US embassy cable - 04RANGOON110

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, Economy 
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