Fake medicine is spreading throughout Cambodia, particularly in rural areas and provinces

along the borders with Vietnam and Thailand, officials at the Ministry of Health

(MoH) say.

Heng Huot, director of the Drug Regulation Bureau at the Ministry of Health, displays fake medicines that the MoH says are now being sold throughout Cambodia.

So far this year, the MoH has identified 27 kinds of fake medicine, compared with

35 in 2003-2004 and 26 in 2000.

Minister of Health Nuth Sokhom said every country in the world has fake medicine,

but he acknowledged that Cambodia has a higher proportion of fakes than other countries.

"We are worse than other countries because our people have only limited knowledge

of the problem of fake medicines, there is a lack of cooperation from related organizations,

the exercise of the law is still weak, and punishment of perpetrators too loose,"

Sokhom said.

"Our country has only recently implemented measures to prevent fake medicine

that other countries implemented many years ago.

"Now, besides fake medicine, we also have many complicated regulations relating

to unregistered and expired medicines," he said. "And we continue to work

on the legal issues."

Heng Huot, director of the drug regulation bureau at the Drugs and Food Department

of the MoH, said Cambodia has about 8,000 different medicines; about 30 percent of

them are unregistered and most of the unregistered medicines are fakes.

Huot said most of the fakes are everyday medicines such as Paracetamol, and antibiotics

such as ampicillin and amoxycillin.

He said the fake medicines were made from flour and would not poison people; they

would do neither good nor harm if a person had a simple problem such as a headache.

"But in the case of serious illnesses such as malaria, blood pressure, bleeding

illnesses and so on, using fake medicine could cause a patient to die," Huot

said. "We do not have any statistics relating to victims who died of taking

fake medicine, because we do not have any regulations to report such cases to hospitals

the way other countries do. But people must have died from taking fake medicines."

The fakes were known to be smuggled from Thailand and Vietnam, but Huot said he did

not know for sure where they were manufactured.

"Sometimes, for example, the fakes might be produced in Cambodia and the name

of another country put on them. So far, in Cambodia, we have not yet found any places

that produce fake medicine," he said.

In January the Post spoke to women's health experts who reported that a rise in black

market abortion pills was leading to serious injuries and even death for pregnant

women.

Known as misoprostal and mifepristone tablets, the medicine costs about $15.

"This kind of drug sells on the black market and it's not recognized by the

Ministry of Health. It's very dangerous to a woman," said Ros Thoeun, program

director for local women's health NGO Marie Stopes Cambodia, at the time. "They

don't know how to take it because the instructions are written in Chinese - they

use it and sometimes use too much."

Recently, Dallas Mildenhall, a New Zealand scientist working with Interpol issued

a warning for Asian-based companies producing fake anti-malaria medicines on an industrial

scale in China, Vietnam, Thailand and Burma, a German news agency reported.

Mildenhall said the fake drugs, sold mostly in Africa and Asia, were killing thousands

of Southeast Asians each year. He said his analysis of fake pills along the China-Vietnam

border showed substances in the pills ranging from insect remains to human and animal

hair, the agency said.

Cambodia has six factories producing generic medicine, all of them legal and recognized

by the Ministry of Health. And Cambodia has 100 companies importing drugs from 30

countries over the world such as France, the United States, India, China, and Thailand.

Forty companies import drugs to supply to private hospitals, clinics and pharmacies,

and more than 10 companies won the bidding among 60 companies to import drugs to

supply public hospitals.

Every year, Huot said, the government spends about $12 million on medicine, NGOs

about $20 million and private clinics more than $20 million.

Huot said he would like people to be confident when they buy medicine that it is

real and not fake. They should not forget to check the container to make sure it

has a "vignette" showing the name of the company importing the medicine

and below that the letters CAM with a code number. If it did not, it must be fake

medicine.

But Huot acknowledged that fake medicines can carry a fake vignette. He called on

pharmacies to exercise conscience in selling medicine to the people because only

pharmacies could know where they bought their medicine and whether they were likely

to be real or the fake.

But that highlights a further problem: 2,000 of the country's 4,000 pharmacies are

illegal.

Health Minister Sokhom said his ministry had agreed to set up interministerial committees

throughout the country to eliminate fake medicines. The committees would embrace

the Ministries of Health, Interior, Justice, Information, Commerce, Economy and Finance,

Education, Agriculture, and Forestry and Fisheries.