Bangkok Post - February 9, 2008

So he might find a recent warning by the Food and Drug Administration (FDA) to be of interest - not for what was said, but more for what was left unsaid. The FDA used a public forum to wag its finger at anyone thinking of buying drugs from internet-based pharmacies and warned that such medicines would, in all likelihood, be fake.

The agency added that prospective purchasers also ran the risk of being defrauded by identity-stealing cyber-criminals and cited the complaints it had received from Thais who had been cheated. There were a great many of them.

This was a predictable but sensible warning. Although most of the disreputable online pharmacies located here or in South America or India have been closed or brought under control, there are still plenty of pitfalls for the unwary. Anyone shopping online for illegal narcotic or controlled hypnotic drugs will not find brand names or generics available. They will merely find fakes and be given the opportunity to spend thousands of baht on what probably will turn out to be powdered glucose. Unregulated dietary and other nutritional supplements are, however, available and can usually be trusted if ordered from a reputable supplier.

In its warning, the FDA singled out such prime targets of pill pirates as erectile dysfunction drugs, which it said were most likely to contain fake ingredients, no ingredients at all or just a tiny amount of the active substance. In making this claim, the drug control agency was absolutely correct.

But it overlooked one very important home-grown aspect of all this. It neglected to mention that potential customers do not need to shop overseas on the internet to find fake drugs. They are already being peddled through a few dishonest pharmacies and clinics right here in this country. In fact, the World Health Organisation believes the problem is such a big one that at least 25% of prescription medicines sold in the developing world are fake.

And, as for the FDA warning about anti-impotence drugs, a prominent local urologist tells of what happened when Pfizer, the manufacturer, purchased samples of Viagra from a range of pharmacies in Bangkok and the provinces and then examined the test products they had bought for the survey - the packaging on nearly all of them was perfect, right down to the hologram, but of 217 purchases of the little blue pill, only 15 were the original product. The copies each contained anywhere from 17% to 48% of the required necessary ingredients. An independent survey done by Swedish medical researchers came up with much the same result.

But such drugs, unless taken by certain heart patients, are normally not life-threatening. Other drugs being counterfeited by unscrupulous criminal gangs are. And these pose the biggest danger. The most commonly counterfeited of these are treatments for conditions such as HIV/Aids, tuberculosis and, especially, drug-resistant malaria.

The malaria problem, endemic in border areas, is worsened by a growing trade in fakes, including the relatively new and effective Artemisinin-based Combination Therapy (ACT) drugs.

Our present drug law is more than 40 years old and too outdated to deal with e-commerce and counterfeit pharmaceuticals being shepherded across borders.

Taxes and tariffs on legitimate imported drugs are high. Fakes are tax-free. The current fine of 5,000 baht is laughable compared to the lucrative profits available. While counterfeits with a face value of 84 million baht were seized last year, we have to do better, and that will require action at Mr Chaiya's level. It deserves a place on his priority list.

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