Despite the discovery by health officials in October 1999 of counterfeit malaria medication on drug store shelves, consumers remain at grave risk, a government drug official said Wednesday.
Dr Chroeng Sokhan, a director at the Ministry of Health’s Department of Drug and Food, said more than 50 percent of malaria medication sold nationwide are placebos, or ineffective medication.
“People are buying them because they are cheap,” Chroeng Sokhan said, adding that more than 50 percent of all antibiotics sold in Cambodia are counterfeit.
Chea Chhay, undersecretary of state for the Health Ministry, said police have been hesitant to pull fake malaria medication off store shelves because many pharmacies have direct ties to government officials, and such a measure would affect sales.
“If we force them to stop selling fake drugs, it will affect business,” Chea Chhay said.
The solution, he said, is to persuade pharmacy owners to push proper medication, provided by the government, at reasonable prices.
“There is only one way to reduce fake drugs, and that is to only distribute real drugs to sell at cheap prices at legal pharmacies and clinics, especially in remote areas,” he said.
The National Malaria Center and the European Commission’s malaria program have helped with the limited distribution of Malarine, a pre-packaged drug that contains the powerful drugs Mefloquine and Artesunate.
Malarine is only being distributed in four provinces, but officials from both groups hope Malarine will see national distribution to both public health facilities and private sellers later this year.
The World Health Organization has chipped in by assisting the Drug and Food Department in developing an action plan to determine the severity of fake medication in Cambodia.
WHO is contributing $10,000 so that a survey of all over-the-counter drugs can be conducted by the drug and food department, possibly this year, said Bill Pigott, head of WHO’s office in Cambodia.
Fake drugs are “still a problem,” Pigott said. “Fake malaria medication is just one among thousands of other problems of fake drugs.”
In an effort to increase public awareness, the Health Ministry has conducted television and radio public service announcements since the problem surfaced last October, Chea Chhay said.
Local health officials then discovered ineffective versions of the normally powerful anti-malaria medicines Mefloquine and Artesunate at drug stores. Tests conducted by three independent laboratories showed the two drugs containing no medication.
Bad Mefloquine tablets were found at Phnom Penh pharmacies at $0.07 per tablet, compared to the normal price of $1, while 12 tablets of fake Artesunate were going for 1,000 riel. Effective versions cost at least 3,500 riel.
In a Letter to the Editor published in The Cambodia Daily April 18, 2000, “Spotting Fake Drugs Takes a Cautious Eye,” consumers can detect fake medication on their own based on appearance, said Gerald Moore, a local consultant in health and pharmaceuticals.
Moore wrote that generic versions of real drugs are usually cheaper in price, adding that “any drug selling for 80 to 90 percent less than normal must be considered suspect.”
Nearly 900 Cambodians died of Malaria in 1999, according to the NMC’s national report. Roberto Garcia, co-director of the EU’s malaria program, said last week that figure could be as much as five times higher than reported because the data does not include Cambodians living in secluded areas.
Malaria placebos are also believed to have caused the death of Sam Veasna, a wildlife official in Siem Reap who contracted the parasite, but eventually died when the administered medicine did not work.
Moore suggested consumers watch for proper packaging, the name and address of the manufacturer on the label, and that the batch number and date of expiration are clearly printed.
Chroeng Sokhan recommended drug buyers seek a physician for proper medication. He said many pharmacists do not have proper training, and thus would be more prone to selling fake medication.
Chea Chhay said the Health Ministry is investigating the origin of fake medication, and have so far concluded they are coming from Cambodia’s neighboring countries.