Indonesian authorities have arrested 15 people over their alleged role in a nationwide criminal ring distributing fake vaccines to hospitals for more than a decade, according to the Jakarta Post and Australian Associated Press (AAP).
Implications | Counterfeit immunisations including for hepatitis C (HCV), hepatitis A (HAV), tetanus, and measles have allegedly been sold on to private hospitals and medical institutions across Indonesia. |
Outlook | Indonesia's government maintains that only private hospitals were affected by these counterfeit vaccines, although the Indonesian Consumer Foundation is encouraging parents to file a class action against the Health Ministry and the BPOM. Regulating against counterfeit medicines is expected to remain challenging given the country's size and remote rural areas. |
In a recent series of arrests in Indonesia, Rita Agustina and Hidayat Taufiqurahman, her husband, are accused of operating a criminal ring that allegedly injected fake vaccines into old vials collected from hospitals. Imitation vaccines for conditions including hepatitis C (HCV), hepatitis A (HAV), tetanus, and measles were allegedly sold on to private hospitals and medical institutions across Indonesia.
Indonesia's Drug and Food Monitoring Agency (BPOM) began investigating the criminal syndicate in 2013, following a report from a hospital of an anomaly in a vaccine. Authorities believe the gang has been operating for 13 years and are unable to trace how many children have received fake immunisations, although public hospitals seem unaffected by the group's activities.
Indonesia's Health Minister, Nila F Moeloek, has said the fake vaccines were IV solutions, and therefore useless but unlikely to have "extraordinary" effects on children. Moeloek added that the counterfeits made up 1% of vaccines distributed and that parents should take their children to the nearest public health clinic to receive genuine vaccinations.
Indonesia's Ministry of Health (MoH) has come under intense criticism. Members of the House of Representatives have accused the ministry and BPOM of monitoring vaccine distribution weakly, underestimating the issue, and ignoring public anxiety. The Indonesian Consumer Foundation (YLKI) has also accused the MoH of negligence.
National Mandate Party (PAN) representative Saleh Daulay said the MoH's "dereliction" was a violation of Indonesia's Health Law as well as its constitution. Other lawmakers have even accused the MoH of collaborating with the syndicate. "The distribution happened for 10 years," said NasDem Party representative Irma Suryani Chaniago. "It doesn't make sense for the Health Ministry to not know about it. Health officers are supposed to be able to differentiate a real vaccine from a fake one, even from the price difference."
Outlook and implications
Public outcry over reports of the counterfeit vaccine ring has been ferocious, reminiscent of the reaction in China to similar revelations, particularly Chinese authorities' awareness of the issue long before the public. The government maintains only private hospitals were affected by the counterfeit vaccine trade. Jakarta Health Agency head Koesmedi Priharto has said the agency has examined city-owned hospitals and community health centres (puskesmas) without yet finding any counterfeit vaccines, after checking community health centres in 44 of the city's districts. The agency plans to investigate private hospitals next. YLKI is encouraging parents to file a class action against organisations including the MoH and BPOM.
Despite public outrage, the revelations are not necessarily surprising. The Asia-Pacific region is home to significant counterfeit medicine trade, despite government and international law enforcement efforts (see World - Asia-Pacific: 22 December 2015: Interpol carries out major operation against counterfeit medicines across Asia). The vaccine sector is also receiving considerable government investment as well as rising demand from Indonesia's growing population. These factors, plus the government's struggle to effectively enforce healthcare regulations across the country's more rural and far-flung areas, indicate that it will remain challenging to clamp down on counterfeit medicines in Indonesia.