Recent examples of fake drugs include neomycin eye drops and meningococcal vaccine made of tap water; paracetamol syrup made of industrial solvent; and contraceptive pills made of wheat flour. Some counterfeit drugs even contain actively harmful ingredients, not just bogus placebos.
Death and illness arising from this murderous trade are considerable, especially in developing countries, say the authors. Guidelines have been produced, but most developing countries do not have the infrastructure and financial resources to implement them. In the past, drug companies have tended to avoid publicising the problem for fear of damaging public confidence in medicines. Some countries, well aware of the scale of their problem, have preferred to ignore it, they add.
Much of the counterfeit drug trade is probably linked to organised crime, corruption, the narcotics trade, unregulated pharmaceutical companies, and the business interests of unscrupulous politicians, say the authors. Much greater international political will to eliminate the problem is required, they conclude.