Philippine Senator Ralph Recto describes it as “a large-scale swindle of the cruelest kind” — the proliferation of counterfeit drugs in the Philippines that has earned the country its latest dubious distinction – as a hot spot for knockoff medicines in Southeast Asia.

In its study this year on transnational crime in Asia, the UN Office on Drugs and Crime (UNODC) report found that the Philippines had the highest incidence of “falsified medicines” in Asia.

Of 460 incidents of counterfeiting and illegal distribution of pharmaceutical products recorded in the region from 2013 to 2017, 193 occurred in the Philippines, 110 in Thailand, 93 in Indonesia and 49 in Vietnam.

Though most of the fake drugs were funneled from China, Pakistan and India through crime networks, the Philippines itself turned out to be the source in 12 incidents of either falsified or illegally distributed medicines in the US, Japan and Germany, according to the UN report.

International criminal organisations may have earned as much as $2 billion from trafficking falsified medicines in the Philippines in 2014.

The counterfeit drugs range from medicines for urinary tract infection, erectile dysfunction, infection and the central nervous system to nutrition supplements, skin whiteners and over-the-counter staples like paracetamol, as well as anti-TB medication and rabies vaccines.

The UN study defined “falsified medicines” as pharmaceutical products “marketed with the intention to deceive buyers.”

They could be misbranded, falsely labeled or expired. Or they may contain too little, too much or none of their purported active ingredient.

At best, these products are ineffective and merely rob consumers of their hard-earned money while giving them false hopes of medical recovery. At worst, they could be harmful or even deadly.

As the UN report warned, “the illicit trade in falsified medicines . . . could represent the most harmful form of transnational organised crime in terms of its direct impact on public health and safety.”

The spread of counterfeit medication is enough “cause for alarm and action,” Recto said in his Senate resolution seeking an inquiry into the matter.

About half of the total P372.8 billion—or P187 billion ($9.5 billion)—“out-of-pocket” health expenditures among Filipinos in 2017 went to pharmaceutical products, Recto pointed out.

In fact, a June 2018 report by the Philippine Institute for Development Studies said the Philippines is the third largest pharmaceutical market in the Asean, worth $3.8 billion in 2017. The market is predicted to exceed $4 billion by 2020, as it grows at 3.5 percent a year.

Such a lucrative market has attracted hordes of charlatans and felons, as evidenced by online sites that host sellers hawking medications alongside fashion items, as though people’s health were as disposable as last season’s footwear.

To its credit, the Food and Drug Administration (FDA) recently ordered e-commerce sites Lazada and Shopee to desist from selling medicines online until they secure the proper licenses.

“Buying medicines online over the internet can pose serious health risks,” said the FDA. “Even if the medicines bought online looks the same, there is no guarantee it is genuine . . . Also, these medicines may not be stored correctly in accordance with its appropriate storage conditions.”

Only sellers with an existing FDA-licensed pharmacy and a physical address are allowed to serve online orders of medicines, and ordering medicines online is also subject to approval.

Recto’s call for a Senate probe should help uncover the magnitude of this worrying problem. For a start, the government should

identify the “misbranded, spurious, fake and falsely labeled drugs” often sold cheaply in sari-sari stores, quoting the results of the FDA’s latest investigation.

The agency can also be more aggressive in publicising the brand names of counterfeit medication it had tested, and launch an information campaign on how consumers can differentiate real from fake drugs.

Cross-border cooperation among countries is as crucial to plug the leaks in individual legal systems that allow criminal syndicates to exploit loopholes in exporting their nefarious goods.

But what should be the most effective deterrent to the runaway sales of counterfeit drugs is for the government to regulate the prices of safe and genuine medication to make them more accessible to and affordable for those who need them most.

Who’d want to buy cheap but fake drugs if genuine and affordable meds are available?

Philippine Daily Inquirer editorial desk.