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Study reveals high level of counterfeit drugs

Study reveals high level of counterfeit drugs

A joint study by the Ministry of Health and the World Health Organization has

found that 10 percent of drugs sold locally are counterfeit, while 3 percent are

substandard. Health officials said the trade caused thousands of deaths

worldwide, adding there was little doubt Cambodians were dying

too.

Chroeng Sokhan, vice-director at the ministry's Department of Drugs

and Food (DDF), said lack of information meant precise figures were impossible

to get. He said the burden falls mainly on the poor in both urban and rural

areas as they lack money to buy quality drugs.

"I don't doubt the danger

exists," he said when asked whether people have died from using counterfeit

drugs. "I have heard some patients died from stomach ulcers which they tried to

treat with counterfeit drugs."

In his speech at a workshop held in Phnom

Penh April 4, Dr Jim Tulloch, a representative for the World Health Organization

(WHO), said almost half the counterfeit drugs were fake antibiotics. He stressed

the attendant dangers.

"Use of counterfeit antibiotics can lead to death

through ineffective treatment," Tulloch said. "This is just one example of the

risks caused by counterfeit drugs. Every year countless money and thousands of

lives are lost [internationally] because of the use of counterfeit

drugs."

DDF's Sokhan described the report's findings as alarming. He said

a feasibility study conducted by investors estimated the value of the illegal

trade, most of which comes from neighboring countries, at between $50-100

million a year. Official imports, he said, were around $12 million a

year.

Among the reasons for the high rate of fake drugs were corruption,

weak law enforcement, poverty and high sales taxes.

"Counterfeit and

substandard drugs are mostly infiltrated into Cambodia through illegal drug

outlets," said Tea Kim Chhay, the director of DDF. "For many years these drugs

have been available in Cambodian markets, but there have been no studies or

research to combat the problem."

In 1995 government policy was to allow

the free import of drugs into Cambodia. As part of that, the authorities

registered the drug importers and outlets. Figures today show that of the

country's almost 2,250 pharmacies, around 2,000 are illegal. When asked which

were reliable, ministry of health and WHO officials said they did not

know.

Sokhan said that one way to eliminate cross-border counterfeit

drugs would require strictly controlling the outlets. Those which are illegal,

he said, should be shut down for good. Past experience is not

encouraging.

In 1996 and 1997, DDF filed 27 complaints against

counterfeit drug dealers with Phnom Penh's municipal court. Five cases were

solved, which involved closing the pharmacies and fining the owners $250. All

five subsequently re-opened, said Sokhan.

Public education on the dangers

of counterfeit drugs, officials said, was key to combating the problem. WHO's Dr

Tulloch said that in addition there should be improved cooperation between

doctors, vendors, the local industry, as well as improved

legislation.

"It is a difficult problem to eliminate completely, and it

is not possible to point fingers at one person or areas which are to blame,"

said Dr Tulloch. "But if the different parts of the government, industry and

society work together, it is possible to reduce the extent of the problem."

Research for the project began mid-2000, and was funded by WHO. DDF

selected 230 samples of 24 different products from Phnom Penh and five

provinces. Testing results showed that 13 percent were either counterfeit or

sub-standard.

All the more reason to try us, say traditional

medics

 

Though Cambodia has some of the modern world's latest medical technology,

many people still turn to traditional medicine to cure their ailments, says

Cheng Sun Kaing, former director of the National Center for Research on

Traditional Medicines.

Kaing has noticed a growing number of traditional

medicine stalls in markets nationwide, and says that using traditional medicines

is less dangerous than modern drugs, which could be fake.

"If traditional

medicine is used properly there is almost no danger," says Kaing. "But [if] the

Kru Khmer (the Khmer traditional healer) mixes the wrong ingredients, it would

cause problems."

The Center lists more than 200 herbal treatments used in

traditional healing. Some Kru Khmer, says Kaing, are not that good at their

craft, so his department invites them in for a meeting at which they can improve

their skills. But is traditional medicine merely superstition for the

credible?

"I would not say that - I believe in this superstition," he

says. "If it did not work, then people would have stopped believing in it a long

time ago. That is why people are still curing their diseases in this

way."

Hath Sophoan, a 36-year-old vendor of Khmer herbal medicine at Psah

Serey Pheap in Phnom Penh, has more than 100 different ingredients in his shop.

Not least among his ingredients, and quite apart from his extensive selection of

plant matter, are dried gibbon, python skin, and dried toad for mixing in rice

wine.

In the old days he also sold the gall bladders of bears, tiger

organs, and various other endangered species, but the government put a stop to

that.

Each day his customers come to ask his advice on the best

ingredients to use for their ailments. Not surprisingly Sophoan says traditional

medicine is much safer than its modern cousin. And not least, he adds, it is

cheaper too. None of his customers has complained in almost 20 years of

business.

"Modern medicines can cause death if they are misused," he

says. "So far I have had no trouble at all."

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