COMBATING COUNTERFEIT DRUGS IN INDONESIA National Agency of Drug and Food Control Indonesia First ASEAN-China Conference on Combating Counterfeit Medical Products Jakarta, 13-15 November 2007 BACKGROUND INDONESIA located between two continents and two oceans, which is easily accessible by land, sea, or air. some problems are still being faced, including in the field of drug control. problems may arise from borderline areas, which are susceptible to smuggled, counterfeit medicines. Regarding counterfeit medicines they may be Illegally imported or Distributed Locally manufactured by to illegal illegal manufacturer market NUMBER OF INTERNATIONAL PORT SEAPORT : 141 AIRPORT : 10 FREE TRADE ZONE Free Trade Zone BATAM, including Batam Island, Tonton Island, Setotok Island, Nipah Island, Rempang Island, Galang Island and Galang Baru Island. Free Trade Zone BINTAN, including Galang Batang Industrial Estate, Maritim Industrial Estate, and Loban Island, Senggarang Industrial Estate and Dompak Barat Industrial Estate Free Trade Zone KARIMUN, including number of Karimun Island, Karimun Anak Island Free Trade Zone SABANG. LEGISLATIVE INFRASTRUCTURE BORDER POST Efforts have been taken by establishing Border Posts in some areas, i.e : SKOU (Papua New Guinea) MOTA AIN, NAPAN & META MAUK (Timor Leste) MARORE & MIANGAS (Philipine) ENTIKONG & JAGOI BABANG (East Malaysia Land) NUNUKAN (East Malaysia Ocean) SUNGAI GUNTUNG (West Malaysia Ocean) SAMBU BELAKANG, PADANG & TAREMPA (West Malaysia Ocean) Objective : To control imported goods To minimize illegal & counterfeit drugs entering the country Definition Counterfeit Drugs (CD’s) definition in Indonesia based on Indonesian MoH Decree No. 949/2000 : A medicinal product which is manufactured by illegal manufacturer or deliberately mislabeled with respect to identity of registered product. Basic Law and Regulation related drug counterfeiting 1. 2. 3. 4. 5. Law No. 1/1946 on Criminal Act Law No. 23/1992 on Health Law No. 8/1999 on Consumer Protection Law No. 14/2001 on Patent Law No. 15/2001 on Mark NUMBER OF CASES ILLEGAL SECTOR OPERATION RESULT (NADFC DATA) PERIODE 2005 - October 2007 Number of Cases 60 51 50 40 37 Total 28 30 20 14 13 15 Illegal Imported products 21 19 Counterfeit drugs 10 2 0 2005 2006 Year 2007 COUNTERFEIT DRUGS (55 ITEMS) PERIODE 2005 - October 2007 9% 15% 4% 7% 28% 2% 4% 11% 7% 4% 9% analgetic antiinfection antihistamine antidiabetic antihipertensi afrodisiak antiinflamasi transquilizer hormon others vitamin FINDINGS ON CASE I (2007) 13% counterfeit drugs 22% IIlegal imported drugs Not confirmed yet 65% FINDINGS ON CASE II (2007) 27% 29% counterfeit drugs IIlegal imported drugs original 10% Not confirmed yet 34% COUNTERFEIT DRUGS FINDING FREQUENCIES PERIOD 2001-2007 (October) Ponstan 500 mg Fansidar tablet obat palsu drugs Counterfeit Dextamine tablet Daonil tablet Ponstan 250 mg kapsul Lasix tablet Incidal kapsul Supertetra soft cap Fulcin 500 mg tablet Broadced inj 1 g Amoxsan 500 kapsul 0 1 2 3 4 5 frekuensifrequency temuan per 7 tahun terakhir * The data is made from finding frequencies > 3 times 6 7 NUMBER OF CASES SUSPECTED CONFIRMED IMPORTED / DOSMETIC VITAL MEDICAL 2007 2 * 2 Import and Domestic Yes 2006 1 1 Domestic No 2005 3 3 Domestic Yes (injectable) * a result of joint operation whereby an illegal warehouse was found filled with thousand of boxes of 26 items of counterfeit medicines, with an estimated value of up to 25 billion rupiahs HOW WHERE THESE CASES DETECTED % or number of cases Patients complaints NO DATA AVAILABLE Health professionals reports NO DATA AVAILABLE Enforcement/investigation work NO DATA AVAILABLE Routine checks NO DATA AVAILABLE Reported by affected manufacturer 28,6% (2005), 20 % (2006), 4,16% (2007) NUMBER OF PROSECUTIONS / CONVICTIONS/PENDING NADFC DATA MANUFACTUR ER WHOLESALER / IMPORTER RETAILER INFORM AL SECTOR 2007 1( in process) 1 (in process) 2006 - - 1 (in process) 2005 - - 3 (2 Sentence penalty, 1 Wanted List) - NATIONAL COORDINATION Mechanism of national coordination Combating Counterfeit Drugs requires joint effort Government Drug/National Regulatory Authority Drug medicines manufacturers importers & wholesalers Healthcare & medicine providers medicines Civil societies Patient Interest Groups Ministries, police, customs, Prosecutors Patients / consumers BENEFITS & LIMITATIONS OF COORDINATION BENEFITS Technical support such as laboratory test, expert witness statement will be provided by NADFC if needed If facing difficulties, force