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Cablegate: Burma Can't Fight Phony Pharmas From India And

This record is a partial extract of the original cable. The full text of the original cable is not available.

UNCLAS SECTION 01 OF 02 RANGOON 000110

SIPDIS

SENSITIVE

STATE PASS AID/ANE, HHS FOR OGHA
STATE FOR EAP/BCLTV, EB, AND OES
BANGKOK FOR AID
USPACOM FOR FPA

E.O. 12958: N/A
TAGS: EAID SOCI ECON BM
SUBJECT: BURMA CAN'T FIGHT PHONY PHARMAS FROM INDIA AND
CHINA


1. (SBU) Summary: Sick Burmese are suffering under a flood of
fake, unregistered, or sub-standard pharmaceuticals primarily
imported from India and China. Though honest importers and
the government are making some efforts to deal with the
situation, little can be done without a better regulatory
framework, more government enforcement resources, and an
improvement of the economy. End summary.

A Flood of Knock-Offs

2. (SBU) A prominent physician, drug importer, and head of
the Myanmar Pharmaceutical Suppliers Entrepreneur Association
(MPSEA), echoed recent statements by WHO that ersatz,
unregistered, and sub-standard medicines were growing
problems for Burma. Though domestically produced Burmese
fakes are limited mostly to local-label vitamins and mild
pain relievers, the majority of imported counterfeits are
powerful brand-name antibiotics and other drugs used to fight
serious infectious diseases like TB. He asserted that
increasing poverty in Burma was driving demand for cheaper
drugs and that supply was abundant due to booming counterfeit
drug industries in neighboring India and China. Poor legal
controls on the distribution of pharmaceuticals in Burma,
wide-open borders, and inadequate government resources to
enforce existing regulations exacerbate the problem.

3. (SBU) Currently the law requires all drugs for sale in
Burma be tested by and registered with the GOB's Food and
Drug Administration (FDA). In reality, though, the FDA has
few resources to spot check pharmacies -- usually quite
informal -- and drugs for sale to ensure they are genuine and
registered. Instead, the government is dealing with the
growing problem by trying to arrest distributors and
importers suspected of dealing in fake pharmaceuticals. On
December 13 of last year, authorities arrested several people
and seized more than five million phony imported antibiotic
capsules.

Don't Do (Fake) Drugs!

4. (SBU) In the current environment, it is a losing battle
against these dangerous medicines. The doctor said that
counterfeiters are so good now it is impossible to tell a
drug is fake from its appearance or packaging. Only lab
tests can tell the difference between real pharmaceuticals
and the chalk or flour fillers favored by fraudsters. In
Burma such testing is quite difficult due to a lack of
knowledge, labs, and human resources. Even prices offer no
clue. Though knock-offs have gained market share because
they are cheap, there is no way for a consumer to know
whether a certain drug is being sold "below market" value.
There are no common benchmark prices for drugs amongst the
country's distributors -- only a tiny number of which are run
by someone with any pharmacological training. Also, clever
counterfeit dealers often discount their wares only a small
amount (perhaps 5 kyat (0.5 cent) per tablet) to avoid
arousing suspicion.

5. (SBU) For now, the doctor said, his association is
striving to educate the government and consumers via the
media regarding the dangers of counterfeit or sub-standard
pharmaceuticals. Association members have also agreed to
police themselves, trying to avoid buying and distributing
bad medicine and encouraging other sellers in their
marketplaces to eschew the cheap but dangerous drugs.
Finally, the MPSEA is reaching out to the best-established
pharmacies and private clinics around Rangoon, urging them to
pay a little more to buy from well-known multinational
companies via reputable importers -- such as MPSEA members.

Comment: Little Can Be Done

6. (SBU) The Association's best education efforts and the
government's arrests only scratch the surface. Nothing will
stop the inflow and consumption of bogus drugs until there is
a better regulatory framework and more resources for
enforcement. Currently there is no system of prescriptions
and no requirements for the establishment of a pharmacy or
for selling even the most potent medication. The situation
may get worse, the physician opined, if India cracks down on
its domestic sales of counterfeit pharmaceuticals and its
producers rely even more on Burma for sales. End comment.
Martinez

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