On 3 October, vendors in the country’s main medicine sales hub (Mitford Medicine Market in Dhaka), and most pharmacies nationwide, staged a one-day strike protesting against the recent government crackdown at Mitford market.
Law enforcement officers seized some US$640,000 worth of fake, substandard and unauthorized medicine from Mitford market on 28 September. About 100 people were detained and nearly 30 shops shuttered following the swoop. The shops later reopened after vendors protested.
Sadekur Rahman, president of the Bangladesh Chemist and Druggist Samity, an association of pharmacies across the country, said vendors should not be held responsible for the quality control of their products.
“We buy medicine from drug companies and the companies or drug administration is responsible for that,” he said. “The national drug administration should strictly monitor the market if counterfeit or sub-standard medicines are being sold,” he added.
Golam Kibria, a director of the Directorate General of Drug Administration, told IRIN the government continues its investigations, despite the backlash. “Vigilance has not stopped and it will continue,” he said.
“People are taking poison without knowing it,” said Abdur Rahman, a professor in the pharmacology department at the University of Dhaka, who noted sales of counterfeit or sub-standard medication are most common in rural areas due to the lower levels of health awareness and formal education there.
Counterfeit sales up
Kibria said Mitford market is a “hub” for counterfeit medicines.
The administration has increased raids based on reports that more counterfeits are being traded, he added.
In 2010 after testing 5,000 medicine samples from across the country the Public Health and Drug Testing Laboratory (the country’s testing authority) found that 300 (6 percent) were either counterfeit or of substandard quality, according to one trade report.
Just two years later local media reported the same laboratory finding that the percentage of counterfeit or “very poor quality” drugs had doubled, according to results from a 2,500 drug sample test. Drugs failing the test included popular antibiotics and lifesaving drugs.
In 2009 a government team visited 193 pharmaceutical companies, examined their levels of performance, and divided them into A, B, C, D, E and F categories.
According to their report, companies ranked A-C produced drugs in compliance with the Good Manufacturing Practice (GMP), an international standard of medicine quality control; those falling into D-F did not.
The probe found 62 companies to be in non-compliance with GMP.
In 2009, 24 children died of acute renal failure after taking adulterated Paracetamol syrups made by a local medicine company, Rid Pharmaceuticals Ltd. A government probe detected diethylene glycol, a chemical used in the dyeing and leathery tannery industries.
The situation has only grown worse since then, say experts, even though recent systematic studies are lacking.
“The great danger of counterfeit and sub-standard medicine is they are silent killers [slowly] damaging important organs, but people who are taking the medicine do not understand it,” said Rahman, who noted most suspicious cases are not reported or investigated.
Traders told IRIN they earn large profits by selling outlawed medication supplied by rogue companies at low cost.
“It is possible to make double the profit by selling counterfeit and sub-standard medicine than the original [product],” said Belal Hossain, a trader at Mitford market, who emphasized that he did not knowingly sell fake medicines.
According to market research firm Business Monitor International, sales of pharmaceuticals in Bangladesh in 2013 are expected to reach $1.8 billion. In 2010 the company estimated that due in part to the country’s unlicensed pharmacies, about 9 percent of sales then were linked to “spurious drugs”.
Traders told IRIN adulterated or fake versions of medication were more popular in rural areas where cost is a larger factor in what people buy.
“It is easy to sell substandard and counterfeit medicine in the rural area as people prefer low-cost medicine,” said Hossain.
Health Minister Ruhul Haque said in parliament in mid-October that 20 of the 62 companies found to be below standard in 2009 have had their business licenses suspended, while cases are pending against the remaining companies.
Haque said that when the national drug administration verified medication was substandard, they file cases in court per the 1982 Drug Control Ordinance and its 2006 amendment.
According to the Health Ministry, from January 2012 to June 2013, 13 such cases were filed.
The country’s only drug testing laboratory (in Dhaka) tests about 3,000 drug samples a year, only 6.5 percent of the 23,000 brands of allopathic (usual as opposed to homeopathic) drugs manufactured in the country, according to Drug Administration officials.
The government is drafting “2013 drug rules” (still not before parliament) to fight fake and sub-standard pharmaceuticals.