effort will be provided by the Police Provided information of import-registered products for the custom Several Laws and regulation as basic legal process to combat Counterfeit Drugs are available • LIMITATIONS Lack of the reference standard available in NQCL Lack of coordination among law enforcement agencies at all level (National-provincial-district) On-line system is not in place Weakness of Implementation of some Laws, such as need appeal from the manufacturing authorization holder of authentic drugs STRATEGIC ACTION ON COMBATING COUNTERFEIT DRUGS (CDs) in INDONESIA ILEGAL MANUFACTURER ILLEGAL MARKET CONSUMER National Program ; ILEGAL DISTRIBUTOR FACTS : • CDs are found, mostly in illegal market • Difficult to differenciate with the genuine one • Lack of public awareness (consumers buy drugs in the illegal market) STRATEGIES : • Breaking up the Illegal chain • Sustainable law enforcement with deterrent penalties • Reveal modus operandi, identify the intellectual actors and their network • • • • • • Comprehensive investigation and mopping-up what is already in circulation National Joint Operation and joint investigatin with police (in ilegal market) Strenghtening the infrastructure Improvement collaboration and coordination with other law enforcement agencies Increasing comprehensive drug distribution control Increasing public awareness and law enforcement agencies REGIONAL LEVEL GAPS IMPLICATIONS STRATEGY Inter-sectoral coordination is not based on written procedure which are clearly defined roles, adequate resources and effective administrative and operational tools. Lack of awareness about the severity of the problem among stakeholder. No comprehensive program on combating counterfeit drugs Develop national tskforce on intersectoral coordination base on written procedures, clearly defined roles, adequate resources, and effective administrative and operational tools. No deterrent sanctions No specific law on Counterfeit Drugs. Limitation of reference standard on NQCL No deterrent sanctions The time line of lab result is not on schedule Increasing awareness on the harmful/impact of counterfeit drugs through seminar for the specific target groups such as Pharmaceutical Manufacturer, Health professionals, patients, training for Law enforcement Agencies, and DRA Assist national authorities to develop risk communication and advocacy materials Develop draft on counterfeit drugs Law Need collaboration to get reference atandard assist by WHO REGIONAL LEVEL GAPS IMPLICATIONS STRATEGY Lack of Information difficulties on Promote networking and Exchange among contacting the collaboration among ASEAN DRA countries, no designated person in charge on counterfeit drugs person in charge at DRA Different definition of Different follow Develop TOR which are include Counterfeit Drugs up action discussion among ASEAN among Countries countries on : Lack of networking on the definition of counterfeit Counterfeit drugs difficulty to know drugs. problem among ASEAN the genuity of Survey existing national and DRAs the suspected international legislation & drug requirements Difficulty to trace Assess existing national best practices and develop model the suspect if best practices they escape to Promote secure exchange of other countries information and alerts among ASEAN DRA Proposed Project against Counterfeit Drugs ASEAN Project on Strengthening Collaboration on Combating Counterfeit Drugs Development of common definition of counterfeit drug within ASEAN Countries Development ASEAN Scheme on tackling of counterfeit drugs Development a Regional Strategy and Systematic Program OUTPUT Exchange of information by designated unit of DRA Develop data base of counterfeit drugs Develop Alert System CONCLUSION No adequate data on “how where the cases detected” showed that reported mechanism is not in place as well as awareness of severity of the cases Weaknesses on inter sectoral coordination due to some factor i.e : no written standardized procedure, no specific law on counterfeit medical product. Lack of networking on combating counterfeit medical product in regional, i.e : among ASEAN countries. EXPECTATION Establish national and regional taskforce on combating counterfeit drugs Combating counterfeit drugs need international support still a long way to go! ENTIKONG NUNUKAN SKOU JAGAOI BABANG back MIANGAS & MARORE SUNGAI GUNTUNG TAREMPA, SAMBU BELAKANG PADANG back MOTA AIN, NAPAN, META MAUK
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