Searching for better global health governance for dangerous counterfeit medicines

Perhaps no greater challenge exists for global health security and patient safety than fake, unregulated, and/or poor quality drugs, collectively “dangerous counterfeit medicines” now endemic in the global drug supply chain. Dangerous counterfeit medicines are prevalent everywhere including traditional healthcare settings, pharmacies, and the Internet. These dangerous medicines are on the rise in both therapeutic and geographic scope, threatening patient lives, potentially leading to antimicrobial resistance, and profiting illicit actors. Yet, despite these clear threats, surveillance is extremely limited, with available data pointing to an exploding global health crisis worldwide. Data from the Pharmaceutical Security Institute (“PSI”), indicates an alarming global increase in total incidents of counterfeiting in all global regions and for a wide range of medical products. Efforts such as World Health Organization IMPACT have made inroads in combating this illicit trade, but are stymied by ineffectual governance and conflict between ideologies of access to medicines and intellectual property rights. To address this important issue we advocate for the establishment of a comprehensive global health governance framework leveraging the respective strengths of international organizations. This includes utilizing the United Nations Office on Drugs and Crime (“UNODC”) for global enforcement against dangerous counterfeit medicines and focusing the World Health Organization's efforts on providing technical assistance on surveillance and collecting epidemiological data on dangerous counterfeit medicines as well as developing programs to improve access to safe medicines.