A joint study by the Ministry of Health and the World Health Organization has
found that 10 percent of drugs sold locally are counterfeit, while 3 percent are
substandard. Health officials said the trade caused thousands of deaths
worldwide, adding there was little doubt Cambodians were dying
too.
Chroeng Sokhan, vice-director at the ministry's Department of Drugs
and Food (DDF), said lack of information meant precise figures were impossible
to get. He said the burden falls mainly on the poor in both urban and rural
areas as they lack money to buy quality drugs.
"I don't doubt the danger
exists," he said when asked whether people have died from using counterfeit
drugs. "I have heard some patients died from stomach ulcers which they tried to
treat with counterfeit drugs."
In his speech at a workshop held in Phnom
Penh April 4, Dr Jim Tulloch, a representative for the World Health Organization
(WHO), said almost half the counterfeit drugs were fake antibiotics. He stressed
the attendant dangers.
"Use of counterfeit antibiotics can lead to death
through ineffective treatment," Tulloch said. "This is just one example of the
risks caused by counterfeit drugs. Every year countless money and thousands of
lives are lost [internationally] because of the use of counterfeit
drugs."
DDF's Sokhan described the report's findings as alarming. He said
a feasibility study conducted by investors estimated the value of the illegal
trade, most of which comes from neighboring countries, at between $50-100
million a year. Official imports, he said, were around $12 million a
year.
Among the reasons for the high rate of fake drugs were corruption,
weak law enforcement, poverty and high sales taxes.
"Counterfeit and
substandard drugs are mostly infiltrated into Cambodia through illegal drug
outlets," said Tea Kim Chhay, the director of DDF. "For many years these drugs
have been available in Cambodian markets, but there have been no studies or
research to combat the problem."
In 1995 government policy was to allow
the free import of drugs into Cambodia. As part of that, the authorities
registered the drug importers and outlets. Figures today show that of the
country's almost 2,250 pharmacies, around 2,000 are illegal. When asked which
were reliable, ministry of health and WHO officials said they did not
know.
Sokhan said that one way to eliminate cross-border counterfeit
drugs would require strictly controlling the outlets. Those which are illegal,
he said, should be shut down for good. Past experience is not
encouraging.
In 1996 and 1997, DDF filed 27 complaints against
counterfeit drug dealers with Phnom Penh's municipal court. Five cases were
solved, which involved closing the pharmacies and fining the owners $250. All
five subsequently re-opened, said Sokhan.
Public education on the dangers
of counterfeit drugs, officials said, was key to combating the problem. WHO's Dr
Tulloch said that in addition there should be improved cooperation between
doctors, vendors, the local industry, as well as improved
legislation.
"It is a difficult problem to eliminate completely, and it
is not possible to point fingers at one person or areas which are to blame,"
said Dr Tulloch. "But if the different parts of the government, industry and
society work together, it is possible to reduce the extent of the problem."
Research for the project began mid-2000, and was funded by WHO. DDF
selected 230 samples of 24 different products from Phnom Penh and five
provinces. Testing results showed that 13 percent were either counterfeit or
sub-standard.
All the more reason to try us, say traditional
medics
Though Cambodia has some of the modern world's latest medical technology,
many people still turn to traditional medicine to cure their ailments, says
Cheng Sun Kaing, former director of the National Center for Research on
Traditional Medicines.
Kaing has noticed a growing number of traditional
medicine stalls in markets nationwide, and says that using traditional medicines
is less dangerous than modern drugs, which could be fake.
"If traditional
medicine is used properly there is almost no danger," says Kaing. "But [if] the
Kru Khmer (the Khmer traditional healer) mixes the wrong ingredients, it would
cause problems."
The Center lists more than 200 herbal treatments used in
traditional healing. Some Kru Khmer, says Kaing, are not that good at their
craft, so his department invites them in for a meeting at which they can improve
their skills. But is traditional medicine merely superstition for the
credible?
"I would not say that - I believe in this superstition," he
says. "If it did not work, then people would have stopped believing in it a long
time ago. That is why people are still curing their diseases in this
way."
Hath Sophoan, a 36-year-old vendor of Khmer herbal medicine at Psah
Serey Pheap in Phnom Penh, has more than 100 different ingredients in his shop.
Not least among his ingredients, and quite apart from his extensive selection of
plant matter, are dried gibbon, python skin, and dried toad for mixing in rice
wine.
In the old days he also sold the gall bladders of bears, tiger
organs, and various other endangered species, but the government put a stop to
that.
Each day his customers come to ask his advice on the best
ingredients to use for their ailments. Not surprisingly Sophoan says traditional
medicine is much safer than its modern cousin. And not least, he adds, it is
cheaper too. None of his customers has complained in almost 20 years of
business.
"Modern medicines can cause death if they are misused," he
says. "So far I have had no trouble at all."
