In February 2005, a 23-year-old Burmese man checked into a rural hospital in East Burma with a fairly ordinary case of malaria. The hospital gave him the usual treatment — artesunate pills, a medicine heralded as a miracle cure for its speed in treating the disease. Three days later, he slipped into a coma. Within 12 hours, the man was dead. The miracle drug had failed — or so it seemed. The hospital’s entire stock of artesunate was counterfeit, investigation later showed. The pills, which looked like legitimate artesunate made by Chinese company Guilin Pharmaceutical Co. contained only 20 percent of the necessary active ingredient. Death brought the Burmese man a kind of fame — his was the first confirmed death directly linked to counterfeit antimalarials.

Researchers suspect that counterfeit medicines like the fake artesunate kill hundreds of thousands of people annually, but precisely quantifying the size of the counterfeiting problem is difficult: Few counterfeiters get caught, and even fewer deaths from fake drugs are detected. But as technology makes copying chemicals easier and the Internet speeds the pace of commerce, most government officials, pharmaceutical executives and health care workers fear an epidemic of counterfeit medicines spreading around the globe. The health care nonprofit Center for Medicines in the Public Interest predicts that counterfeit drug sales will reach $75 billion globally in 2010, an increase of more than 90 percent from 2005.

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