Bogus drugs

A survey of pharmacies in the Philippines found 8% of the drugs bought were fake Another survey in Cambodia in 1999 showed 60% of the 133 drug sellers sampled were selling anti-malarial tablets that had either expired, were ineffective, or fake

However, most developing countries do not have the infrastructure and financial resources to implement them.

The BMJ says that drug companies have tended to avoid publicising the problem for fear of "damaging public confidence in medicines".

And it says some countries, well aware of the scale of their problem, have preferred to ignore it.

The BMJ says that much of the trade is probably linked to organised crime, corruption, the narcotics trade, unregulated pharmaceutical companies, and the business interests of "unscrupulous" politicians.

It says far greater international political will to eliminate the problem is required.

The German Pharma Health Fund has developed a "Minilab" which can assess the authenticity of many key drugs relatively cheaply.