In early 2005, a 23-year-old complaining of fever was taken to a rural hospital in eastern Myanmar and diagnosed with an uncomplicated form of malaria. He was treated with a standard dosage of an inexpensive oral antimalarial known as artesunate, a derivative of a key malarial drug that had already successfully treated hundreds in the area. Yet on the third day, the man fell into a coma with kidney failure. Stronger medicines administered at a second and then third hospital were unable to fight off the increasing numbers of malarial parasites in his bloodstream. He died shortly after.

As it turned out,  the artesunate he’d been given was fake. Labelled as manufactured by Chinese company Guilin Pharmaceutical, the tablets were part of a large batch purchased by the public hospital that turned out to be bogus. In this case, the supposedly life-saving drug contained little more than paracetamol. Incensed by what should have been an easily preventable death, the village committee collected all the artesunates they could find from local shops, built a bonfire, and sent them up in flames.

Almost 15 years later, the scourge of fake medicines continues in Southeast Asia, a hub for cross-border drug smuggling, with new cohorts of fraudsters able to slip poor quality medicines into the largely unregulated supply chain with increasing sophistication, making detection harder than ever.

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Cristyn Lloyd

Cristyn Lloyd is a freelance writer based in Phnom Penh.