The Right Chemistry: The scourge of counterfeit drug production

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Some of the drugs lack any active ingredient, some are degraded medications, and some are legitimate drugs diluted to ineffective levels.

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No visit to Vienna is complete without a ride on the Wiener Riesenrad, the giant Ferris wheel that since its construction in 1897 has been a landmark in the city’s famed amusement park, the Prater. I first heard about this attraction from my father who had been sent by my grandparents to an accounting school in Vienna in the early 1930s. He would tell me stories about the delights of Sacher cake, wiener schnitzel and riding in the cabins of the giant wheel. After we had escaped from the Russians to Austria during the Hungarian Revolution of 1956 by crawling through the mud under the barbed wire fencing that marked the border, we ended up in Vienna. What a thrill it was to be taken to the Prater! The Riesenrad was even bigger than I had imagined.

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I think one of the reasons that I became a fan of The Third Man, the classic 1949 film, is that a pivotal confrontation between Holly Martins, the good guy, and Harry Lime, the devious racketeer, takes place inside a cabin of the giant wheel. But there is another reason the film appeals. It has a fascinating scientific connection. The existence of the fictional racket in which Lime is involved, the selling of fake penicillin, was actually stimulated by factual events. Not only that, the marketing of counterfeit drugs has since become even more real, blossoming into a global industry that leaves a swath of misery in its wake.

Penicillin was the world’s first legitimate wonder drug, effective in the treatment of various microbial infections, including venereal disease. Although it first became available in 1941, supplies were limited and were mostly restricted to use by the military. This led to a large black-market trade, and in 1946, the year in which The Third Man takes place, seven men and three women were arrested in Berlin, charged with the manufacture and sale of fake penicillin. The ring included an American doctor, two former GIs and a former German army private who was the leader and organized the theft of used penicillin bottles. These were then filled with the antimalarial drug quinacrine and some face powder dissolved in a glucose solution. Besides being totally ineffective, the fake penicillin was also contaminated by impurities that at least in one case made a Russian officer who had been injected extremely sick.

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Graham Greene, who wrote the screenplay for the movie, worked for the British Secret Intelligence Service during the war and was very aware of the illegal penicillin trade. He even knew the drug had been used as an espionage tool by Major Peter Chambers, an American intelligence officer who extracted secrets from Soviet soldiers in return for penicillin to treat their gonorrhea and syphilis. The soldiers were quite keen on this deal, given that contracting the disease could lead to a court martial. According to historians Paul Newton and Brigitte Timmermann, who described this scheme in the British Medical Journal, Chambers had given it the memorable codename Operation Claptrap.

In the film, Lime organizes the theft of real penicillin from a military hospital by an orderly and enlists a physician, Dr. Winkel, to sell it to a hospital where it is to be used for treating children afflicted with bacterial meningitis. The doctor’s apartment is filled with expensive objets d’art, so he obviously has been well paid for his black-market crimes. And crimes they were, since the children treated with the fake drugs were dying.

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Harry Lime had hatched a clever scheme to evade the authorities by faking his own death. Holly Martins, who had come to Vienna on the invitation of his old friend Harry only to find he had just been killed in an automobile accident, becomes suspicious of the death when he hears from a witness that contrary to the police report stating that two men had carried Harry away after the accident, there was a “third man.” He eventually discovers that Harry is still alive and the man killed in the accident and buried in his place was the orderly who had stolen the penicillin. Was Harry the “third man” at the scene who pushed the orderly into the path of the car?

When Holly finds out from the police investigator that Harry was involved in the penicillin scheme and is then invited to the hospital to see for himself the “murder” of the children, he agrees to co-operate with the police and trap Harry. A chase through the sewers of Vienna follows and in the end Harry learns that crime does not pay.

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Unfortunately, today, crime does pay for a lot of criminals around the world involved in counterfeit drug production. About a third of all prescription drugs in developing countries are fake, and countless numbers in the developed world are exposed to fakes from rogue online pharmacies. Some of the drugs lack any active ingredient, some are degraded medications, and some are legitimate drugs diluted to ineffective levels. Obviously, drugs for malaria, cancer, hypertension and infections that have no active ingredient are directly responsible for killing people, but the diluted antibiotics or malaria medications are harmful in yet another way. They don’t have enough of an active ingredient to treat the disease, but it is enough to foster resistance in bacteria and in the parasite that causes malaria. COVID has also give rise to fake drugs, including hydroxychloroquine and ivermectin. Even real hydroxychloroquine is a problem because while it is ineffective against COVID, it can cause resistance against the malaria parasite.

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Like Harry Lime, the fake drug producers do not care about lives. When Harry is looking down from the Riesenrad he asks Holly if he would feel pity if one of the “dots,” the people walking far below, stopped moving forever. Criminal counterfeitersdo not care how many dots they wipe off the face of the Earth.

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Joe Schwarcz is director of McGill University’s Office for Science & Society (mcgill.ca/oss). He hosts The Dr. Joe Show on CJAD Radio 800 AM every Sunday from 3 to 4 p.m.

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