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The Drug Industry’s Poison Pills

BOSTON – One does not need to spend a lifetime in the global health-care sector to appreciate that substandard or counterfeit drugs are a major public-health hazard. These bogus products have infiltrated pharmaceutical supply chains from Azerbaijan to Zambia, wrecking the most promising programs to control, manage, and eradicate deadly diseases. Yet little is being done to stop this criminal activity.

Growing up in Pakistan, I realized how vital it was for my mother, like any educated parent, to know which drugs and pharmacies could be trusted. Little has changed since then. Local pharmacists from Lahore to Lusaka continue to sell a variety of brands of the same drug at different prices; and shopkeepers are called upon to give a candid opinion of their benefits and shortcomings.

Unfortunately, the problem runs a lot deeper than a few bad drugs sold at the corner pharmacy. Around $75 billion of substandard drugs are sold annually, causing an estimated 100,000 deaths worldwide, and making many more people seriously ill. The trade in inferior drugs also undermines fragile public-health systems in poor countries. As well as killing consumers, the effects of bad drugs can be passed from parent to child, and even create new drug-resistant strains of diseases that threaten us all.

Yet the fight against substandard drugs has never been taken as seriously as other global health crises such as malaria, HIV, or maternal and infant mortality. This may be because there is no obvious solution.