Murder by fake drugs

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Abstract
Until recently the most infamous internationally known example of fake drug dealing was Graham Greene's fictional account of a British fake penicillin peddler who was eliminated in the sewers of postwar Vienna in The Third Man .1 Unfortunately, malevolent dealings in counterfeit drugs are very much a contemporary reality. Notorious recent real examples include neomycin eye drops and meningococcal vaccine made of tap water; paracetamol syrup made of industrial solvent; ampicillin consisting of turmeric; contraceptive pills made of wheat flour; and antimalarials, antibiotics, and snake antivenom containing no active ingredients.2 3 4 5 6 7 8 9 In a recent survey of pharmacies in the Philippines, 8% of drugs bought were fake (quoted by Wondemagegnehu2). A countrywide survey in Cambodia in 1999 showed that 60% of 133 drug vendors sampled sold, as the antimalarial mefloquine, tablets that contained the ineffective but much cheaper sulphadoxine-pyrimethamine, obtained from stocks that should have been destroyed, or fakes that contained no drug at all. 3 4 In another recent survey, 38% of tablets sold in five countries in mainland South East Asia as the new antimalarial artesunate were fake.5 Artesunate is …