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Homeland Security


Department of Public Information . News and Media Division . New York

7 March 2007

Fly-by-night Internet pharmacies and shady drug manufacturers pushing stolen or counterfeit medicines posed serious health risks to consumers, with mislabelled drugs that could be ineffective or even lethal, according to the head of a United Nations-backed drug-monitoring panel.

Dr. Philip Emafo, President of the International Narcotics Control Board (INCB), which monitors the implementation of international conventions to control illicit drugs, told correspondents at Headquarters this morning that mounting evidence showed that internationally controlled drugs had become increasingly available in the unregulated market.

Citing the Vienna-based panel’s recently released 2006 annual report, which spotlighted that emerging trend, he warned that “unregulated markets” included not only illegal sales over the Internet with the drugs being delivered by courier or in regular mail, but also sales by pharmacists who sold controlled drugs without asking for a prescription -- or requesting a faxed prescription that could easily be faked.

The quality, safety, efficacy and sources of drugs sold on the unregulated market were “unknown and of doubtful quality”, he said, adding that the sources of drugs available to unregulated markets were generally from theft or unauthorized sales from licensed manufacturers, wholesale and retail distributors, and health care institutions and providers. “It is important for consumers to realize that what they think is a cut-price medication bought on an unregulated market may have potentially lethal effects whenever the consumed drugs are not the genuine product or are taken without medical advice,” he said.

“Unregulated markets undermine national drug laws and regulation and undermine also national drug regulatory authorities,” said Dr. Emafo, who was joined by Koli Kouame, Secretary of INCB. Again citing disturbing statistics, he told correspondents that an estimated 25 to 50 per cent of medicines used in developing countries were fake, and that opioids, benzodiazepines, stimulants and barbiturates could be readily obtained without prescription, even in developed countries with tighter restrictions.

The driving factors behind the trend included limited access to health care facilities, particularly in a number of developing countries; lack of public awareness about the dangers inherent in purchasing drugs on unregulated markets; inadequate control regulations; weaknesses in regulatory enforcement; and consumer demand for drugs, particularly for frequently abused substances.

He said the report included a number of urgent recommendations and, among others, INCB called on Governments to enforce legislation to ensure drugs were not illegally manufactured or diverted from authorized manufacture and distribution channels to unregulated markets. The Board also recommended that Governments build up the capacity and staff of their drug-regulatory authorities, and establish a comprehensive legal framework to enforce existing legislation.

Turning to other issues included in the report, he noted an increased abuse of and trafficking in pharmaceutical preparations containing narcotic substances -- stimulants like fentanyl or opiate analgesics such as codeine and the controlled-release substance OxyContin -- in North America and some parts of Europe. While those substances were now entering illegal channels, primarily through theft from pharmacies and faked prescriptions, they were also being created in clandestine factories. National authorities in countries as diverse as Austria, Mexico and the Ukraine had recently dismantled clandestine fentanyl laboratories, he added.

Afghanistan posed a particular problem, in the sense that opium poppy cultivation was on the increase, and there was a need for action on the part of the Afghan authorities and the international community, he said, calling for broad cooperation and assistance for the war-torn country. He noted with concern that there had been proposals to legalize opium poppy cultivation in Afghanistan, but the Board believed that suggestion was simplistic, not feasible and based on an incorrect premise.

That claim had been based on the purported shortage of licit opiate raw materials for medical and scientific purposes. “That is simply not true. There is no such shortage,” he said. In fact, total production had been in excess of actual needs since 1999. Moreover, as of 2005, the total stock of licit opiate raw materials was sufficient to cover global demand for nearly two years. The Board was satisfied that the Afghan Government had ignored the debate and the pressure of those pushing for legalization.

Giving some highlights of the report’s analysis of the world drug situation, he said cannabis continued to be the planet’s most abused drug, Afghanistan continued to be the source of the world’s illicit opiates and Africa continued to be increasingly targeted by cocaine-trafficking organizations.

He also cited rising abuse of and trafficking in cocaine in a number of South Asian countries, and said that Europe was the world’s biggest abuser of cocaine; drugs were being exchanged for arms in some parts of the world, including Papua New Guinea; large-scale illicit manufacturing of MDMA (Ecstasy) continued in Australia; and Oceania continued to be a major route for the transhipment of Ecstasy and other methamphetamines.

The official’s exchange with reporters centred on recent public criticism that INCB was impeding the global fight against HIV/AIDS and lacked accountability, with correspondents asking Dr. Emafo about INCB’s position on so-called “safe injection rooms” and needle exchange programmes, as well as its lack of cooperation with anti-drug activists and civil society organizations.

To suggestions that the Board was ignoring proven measures that provided clean needles and treatment to drug users, he said that its mandate was to ensure that drugs were available for medical and scientific purposes. However, the Board was aware that those who used drugs shared needles and that the sharing of needles could lead to the transmission of virus such as hepatitis B and HIV. “Therefore, the Board believes that action could be taken to reduce the chances of the transmission of these viruses through the offering of sterile needles and syringes. They Board has never been against that particular practice,” he said.

But the Board “frowns seriously” on rooms being established for the purpose of abusing drugs obtained illicitly -- and that practice being called “treatment”. “If you are treating an individual, you should know what you are treating an individual with,” he said. The relevant conventions provided for prevention, after care, treatment, social reintegration and rehabilitation of drug dependent persons. Governments should ensure that persons under the influence of drugs or drug dependent were treated humanly and reintegrated into society. But, the Board did not believe that it was right for people to be encouraged to come to a “room” and abuse drugs. “By so doing, Governments were promoting drug abuse,” he said.

To charges that the Board was against the use of substitution treatment, he refuted that allegation, saying that the Board had continually held that, if medical practice in any country allowed for such treatment, then it was the “best practice”. He urged correspondents to look at the Board’s 1993, 2000 and 2003 reports, where it had clearly stated what it thought should be done for drug dependent persons. The Board believed that there should be drug reduction worldwide and that people who were drug dependent should be treated, not encouraged to use drugs.

Mr. Kouame added that the entire issue had been presented in the press as “drug control v. HIV/AIDS”, and that was not the case. Drug control was centred on harm reduction. INCB was ensuring that people who received drugs were receiving them under proper conditions, in line with the aims of the relevant international conventions. Drug addiction was as much a disease as AIDS, and needed to be treated. INCB was focused on drug control. That was its mandate.

On transparency and why the Board had no dealings with civil society, Dr. Emafo said that INCB’s mandate was to discuss drug control matters with Governments, not with civil society. He added that the Board also consulted with intergovernmental organizations and other international organizations that had mandates for drug control, such as Interpol and the United Nations Office on Drugs and Crime (UNODC).

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For information media • not an official record

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