It's an alarming headline, isn't it, particularly when it comes from WHO and is repeated by MHRA (my employer). However, although it may be accurate you need to be careful when interpreting this sort of headline. First off, it's an estimate, and countries with a newly developing market for pharma products tend to have extremely poor stats on prescribing. Then there is the issue that the countries with the highest susceptibility to counterfeits of key health (as opposed to lifestyle) drugs are the ones with very small, and developing markets for drugs. Poor regulation goes hand in hand with a new market. So a third of a very small market is still a a small amount overall. The proportion of global counterfeits which are marketed at developing economies is tiny - the overwhelming majority are directed at the developed world, and the biggest class in these, by a long way are anti-impotence drugs.
It is, nevertheless, absolutely despicable that any criminals would seek to make a profit out of selling fake drugs to a developing market where standards of regulation and product awareness are poor. The safety standards used by the legitimate manufacturers are incredibly high - counterfeit standards are appalling.
One of the positive things the MHRA has been doing is looking beyond our borders and trying to promote higher standards of regulation in other countries, trying to deal with the issue as a true global problem, which is what it is. The other side of the attack is to persuade the countries where, historically a lot of the fake drugs have come from - India, China and Egypt - to come down hard on counterfeiters. This is having good effect in India where there is a lot of interest in cleaning up production, as there is also a large and high quality legitimate supply there. China too is making significant steps in cracking down on counterfeiters for much the same reason.
It's a difficult, and emotive issue, and I'm happy that in the UK at least we employ a large staff to try to keep counterfeits under control - far more than most European countries, which generally have just a handful of staff employed in this capacity. The biggest risk to health from counterfeits in developing markets comes where the drug market expands more quickly than the regulatory regime needed to keep the supply chain clean. Counterfeiters are utterly immoral and would think nothing of exploiting such potential.
Incidentally, all the efforts the MHRA takes to regulate medicines is costly. But who pays? The taxpayer? No, it's the legitimate pharma industry. Medicines regulation gets no money from the treasury at all, it's entirely funded by licence fees of various sorts payed by the pharmaceutical industry.
Jon