Monday, March 3, 2008

Window on Eurasia: Russia’s Most Serious ‘Drug Problem’

Paul Goble

Baku, March 3 – The U.S. Department of State said last week that the Russian Federation has replaced Kosovo as the most important transshipment point for heroin coming out of Afghanistan, but in some respects, the Russian people now face an even more serious “drug” problem: the massive distribution there of fraudulent medicines.
According to Russian officials, up to 30 percent of the medications sold on the Russian market are not what they purport to be, but Aleksandr Kalinin reports in the current issue of Stoletiye that independent experts say the real share of such fake medicines may be as much as 60 percent of the total
Moreover, since the Russian government introduced new taxes on medications in 2002, more and more Russians in recent years have consumed such fraudulent medications, with 50 percent saying they have done so occasionally and ten percent reporting this as a constant problem (
Because the new taxes pushed prices up 20 to 30 percent and because the government lacks an effective system of monitoring drug production and distribution, the producers of fraudulent medicines have found both new opportunities for “super profits” and an expanding market among people who do not or cannot pay the higher prices.
One of the reasons that the health ministry’s department of government control of medications finds it so difficult to deal with this problem, Kalinin writes, is that the Russian pharmaceutical market after the collapse of the Soviet system involves some 2500 different distributors, compared to only four in France and ten in Germany.
Most of these Russian firms are small, and it is relatively easy for the producers of fraudulent medications to use them as fronts, confident that no one from the government will check and that the victims of this kind of medical fraud will not be able to trace their problems back to the producers.
Moreover, because they can make enormous sums of money and generally escape any responsibility for their crimes, foreign producers of fraudulent drugs have entered the Russian marketplace, a development that adds to the problems such drugs pose both to those who take them and the Russian government that cannot protect its citizens.
Both the foreign and domestic producers of such medications, Kalinin continues, have learned how to copy the appearance of the genuine pills and containers of the genuine article. Consequently, neither distributors nor medical personnel in many cases are able to say whether a particular batch is real or a fraud.
That can be determined only in a medical laboratory, but until someone gets sick, fails to get well, or dies, there is little chance that officials will ask for any testing. And sometimes the producers of these false medications include a little of the real drugs in them to confuse anyone who might test the drugs.
Kalinin says that health ministry officials sometimes send warnings to pharmacies about false drugs, calling for the destruction of a long list of medications. But even in those cases where the ministry knows “who, what, where and when” such medications have been produced, it can do little more.
Its officials have no enforcement powers, and when they ask the militia to intervene, their requests regularly go to the bottom of the pile because for the Russian police, dealing with fraudulent medications is very much a “secondary” task, far less important or career enhancing that dealing with other crimes.
An interdepartmental commission of the Russian Security Council has described the massive quantity of falsified medications in Russia to be a serious threat and called on all law enforcement bodies to take action to respond to it. But so far, that has had little effect, and “falsified” drugs continue to harm the health of the Russian people.
Moreover, Kalinin notes, even if the Russian government does finally do something in this area, it will discover as other states have that the producers of such profitable false medications are becoming ever more clever and inventive in order to keep ahead of the authorities.
Unfortunately, average consumers have few ways of protecting themselves. The only advice pharmacists offer is to purchase medications only in larger apothecary stores and to avoid buying any drugs whose prices appear to be too good to be true: Such “medicines” almost certainly are.

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