- A death sentence
A young woman struggled with her weight for years and became so ashamed of her body that she was afraid to leave her home. Desperate for a solution, she searched the Internet for weight loss drugs and stumbled upon an illicit fat-burning drug, which she ordered. When the yellow tablets arrived, she immediately took some of them, but they sent her heart rate racing and her temperature soaring. The following day her mother found her feverish and sweating in a cold bath, desperately trying to cool down. She was rushed to hospital, but eight hours later she had a fatal heart attack. This young woman’s life was cruelly snatched away, all because she was so desperate to lose weight that she would do anything - even use fake, illicit medication.
Pharmaceutical crimes include the market in counterfeit, falsified and illegally traded medicine, and are not a new phenomenon. According to Bate (2008), counterfeit or illicit pharmaceuticals have been around since the 19th century, when technology advanced and criminal entrepreneurs involved in counterfeiting began producing and distributing fake goods that offered the most lucrative opportunities with minimum legal risk.
In 1985, the World Health Organisation (WHO) first became aware of the public health issues associated with counterfeit medicines and by 2010, it estimated that the global counterfeit pharmaceutical market had a turnover of $75 billion (WHO, 2012). Behner et al (2017) provide more recent figures, according to which sales range from $163 billion to $217 billion per year. In 2017, the WHO said that one of ten medicines that are sold worldwide is illicit, a figure that can reach up to seven out of ten in some countries (http://mediaroom.sanofi.com/fighting-counterfeit-drugs-starts-with-knowing-it-exists). As many as 12.8 million consumers have been exposed to counterfeit medicines in European countries (Jackson et al, 2012). The market in illicit counterfeit pharmaceuticals is the most lucrative sector of the global trade in illegally copied goods (Behner et al, 2017).
Shockingly, Hall et al (2017) stress that the head of Interpol's pharmaceutical crime sub-directorate estimated that each year, across the world, up to one million people die after having consumed illicit medicine, most of whom reside in developing nations. Murumba (2017) notes that, according to the WHO, Africa contributes to 100 000 of these fatalities. Health risks are primarily present in cases of either substandard medicines that contain unsafe or poisonous substances or life-saving medical treatments that lack the effective ingredients (Degardin et al, 2014). Behner et al (2017) stress that beside the fact that illicit medicines harm or kill millions of people around the world, they also inflict serious damage to the genuine brand names and affect the bottom lines of major pharmaceutical manufacturers.
What is pharmaceutical crime?
According to Interpol, pharmaceutical crime involves the manufacture, trade in and distribution of fake, stolen or illicit medicines and medical devices. It encompasses the counterfeiting and falsification of medical products and their packaging and associated documentation, theft, fraud, illicit diversion, smuggling, trafficking and illegal trade of medical products as well as the money laundering associated with it (www.interpol.int/Crime-areas/Pharmaceutical-crime/Pharmaceutical-crime).
Hall et al (2017) argue that organisations and researchers have not yet agreed on which terminology to use when speaking about illicit pharmaceuticals. Currently various terms are used for different contexts. These include:
- falsified medicines, which is a broader term encompassing all pharmaceuticals falsely claiming to be an authentic product (IRACM, 2013);
- substandard medicines that are genuine products that do not meet national regulatory standards (Degardin et al, 2014);
- counterfeit medicines, which relates to products that infringe intellectual property rights (WHO, 2012); and
- unlicensed pharmaceutical drugs, which can be generic or branded products legally produced abroad and then sold in a country with different licensing agreements
- in order to bypass existing intellectual property laws and patents (www.firstwordpharma.com/ node/1114092#axzz4yPO97Qxm).
- For the purposes of this article, we will use the term "illicit medicine".
Pharmaceutical crime - a transnational organised crime
Criminal elements have become involved in all aspects of the chain of supply of illicit medicines, from manufacturing to distribution. They are driven by financial gain and in order to make big profits, criminals are usually required to possess a high degree of sophistication and organisation. However, pharmaceutical crime is not understood to be as organised as more established criminal activities, such as drug trafficking or people smuggling. Murumba (2017) stresses that the trafficking of illicit medicine is closely linked to other serious crimes, such as money laundering and the funding of terrorist groups.