Moderators: Dr G. Vecina Neto, Brazil, and Dr H. Rees, South Africa

There is widespread recognition that, at its worse, counterfeiting can lead to significant morbidity and mortality. This is particularly serious with regard to the high percentage of counterfeit antibiotics and steroids available. The amount of counterfeit drugs increases in developing countries - the possibility of counterfeits being offered in the United Kingdom is less than i%, and in Brazil it is less than 5% - while in Niger it is 40%. Unfortunately, there is a general lack of national data available on counterfeit drugs.

At the national level, there is a need to encourage increased reporting of possible counterfeit drugs. A basis for suspicion of counterfeiting and reporting would be different appearance of drug or packaging from the original, ineffective action, or very low price. At the national and international levels, industry should be more closely engaged in identifying possible counterfeit medicine outlets.

Many countries should focus attention on the appearance of counterfeit drugs on the domestic market. Equally important is the regulation of exports. Maintaining the standards of exporting companies must be seen as an integral role of legislation and regulation. The need for improved international cooperation is essential through organizations such as WHO, UNICEF and Interpol.