Most Americans have heard about the cat food/dog food that is killing pets, and that the cause is a fake and cheap additive added to the gluten so that the protein test will be artificially increased.

The shoddy but cheap goods coming out of China underprice locally produced goods, often bankrupting local manufacturing here in the Philippines. But the poor quality of goods that quickly deteriorate or break is a fraud on poor people, and with the medium priced local goods no longer available, it leaves them little choice. Some businesses do survive: our town switched to designer sandals to counteract the competition, but other industries were not so fortunate.

Yet there is a more important story than dogfood or shoddy sandals: Fake medicines.

Some of us are old enough to remember the classic movie The Third Man, about a con man/thief/drug smuggler named Harry Lime who sold stolen penicillin that had been diluted.

Calloway says that Harry Lime stole penicillin from military hospitals, diluted it to make it go further, and sold it back to the hospitals. Holly then asks “Are you too busy chasing a few tubes of penicillin to investigate a murder?” to which Calloway responds by describing the effects on the patients who were given the diluted penicillin, including men with gangrene legs and a group of children with meningitis, some of whom died and some of whom broke down and had to be placed in the mental ward.

This same scam is what is killing patients in Asia: but fake anti biotics and anti malarial medicine.

A NYTimes article quotes a UN Expert:

Estimates of the deaths caused by fakes run from tens of thousands a year to 200,000 or more. The World Health Organization has estimated that a fifth of the one million annual deaths from malaria would be prevented if all medicines for it were genuine and taken properly.

Not only do the drugs lead to deaths, but since, like the penicillin sold by Harry Lime, they contain smaller amounts of the real medicine, the result may be an increase in germ resistance: A major and ongoing problem in all antibiotics but especially a problem with tuberculosis and Malaria.

Most of the deaths have been in Asia, but with the Bush and G8 and private push to eliminate malaria, TB, and HIV, the worry is that these funds, which are given to local government health departments, will end up buying the fake medications from China, and lead to thousands of deaths in Africa.  These sophisticated counterfeits do contain the real medicine but in suboptimal amounts, local quality control laboratories might not detect the fraud, and people will die.

“We make no apology for the use of the term ‘manslaughter’ to describe this criminal lethal trade,” Dr. Newton and his co-authors said last year in an article in The Public Library of Science Medicine. “Indeed, some might call it murder.”

Most of the fake drugs come from China, and one hopes that pressure on that country will help it to reform it’s dubious business practices. Like the Philippines, corruption is rampant and cultural, and much of the substitution is simple greed, without thinking of the consequences of their actions.

Ironically, Hollywood’s film of the Constant Gardener has a similar theme, but LeCarre and Hollywood of course live in an anti American world where it would never occur to them to look past their ideology and see that there are much greater dangers out there, and that eliminating American influence will allow these greater dangers to flourish.

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Nancy Reyes is a retired physician living in the rural Philippines. Her website is Finest Kind Clinic and Fishmarket, and she writes about medicine at HeyDoc Xanga Blog

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