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Counterfeit Medicines on the Rise in India

By Steve Herman New Delhi 16 May 2007

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Adequate health care remains unavailable to most of India's citizens, especially in rural areas. Even those fortunate enough to have access to good care, however, cannot be certain that a prescription from a reliable doctor will ensure their recovery. VOA's Steve Herman in New Delhi explains why.

A customer - in this case, someone sent by Voice of America - complains of sleeplessness and gets a New Delhi pharmacist to hand over a packet of pills without a doctor's prescription.

In India, it is easy to get around the law requiring a prescription for most medicines. But, with or without a prescription Indians cannot be sure the drugs they buy are real, or safe.

Experts say millions of people in India each day are sold counterfeit medicines.

Sanjiv Zutshi M.D.

Dr. Sanjiv Zutshi, a New Delhi physician, thinks nearly anybody in India who receives medication is taking a gamble.

"I think it must be 20 to 30 percent of the drugs might be counterfeit or substandard in that nature," he said.

Surveys have found that in some medicine bazaars here, more than 90 percent of the drugs bought and analyzed are fakes, although many come in sophisticated packaging and look just like the real thing.

Dr. Zutshi says the widespread problem undermines the country's entire health care system.

"I need to be pretty sure that the medicine which I am giving is going to treat the disease," he said. "Otherwise, what's the use of a physician seeing a patient? The whole exercise becomes useless."

There are only 35 drug inspectors at the national level and little more than one thousand spread across India's 28 states. This for a country with more than half a million retail drug outlets and a population exceeding one billion.

Sushma Swaraj

Former Health Minister Sushma Swaraj, now an opposition member of parliament, says those trading counterfeit drugs are conspiring in what she terms "mass murder." She says the culprits are not just drug manufacturers, distributors and retailers.

"Such crime is committed always in connivance with the police," she said. "So many people are being benefited by the money trail. But they don't think how many hundreds of thousands of people are being killed."

She drafted an amendment to India's Drugs and Cosmetics Act, which would have enacted the most severe punishment for those making counterfeit medicines.

"Only you need one or two convictions and one or two hangings. If they think that 'oh, these two drug manufacturers have been given death sentences, they've been hanged,' it will give such a big effect," she said. "Today they are not afraid of anything."

Those in the illicit trade may have little to fear. The legislation, which is still pending, has been watered down and the maximum penalty now is life imprisonment and fines. And there is no indication if or when parliament will act on the bill.

For now, worried physicians, such as Dr. Zutshi, can offer few assurances to patients that they will exchange prescriptions for authentic medications.

"Get it from a reliable chemist," he said. "And do take a receipt for the medicines you have bought and, if possible, go back to the doctor if the effectivity [effectiveness] of the drug is not there."

Authorities say that is good advice for consumers everywhere, not just in India. Counterfeit drugs are being produced and sold in other parts of South Asia, China, Eastern Europe and Latin America. The Center for Medicines in the Public Interest in the United States predicts that sales of bogus pharmaceuticals will total $75 billion by 2010, double the market in 2005.

West Africans Anticipate New Relationship With France

By Naomi Schwarz Dakar 15 May 2007

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France's president-elect, Nicolas Sarkozy, will be inaugurated on Wednesday. Some West Africans, uneasy over Sarkozy's campaign statements on immigration and the status of immigrants, say they worry about their countrymen living in France as well as about the impact on Africa of Sarkozy's presidency. But some African analysts say they think Sarkozy will be good for French-speaking Africa, which, they say, relies too heavily on aid from its former colonizer. For VOA, Naomi Schwarz has more on the story from our regional bureau in Dakar.

Nicholas Sarkozy, 24 Apr 2007

Wary eyes in French-speaking West Africa are being directed towards France as Nicolas Sarkozy begins, on Wednesday, his presidency.

Babacar Gueye, political science professor at Dakar's Cheikh Anta Diop University, says most Africans were hoping for a different outcome.

The May 7 run-off election pitted Sarkozy, a business-oriented conservative with a reformist agenda, against Senegal-born socialist Segolene Royal.

Sarkozy's campaign statements on immigration fueled fears in French-speaking West Africa.

Mamadou Barry, spokeman for Senegal's socialist party, says even before the campaign began, Africans were aware of Sarkozy's hardline policies on immigration when he was France's interior minister.

Those included forcibly repatriating some illegal immigrants.

"His policy when he was minister of interior of putting people in the plane like others did before, his former mentors," said Barry. "People started thinking this guy is totally against immigration."

