Lessons from a Syrian Drug Bust

Over the last three years, the Syrian government has delivered recent history's biggest blow to the illegal pharmaceutical trade--and it hasn't been nearly enough. It's time for Syria's neighbors to follow its example.

Earlier this month, Syria passed Legislative Decree 24 to stamp out the distribution of bogus medicines. This marked the culmination of three years' work which has so far included the prosecution of a network of more than 70 Middle Eastern Arabs, responsible for untold needless deaths. Their syndicate sold dummy drugs which promised, but failed, to treat leukemia, breast cancer, bacterial infections, and other diseases, and in many cases worsened patients' conditions. The crackdown is a domestic triumph for Damascus, since it may be the largest fake-drug ring broken up anywhere in the world.

The Syrian triumph begins in Baghdad. The sanctions placed on Iraq after the first Gulf War encouraged vast amounts of illegal pharmaceutical trafficking, which intensified following the 2003 U.S. invasion. A large operation was developed by various families based in Ramsa, Jordan and Dara'a, Syria, who had previously been peddling legitimate medicines across borders, but from 2003 onward started making the drugs themselves, or finding them from other unauthorized sources.

Working with Chinese suppliers, the Jordanian-Syrian network sold smuggled stolen, expired, and increasingly fake medicines into Iraq, as well as at least six other Arab nations--Syria, Jordan, Lebanon, Egypt, the United Arab Emirates and the Palestinian territories. Their operation included erectile dysfunction and other lifestyle drugs. But their main market was in counterfeiting high-value life-saving drugs. Because the ring acted as wholesalers, their products infiltrated the legitimate supply chain.

For years, it went unnoticed. In the chaotic or degraded environments that exist in much of the Middle East, the death rate from life-threatening illnesses is higher still than much of the rest of the world, and clinical statistics are often poorly kept. Friends or relatives of those who die are obviously saddened, but not necessarily shocked. So the excess deaths caused by the illegal drugs did not raise suspicions.

But three years ago, a keen-eyed pharmacist in Amman, Jordan noticed a problem, and after a brief investigation, the Jordanian anti-corruption police raided several warehouses and a production center, making numerous arrests. Thousands of packets of fake drugs were found in the raids, yielding expired products made by numerous western and Indian firms, as well as fake versions of their products. Expired products can be just as dangerous as fake products, since legitimate but stale drugs break down into dangerous products. Even harmless old acetaminophen (better known as Tylenol or Paracetemol) can be lethal once it passes its sell-by date and begins to degrade. Faked drugs have these breakdown problems too, as well as the likelihood of fungal, bacterial, and viral contamination, since they are produced under unhygienic conditions. Additionally, toxic ingredients may be added to make the pills look good. In the fake pills I've examined I've found bleach, road paint, expired legitimate drugs, and numerous unidentified compounds.

Seventeen individuals were arrested at that first Jordanian raid. But prosecutors were frustrated by domestic law, which is harsh on the narcotics trade, but treats the faking of life-saving medicines as only a minor felony. None of the perpetrators served more than two months in detention, and within three months they had reestablished operations in Egypt and Syria, with their headquarters in Damascus.

Over the next 18 months, fake medicines turned up in Egypt, Syria, Iraq and the Palestinian territories; all had product identification--notably batch numbers and minor packaging flaws--which showed they had come from the same source.

That's when security authorities across the region made their move. After a successful intelligence campaign, local agencies made 15 arrests in Palestine, several in Egypt, and dozens in Syria. The haul from the Syrian warehouses in Damascus and Aleppo alone brought in four tons of expired, stolen, and mainly fake, drugs. Many of the packages allegedly made by companies like GSK, Novartis, Roche, Pfizer and Bristol Myers, had "Ministry of Health Iraq" marked on them, and the war-torn country was undoubtedly the target for many of the products.

While security sources tell me that up to 80% of this illegitimate-drug network has been permanently stopped, there is little doubt that operators throughout the region are still at large and are hunting for new production sources. But Syria at least is closed for business.

Yet until Decree 24 was passed, Syria--like most other countries in the Middle East--didn't have a proper law to prevent pharmaceutical crime. So the dozens of people arrested during the raids were held for many months under security provisions. With the new decree, these people will be prosecuted, and face sentences of up to 20 years of hard labor.

It is obvious that through international intelligence operations, the cooperation of western drug companies and Middle Eastern security officials, and the help of alert and brave members of the public, the fatal menace of the fake drug trade can be shut down.

But the broader implications for the region are that most countries currently have inadequate laws against faking medicines. Until that changes, expect many more people to die from this most odious of trades.

Roger Bate is the Legatum Fellow in Global Prosperity at AEI.

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About the Author


  • Roger Bate is an economist who researches international health policy, with a particular focus on tropical disease and substandard and counterfeit medicines. He also writes on general development policy in Asia and Africa. He writes regularly for AEI's Health Policy Outlook.
  • Phone: 202-828-6029
    Email: rbate@aei.org
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