Armenia: The Drugs Don't Work

When Yerevan pensioner Gohar Simonian fell ill with pneumonia, she was prescribed strong antibiotics which she purchased from a local pharmacy. When they had no effect, she returned to her doctor, who soon discovered that the tablets were useless fakes.

"As a result of taking these counterfeit drugs, Simonian has developed a specific microbial immunity and cannot now be cured, even with the strongest antibiotics," general practitioner Levon Ghukasian told IWPR.

Official records at the Armenian Department of Pharmaceuticals and Medical Technology suggest that every tenth medicine sold in the country is a fake - independent analysts put the figure at 50 per cent.

Ghukasian told IWPR that counterfeit painkillers are widely available - including drugs commonly used during surgery.

"Put yourself in the shoes of a surgeon who has administered local anaesthesia, and prepares to cut, but then discovers the anaesthetic did not work," he said. "Even worse, imagine how the patient feels."

As the bogus drugs are sold in regular pharmacies and are often indistinguishable from the genuine article, only specialists can tell the good from the bad. Academic Emil Gabrielian, director of the Agency for Medical Supplies and Technology, described the situation as "alarming".

A series of surveys conducted by the agency over the past year discovered that more than 100 popular products contained very different formulas from that declared on the packaging.

One item in three was found to contain something completely irrelevant or devoid of any medicinal value. "Some of those drugs were useless imitations," Gabrielian told IWPR.

"During one of our audits, we found a large consignment of vials allegedly containing Haemodesum - a water and salt solution used intravenously to treat intoxication - which actually contained dirty water."

Hrayr Aramian of the State Commission for the Protection of Economic Competition believes that such practices must be stamped out, but admits, "As long as there is a high demand for pharmaceuticals, there will be dishonest people manufacturing and selling fake drugs."

However, the commissioner believes that the sale of drugs that have passed their sell-by date is equally life-threatening and must be treated in the same way as the sale of bogus ones.

Aramian explained that expired pharmaceuticals are difficult and expensive to destroy without causing environmental damage, and huge stocks of such medicines therefore build up in warehouses across Armenia.

"As a result, these expired drugs can illegally make their way onto the market with the most detrimental consequences for thousands of consumers," he said.

Gaps in the relevant legislation also cause difficulties for those who seek to regulate the sale of drugs.

The health ministry teamed up with the police to audit Yerevan's pharmacies in August. The findings astounded even veteran surveyors.

"We found numerous gross violations of pharmaceutical safety standards," a surveyor, who asked not to be named, told IWPR. "Some of them qualified as felonies."

Meanwhile, experts are sceptical about pharmacy audits. "These audits are not going to make a difference unless the laws are changed," said merchandiser Armen Sonian. He thinks the existing laws leave too many loopholes for dishonest dealers.

While around 40 per cent of the pharmaceuticals on the market are genuine and properly registered, they are classed as "contraband" as they have been imported illegally and can be acquired quite cheaply.

Retail pharmacies continue to stock and sell them, as they often cannot resist such offers. One Yerevan employee, who would not give her name, said, "If someone who has brought in a consignment of drugs from Poland offers us a big box of hugely popular painkillers for literally no money, of course we are tempted."

The non-governmental organisation Pharmacists' Union notes that the legal pharmaceutical business has become unprofitable, as it is consistently undercut by cheap illegal imports.

Analysts believe that an Armenian law making pharmaceuticals liable for value added tax, VAT, which came into effect in January 2001, caused an increase in contraband imports.

In neighbouring Georgia, for instance, drugs are VAT-exempt and cheaper. Since the January 2001 law was passed, illegal imports of drugs into Armenia have increased exponentially, smuggled across borders in boxes, purses and suitcases.

Hakop, a small-time trader at the Bagratashen market near the Georgia-Armenia border, told IWPR, "Once I saw customs officers stop two women who were travelling on a Tbilisi-Yerevan coach. They were trying to smuggle six crates of pharmaceuticals into our country.

"They probably would have made it past the checkpoint if they had bribed the driver. Most smugglers do, and get away with even larger amounts of contraband."

Tigran Avetisian is a is a journalist for the Aravot newspaper in Yerevan.