People wait to find out if their visa applications have been approved at the entrance to the French Embassy's visa services office in Dakar, Senegal (File)

Immigration is an important issue in West Africa, where poverty drives tens of thousands each year to seek better jobs in Europe. Many more rely on the funds these immigrants send back home.

Sarkozy has said he wants to revise France's immigration policy to favor highly educated Africans over unskilled workers.

Political Science professor Gueye says this is not good for Africa. He says Africa needs its educated and skilled workers to stay home and develop the country.

But some analysts say the fear of Sarkozy is premature.

Malian women's activist Oumou Touré says most Africans only know what the media has reported about Sarkozy, especially his most incendiary remarks.

Besides, she says, you cannot judge a politician solely by what he says during a campaign.

She says there is a huge gap between actions and words, and she cannot say what impact Sarkozy will have on Africa until he has been president for two or three years.

Senegalese Socialist party spokesman Mamadou Barry hopes Sarkozy will tone down his rhetoric now that the campaign is over.

"Maybe he will have a more humanitarian view," he said. "And, frankly, we will see what really he will do to try to support the economy of those countries sending immigrants, so people will not prefer taking those small boats to go in the ocean to be able to go to France or Spain. Because he is also a very pragmatic guy. We will see really when he comes to power."

Touré says, for one thing, it is time for France to reduce its military presence in Africa.

She says there are fewer wars, and African countries would be better served if France used its resources to support development.

France has military bases in many of its former colonies and retains rapid response troops in Chad, Central African Republic and Ivory Coast.

Nigerian human rights activist Saidou Arji says Francophone Africa's relationship with its former colonizer is already changing.

"At the same time France is trying to reduce its intervention in Africa, the African countries also tried to have several partners. So now I can say that France is not the main partner in terms of trade and other sectors," said Arji.

Political science professor Babacar Gueye says this is a positive development for West Africa.

"Until now, the cooperation between France and Africa was a cooperation based on paternalism, based on aid, and it is time to change that position," said Gueye. "It is time for the African countries to find the solutions to their own problems and stop asking for aid towards France."

Gueye says the election of Nicolas Sarkozy could be the shock Africans need to finally break their dependency on France.

Musharraf Says Muslim Nations Should Stop Blaming Others

By Benjamin Sand Islamabad 15 May 2007

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Pakistan's President Pervez Musharraf has told a meeting of the Organization of the Islamic Conference in Islamabad that Muslim nations must stop blaming others for their troubles and solve their own problems. VOA correspondent Benjamin Sand reports from Islamabad.

Gen. Pervez Musharraf addresses the 34th session of the Islamic Conference of Foreign Ministers in Islamabad, 15 May 2007

Delegations from all 57 members of the Organization of the Islamic Conference attended Tuesday's opening session in Islamabad.

The 38-year-old group is the leading coalition of Muslim nations.

In unexpectedly blunt opening comments, Pakistani President Pervez Musharraf said the meeting comes as the Muslim community faces unprecedented challenges, many of them self-imposed.

"The crises confronting the Islamic world are not only external but also internal, flowing from our own weaknesses, our own vulnerabilities, our own divisions within," he said. "The Islamic world is on a downward slide and we must face this."

General Musharraf said Islamic countries have failed to invest in education and lag far behind the rest of the world in literacy and economic growth.

The president also lashed out at Muslim hardliners who he blamed for fueling Western fears of the Islamic world.

"While the world views Islam as a militant, intolerant religion, this thought is reinforced by our own extremist forces," he said. "We are in a state where these semi-literate clerics are closing the minds of people."

The president urged the Islamic Conference to completely revamp its charter so it can more effectively represent and revitalize Muslim nations.

He said wealthier members of the group should step up their support for lesser-developed Muslim countries.

General Musharraf also called for an end to "outside interference" in Iraq and proposed an all-Muslim peacekeeping force to help patrol the country.

A similar proposal was previously raised by U.S. diplomats but failed to attract support from Islamic countries.

President Musharraf has been a key ally in the U.S.-led war on terror but faces increasing criticism from U.S. officials.

His comments Tuesday come as domestic opposition to his military-backed government has swelled and political analysts here suggest retaining U.S. support may be critical to his political survival.

Pakistan says 600 delegates are attending the conference from the 57 members of the OIC and observer groups. The meeting ends on Thursday.

VOASE0515_Health Report

15 May 2007

Fewer US Women Getting Mammograms
Drop in testing could help explain why breast cancer rates have fallen in recent years.

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This is the VOA Special English Health Report.

Research is often a slow, maddening search for answers where each new finding only seems to raise more questions.

This is the case with a story we told you about last month. It offers a good example of how difficult it can be to define a relationship between two events, or even prove a connection.

