Industry sources say that drugs worth about Tk 700 crore are smuggled into the country or produced here illegally each year, out of a total national drug market worth Tk 3,000 crore.

Counterfeiters are cashing in on demand as patients struggle to pay the high cost of genuine drugs. Poor government supervision, meanwhile, allows their fraud to flourish.

"In fact those items come from India. Sometimes we seize those or custom officers also catch them at the airport. But the reality is that we do not have much manpower to tackle the situation," said one top officer from the Drug Administration, requesting anonymity.

Most fake drugs are substandard in quality, meaning they lack the proper dosage of medicines advertised. In 2003, for example, the government's drug testing laboratory identified fraudulent copies of a drug named Cavinton, used for brain haemorrhages. The fake Cavinton was found to lack one of the main chemical ingredients of the real drug. Cavinton costs around Tk 300 for 50 tablets compared with Tk 130-150 for the fakes.

Many fake drugs are usually of no therapeutic value. The side effects, however, can be extremely harmful. "The direct impact could be life threatening to the patient," said Dr. Nezam Uddin Ahmad, of Bangabandhu Sheikh Mujib Medical University. There are also harmful indirect impacts, he added, saying doctors may not be able to accurately prescribe medicines since the dosages are altered, which can lead to prolonged illness or even a failure to cure a disease.

The government's drug testing laboratory at Mahakhali identified 62 fraudulent and sub standard copies of life saving drugs, including Amoxycillen, Tetracycline, Paracetamol, Cephexine.

"We identify a number of substandard and fake copies of drugs every year and send the report to the Drug Administration. They are the authorities to take actions against the culprits," said Dr. Zahurul Islam, the head of the public health and drug testing laboratory.

Most fakes are made by dishonest pharmacists, according to industry sources. But some small pharmaceutical companies also appear to be involved.

In 2001 the government cancelled the licences of 44 small companies for producing counterfeit drugs. It is not known, however, how many were prosecuted. Twelve others were restricted to producing particular items. But the clampdown has not stopped the practice.

"Those fake or substandard medicine producers are not paying taxes to the government. They are posing a health risk to the people. The government should take necessary steps against them," said one member of the Drug Industries Associations.

The Drug Administration occasionally raids Babubazaar, the country's largest drug market, and seizes illegal products. Sources in Babubaazar said at least 15 kinds of counterfeit drug brands are available, including counterfeit versions of Perictin, Cavinton, Pathaydin, Kenakta Vayal and Eldakton. Unscrupulous traders also put patients at risk by selling drugs that have crossed their expiry dates. In most cases, they merely change or cover up the original expiry date on the packet.

In big cities, many if not all most of the pharmacies sell authentic medicines, but the situation is far worse in village pharmacies, experts warn.

"Sometimes we get samples from the suburban areas or from remote villages. Most of them are substandard medicines. Those pharmacies are cashing in almost without any monitoring," said an officer from the drug testing laboratory.

Counterfeiting flourishes because of poor government supervision of the pharmaceutical industry. The government has only two testing laboratories and 34 drug supervisors for the entire country, 15 for the head office.

Drug Administration officials maintain that they are doing their best. "We are active within our limited manpower to free the market from counterfeit medicines. Whenever we get information we immediately take action," said Dr. Abdul Hakim, Assistant Director of the Drug Administration.

The leaders of the Druggists and Chemists Association disagree. They say the government is not doing enough to control the illegal manufacture and trade of drugs, and that many officials have been bribed to allow fake drugs onto the market. One source cited officials from the Drug Administration as the main culprit in the counterfeit trade.

"Some of our traders sell fake drugs, it is true. But the Drug Administration should be blamed as they let the fake medicine producers produce those medicines," said Sadequr Rahman, President of the Druggists and Chemists Association. "They should inform us about those substandard products, which are prohibited, or about those companies whose licenses are cancelled. But they do not do that," he said.

He continued, "We want to stop selling those fake medicines and initiated several meetings with Drug Administration officials. But they are reluctant to do anything," he added. "Rather one staff from the Drug Administration collects money from the fake drug traders everyday," he said.

Professor Habibur Rahman, the director of the Drug Administration, refused to make any comment about the issue when this correspondent went to his office.