“This week delegates from about 100 member countries of the World Health Organization are meeting in Buenos Aires with the aim of strengthening defenses against substandard and fraudulent medicines,” Amir Attaran of the University of Ottawa and Roger Bate, a resident scholar at the American Enterprise Institute, write in a New York Times opinion piece. “The meeting is extremely important, but to make progress a number of hurdles will have to be overcome,” they say, noting a paper recently published in the BMJ outlines such challenges. “In Buenos Aires, the delegates first need to agree which medicines are good and which are bad,” the authors say, adding, “[C]ountries need to agree that protecting intellectual property and public health are two different things.” Unless countries define the “difference between honest drug companies that sell accidentally substandard medicines, and organized criminals who sell a deliberately falsified … drug,” then “criminals will continue to slip through loopholes and honest companies, pharmacists and doctors will find themselves prosecuted unjustly,” they write.

“Once they have agreed on definitions, countries must next agree on the legal steps they will take together to improve the quality of medicines,” Attaran and Bate say. “These steps then must be put into a treaty to make them legally binding,” they write, listing three reasons why a treaty is necessary: “First, a treaty will foster cooperation among police and prosecutors in the signatory countries as they go after criminals selling fraudulent drugs”; “Second, countries need to cooperate on technical standards for medicine quality and safety in international trade”; “Third, developing countries need to help to bring better quality medicines to their people.” They conclude, “The richer, more advanced countries should help, out of altruism surely, but also self-interest: Some 80 percent of medicines and their ingredients consumed in the United States come from outside the country, often from developing countries. Simply put, either we help fix their medicine quality problems, or we swallow them with a glass of water” (11/20).