In this case, one event was a sudden drop in the use of hormone replacement therapy. The other, which followed, was a sharp drop in the breast cancer rate in the United States.

Many older women stopped taking hormones after a government warning in two thousand two about possible risks.

Last December a team of scientists reported that breast cancer rates fell in two thousand three. Then, last month, they reported that the breast cancer rate was still down in two thousand four. They suggested that the major cause was most likely the drop in hormone use.

For evidence the researchers presented two main findings. One was that the reduction in the breast cancer rate was greatest among cancers fed by estrogen. Estrogen is commonly used in hormone replacement therapy. The other finding was that the reduction happened mainly among older women -- the main users of the therapy.

The scientists suggested that going off hormone therapy reduced the risk of cancer growth. They said other explanations for the drop in the breast cancer rate were possible, but less likely to have played a big part.

Now, a new study looks at one of those other possible influences: a decrease in mammogram testing for breast cancers. The study by the American Cancer Society just appeared in the journal Breast Cancer.

First, the study shows that breast cancer rates began to fall in nineteen ninety-nine. That was three years before the government warning about hormone therapy.

Secondly, the study shows that after the warning, fewer women had mammograms, which are usually done with X-rays. A mammogram is required before starting hormone therapy.

Whatever the reason for the decrease, fewer tests would mean fewer chances to find cancers. Still, many experts believe that the drop in estrogen-fed cancers in older women had something to do with the drop in hormone use.

A final note: government researchers reported Monday that mammogram testing fell four percent between two thousand and two thousand five. The lead researcher called it "very troubling."

And that's the VOA Special English Health Report, written by Caty Weaver. I'm Barbara Klein.

VOASE0515_Explorations

15 May 2007

Charles Lindbergh Flew to Paris, and Into the History Books, 80 Years Ago
On May 21, 1927, he flew the Spirit of Saint Louis across the Atlantic Ocean from New York to Paris and became the first pilot to make the flight without stopping.

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ANNOUNCER:

EXPLORATIONS -- a program in Special English by the Voice of America.

Today, Richard Rael and Shep O'Neal tell the story of one of America's most famous pilots, Charles Lindbergh.

(MUSIC)

VOICE ONE:

Charles Lindbergh is probably one of the best-known people in the history of flight. He was a hero of the world. Yet, years later, he was denounced as an enemy of his country. He had what is called a "storybook" marriage and family life. Yet he suffered a terrible family tragedy.

Charles Lindbergh was born in the city of Detroit, Michigan, on February fourth, nineteen-oh-two. He grew up on a farm in Minnesota. His mother was a school teacher. His father was a lawyer who later became a United States congressman. The family spent ten years in Washington, D.C. while Mister Lindbergh served in the Congress.

Young Charles studied mechanical engineering for a time at the University of Wisconsin. But he did not like sitting in a classroom. So, after one-and-one-half years, he left the university. He traveled around the country on a motorcycle.

VOICE TWO:

He settled in Lincoln, Nebraska. He took his first flying lessons there and passed the test to become a flier. But he had to wait one year before he could fly alone. That is how long it took him to save five hundred dollars to buy his own plane.

Charles Lindbergh later wrote about being a new pilot. He said he felt different from people who never flew. "In flying," he said, "I tasted a wine of the gods of which people on the ground could know nothing."

He said he hoped to fly for at least ten years. After that, if he died in a crash, he said it would be all right. He was willing to give up a long, normal life for a short, exciting life as a flier.

VOICE ONE:

From Nebraska, Lindbergh moved to San Antonio, Texas, where he joined the United States Army Air Corps Reserve. When he finished flight training school, he was named best pilot in his class.

After he completed his Army training, the Robertson Aircraft Company of Saint Louis hired him. His job was to fly mail between Saint Louis and Chicago.

Lindbergh flew mostly at night through all kinds of weather. Two times, fog or storms forced him to jump out of his plane. Both times, he landed safely by parachute. Other fliers called him "Lucky Lindy."

VOICE TWO:

In nineteen nineteen, a wealthy hotel owner in New York City offered a prize for flying across the Atlantic Ocean without stopping. The first pilot who flew non-stop from New York to Paris would get twenty-five thousand dollars.

A number of pilots tried. Several were killed. After eight years, no one had won the prize. Charles Lindbergh believed he could win the money if he could get the right airplane.

A group of businessmen in Saint Louis agreed to provide most of the money he needed for the kind of plane he wanted. He designed the aircraft himself for long-distance flying. It carried a large amount of fuel. Some people described it as a "fuel tank with wings, a motor and a seat." Lindbergh named it the Spirit of Saint Louis.

