many drugs of abuse are commonly over or under diluted with a variety of unsuitable substances.

  • In China 2009, a diabetic medicine with too much active ingredient killed two and hospitalised nine others
  • In Tanzania 2009, an antimalarial was found which contained too little active ingredient to be of any help, and which may induce resistance to develop

The incidence of counterfeit medicines in the supply chain ranges from less than 1% in Europe to 30-40% in parts of Africa and it is thought that the worldwide trade in counterfeit medicines is worth around £20 billion.

Counterfeit medicines

What could go wrong?

  • If you fall ill on holiday and have no medical kit, you may be tempted to buy from a local chemist and find that the medicines do not help you or make you feel worse
  • You may have a regular medication such as an asthma inhaler which you run out of and find that the replacement doesn't work as well as the original
  • A medicine may have too much or not enough of an original ingredient, or a dangerous additive causing severe harm or even death
  • Some medicines such as antimalarials may not contain enough of the correct drug and encourage resistance in the malaria parasite, or allow you to catch malaria

These can often be counterfeit medicines; be vigilant.

How can I avoid counterfeit medicines?

Try to make sure that you have enough supplies of any regular medicines you use to last for the duration of your journey.

If you run out or need to buy emergency medicines try to use reputable and accredited pharmacies. To avoid counterfeit medicines never buy from market stalls.

Online purchases should only be done through properly accredited sites in the UK. 50% of drugs bought online from non-accredited foreign sites were found to be counterfeit medicines.

Before you travel make sure you've got an emergency pack with suitable medicines and equipment for the travelling in the area you're going to.

What is being done about this?

The World Health Organisation (WHO) has a counterfeit medicines programme which constantly monitors the problem.

Companies are working on measures to correctly identify medicines electronically through individual serial numbers on packaging and electronic tagging of boxes.

Medicines can be identified by diagnostic machinery while still in their packaging to identify counterfeits.