Kaisernetwork.org (Washington, DC)
17 November 2008
Global Challenges
Interpol Seizes $6.65M in Counterfeit HIV/AIDS, Malaria, TB Drugs in Southeast Asia
[Nov 17, 2008]
The International Criminal Police Organization recently confiscated $6.65 million worth of counterfeit HIV/AIDS, malaria and tuberculosis drugs in Southeast Asia and made 27 arrests as part of a five-month investigation involving nearly 200 raids, Aline Plancon, an officer involved in the operation, said on Monday, Bloomberg reports. During the investigation, called Operation Storm, authorities seized more than 16 million pills between April 15 and Sept. 15 in Cambodia, China, Laos, Myanmar, Singapore, Thailand and Vietnam. The operation was a joint effort between Interpol, the World Health Organization and the World Customs Organization. It was the first time customs officials, drug regulators, health authorities and police from different countries have collaborated to prevent the distribution of counterfeit medicines, Plancon said.
According to Bloomberg, health officials particularly are concerned about fake artemisinin-based combination therapies used to treat malaria. According to a recent study, counterfeit ACTs containing insufficient amounts of artemisinin are contributing to the development of drug-resistant parasites near the border of Cambodia and Thailand. The rise in drug resistance has reduced the effectiveness of genuine ACTs, thus placing more people at risk for developing drug-resistant malaria, Bloomberg reports.
According to WHO and the Center for Medicine in the Public Interest, worldwide sales of counterfeit drugs could reach $75 billion by 2010, an increase of more than 90% since 2005. An Organization for Economic Cooperation and Development report released last year identified Asia as the largest producer of counterfeit products worldwide. Of the 1,047 arrests made in 2007 related to counterfeit medicine, about 40% took place in Asia, the Pharmaceutical Security Institute reports (Bennett, Bloomberg, 11/17).
Related Opinion Piece
The seizure by Belgian authorities in September of more than two million fake malaria drugs and painkillers manufactured in India for African distribution "shines a light on one of the most pressing problems in delivering life-saving medicines to the world's poorest patients: the proliferation of low-quality and counterfeit products," Roger Bate, a director of Africa Fighting Malaria and fellow at the American Enterprise Institute, writes in a New York Times opinion piece. He adds, "If aid organizations are serious about combating the spread of deadly diseases in the developing world, they must do more to ensure the safety and quality of drugs."
Although WHO reports that about 30% of the world's population lacks essential medicines, "this problem cannot be solved by supplying bogus medicines," Bate writes. According to Bate, insufficient access to drugs has led many governments in developing countries to allow local drug makers to produce cheaper medicines. However, "local producers often make low-quality drugs," he writes, adding that this should be "no surprise" because "[e]ven countries with stringent regulatory systems sometimes turn up bad pharmaceuticals." According to Bate, many developing countries "lack the regulatory structure needed to monitor safety and effectiveness," do not have "laws against selling sub-standard drugs" and lack "sophisticated agencies like the FDA with the trained inspectors and laboratories needed to analyze pharmaceuticals."
According to Bate, it is "essential" for these countries to enact regulations, establish monitoring agencies and build scientific capacity to oversee drug manufacturing and inspect imported and local drugs. Bate also identifies three ways that international aid organizations can help ensure drug quality: providing financial and technical support; refusing to subsidize low-quality drugs; and insisting that only medicines approved by "stringent drug agencies like the FDA" be distributed. Bates writes, "If aid organizations are serious about combating the spread of deadly diseases in the developing world, they must do more to ensure the safety and quality of drugs." He concludes, "Thousands of lives depend on their efforts" (Bate, New York Times, 11/15).
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India's Cellular Ringtone Boosts Country's Condom Sales, Officials Say
[Nov 17, 2008]
Condom sales in India increased by 85 million in the months following a media campaign featuring a cellular phone ringtone that says "condom, condom," officials at India's National AIDS Control Organization said on Friday, AFP/Philippine Daily Inquirer reports (AFP/Philippine Daily Inquirer, 11/14). The ringtone was launched earlier this year by the BBC World Service Trust and features a professional singer repeating the word "condom" more than 50 times. It is part of NACO's efforts to reach youth through projects such as films, online games, mobile advertising and downloads, as well as television and radio advertisements to engage young people in discussions about safer sex (Kaiser Daily HIV/AIDS Report, 10/20). According to AFP/Inquirer, 660,000 people have downloaded the ringtone since August.
The media campaign includes radio and television advertisements, and 150 million men -- including migrant workers who frequent commercial sex workers -- have been reached through the campaign. Yvonne MacPherson, BBC World Service Trust country director for India, said the campaign has "encouraged people to start talking about the condom." The trust on Friday launched a mass media campaign that features a dog called Condom. According to AFP/Inquirer, Indian health officials hope to reach a target of distributing three billion condoms annually by 2010 -- an increase from the current target of 1.7 billion. Officials also aim to increase the use of female condoms by improving the retail network.
Sujatha Rao, head of NACO, said that "huge problems" still exist in promoting condom use in the country, adding that commercial sex workers have said that men "would rather pay more than use a condom." Rao also said the organization's "biggest barrier is the lack of a proper marketing network." The United Nations estimates that 2.4 million people in India are living with HIV/AIDS (AFP/Philippine Daily Inquirer, 11/14).
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Representatives From Indian Ocean Islands Hold Meeting To Address HIV/AIDS
[Nov 17, 2008]
More than 500 representatives from islands in the Indian Ocean -- including Comoros, Mauritius, Madagascar, Reunion Island and Seychelles -- recently expressed concern about the impact of HIV/AIDS on the region during a conference in Mauritius, IRIN/PlusNews reports. Although different issues are occurring in each nation, there is a shared belief that the impact of HIV/AIDS is changing in the region, IRIN/PlusNews reports. Delegates pointed to a common problem of stigma toward people living with the disease.
UNAIDS estimates that Comoros had 200 people living with HIV/AIDS as of 2007, and the country continues to face poverty, low condom use, a lack of knowledge about HIV/AIDS and a high incidence of sexually transmitted infections. IRIN/PlusNews reports that Madagascar's population is becoming increasingly vulnerable to HIV because of limited access to health care and social services, multiple concurrent partnerships and high rates of STIs. Despite these issues, Madagascar still has a relatively low HIV prevalence of 0.1%, and 14,000 people were living with the virus at the end of 2007.
In Mauritius, HIV/AIDS prevalence is 1.8%, and about 86% of the people living with HIV are injection drug users -- an increase since 2000, when IDUs comprised 2% of the HIV-positive population. In addition to providing no-cost antiretroviral drugs, the government has begun a needle-exchange program to address the recent shift in HIV transmission from heterosexual sex to injection drug use. According to IRIN/PlusNews, the move has received criticism. However, Willy Rozenblum -- head of the French National AIDS Council -- praised the Mauritian government for its decision to launch the program. Rozenblum said, "We can eradicate this disease in 50 years with the facilities and knowledge we have at present. We do not need to invent new things if we strictly apply what we have now. There must be strong political commitment to this and to stopping stigmatization, which is often more painful than the disease itself." Mauritius's Prime Minister Navinchandra Ramgoolam has said that the island should increase its efforts to curb the spread of the virus (IRIN/PlusNews, 11/14).
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