VOICE ONE:

In May, nineteen twenty-seven, Lindbergh flew his plane from San Diego, California, to an airfield outside New York City. He made the flight in the record time of twenty-one hours, twenty minutes.

At the New York airfield, he spent a few days preparing for his flight across the Atlantic. He wanted to make sure his plane's engine worked perfectly. He loaded a rubber boat in case of emergency. He also loaded some food and water, but only enough for a meal or two.

"If I get to Paris," Lindbergh said, "I will not need any more food or water than that. If I do not get to Paris, I will not need any more, either."

VOICE TWO:

May twentieth started as a rainy day. But experts told Lindbergh that weather conditions over the Atlantic Ocean were improving. A mechanic started the engine of the Spirit of Saint Louis.

"It sounds good to me," the mechanic said. "Well, then," said Lindbergh, "I might as well go."

The plane carried a heavy load of fuel. It struggled to fly up and over the telephone wires at the end of the field. Then, climbing slowly, the Spirit of Saint Louis flew out of sight. Lindbergh was on his way to Paris.

VOICE ONE:

Part of the flight was through rain, sleet and snow. At times, Lindbergh flew just three meters above the water. At other times, he flew more than three thousand meters up. He said his greatest fear was falling asleep. He had not slept the night before he left.

During the thirty-three-hour flight, thousands of people waited by their radios to hear if any ships had seen Lindbergh's plane. There was no news from Lindbergh himself. He did not carry a radio. He had removed it to provide more space for fuel.

Lindbergh after his famous flight

On the evening of May twenty-first, people heard the exciting news. Lindbergh had landed at Le Bourget airport near Paris. Even before the plane's engine stopped, Lindbergh and the Spirit of Saint Louis were surrounded by a huge crowd of shouting, crying, joyful people.

From the moment he landed in France, he was a hero. The French, British and Belgian governments gave him their highest honors.

VOICE TWO:

Back home in the United States, he received his own country's highest awards. The cities of Washington and New York honored him with big parades. He flew to cities all over the United States for celebrations.

Anne Morrow Lindbergh

He also flew to several Latin American countries as a representative of the United States government. During a trip to Mexico, he met Anne Morrow, the daughter of the American ambassador. They were married in nineteen twenty-nine.

Lindbergh taught his new wife to fly. Together, they made many long flights. Life seemed perfect. Then, everything changed.

On a stormy night in nineteen thirty-two, kidnappers took the baby son of Charles and Anne Lindbergh from their home in New Jersey. Ten weeks later, the boy's body was found. Police caught the murderer several years later. A court found him guilty and sentenced him to death.

The kidnapping and the trial were big news. Reporters gave the Lindberghs no privacy. So Charles and Anne fled to Britain and then to France to try to escape the press. They lived in Europe for four years. But they saw the nations of Europe preparing for war. They returned home before war broke out in nineteen thirty-nine.

VOICE ONE:

Charles Lindbergh did not believe the United States should take part in the war. He made many speeches calling for the United States to remain neutral. He said he did not think the other countries of Europe could defeat the strong military forces of Germany. He said the answer was a negotiated peace.

President Franklin Roosevelt did not agree. A Congressman speaking for the president called Lindbergh an enemy of his country. Many people also criticized Lindbergh for not returning a medal of honor he received from Nazi Germany.

Charles Lindbergh no longer was America's hero.

VOICE TWO:

Lindbergh stopped calling for American neutrality two years later, when Japan attacked the United States navy base at Pearl Harbor, Hawaii. The attack brought America into the war.

Lindbergh spent the war years as an advisor to companies that made American warplanes. He also helped train American military pilots. Although he was a civilian, he flew about fifty combat flights.

Lindbergh loved flying. But flying was not his only interest.

While living in France, he worked with a French doctor to develop a mechanical heart. He helped scientists to discover Maya Indian ruins in Mexico. He became interested in the cultures of people from African countries and from the Philippines. And he led campaigns to make people understand the need to protect nature and the environment.

VOICE ONE:

Charles Lindbergh died in nineteen seventy-four, once again recognized as an American hero. President Gerald Ford said Lindbergh represented all that was best in America -- honesty, courage and the desire to succeed.

Today, the Spirit of Saint Louis -- the plane Lindbergh flew to Paris -- hangs in the Air and Space Museum in Washington, D.C. And the man who flew it -- Charles Lindbergh -- remains a symbol of the skill and courage that opened the skies to human flight.

(MUSIC)

ANNOUNCER:

This Special English program was written by Marilyn Rice Christiano. Your narrators were Richard Rael and Shep O'Neal.

I'm Shirley Griffith. Listen again next week for another EXPLORATIONS program on the Voice of America.