According to the World Health Organization, more than 120,000 people die each year from counterfeit and substandard malaria and tuberculosis medications. Nearly 11% of drugs sold in poor and developing countries are counterfeited, while the majority of child mortality from malaria and pneumonia is due to counterfeit or under-the-counter medicines. Infection-based diseases, such as malaria and tuberculosis, can gain resistance and lead to greater problems due to drugs that are produced under standard and contain the necessary active substances.

Especially in poor and developing countries, due to reasons such as high profit margins, lack of regulation and control, lack of information, complicated supply chains, the amount of counterfeit and illegal drugs increases and causes hundreds of thousands deaths.

The combination of the factors mentioned above and distribution from one country to another explains why some states and their population are more exposed to such crimes than others and that counterfeit medicine smuggling has expanded significantly around the world.

We can explain the details of the factors and more we mentioned above:

1. High profit margins: Producing medicine which complies with the standards is a time-consuming and costly activity, but it is both easier and cheaper to provide physical appearance. 
2. Low risk of penalty: Most countries do not have the necessary laws and sanctions against counterfeit drug producers and sellers. Some countries have them but they are not fully implemented. Those who do counterfeit medicine get the same penalty as those who sell counterfeit branded clothes if caught.
3. Inadequate health services and insurances: In many poor and developing countries health services are either too costly or insufficient, which is why patients tend to use medicines that are cheap and its origin is unknown.
4. Medicines crossing borders easily: Due to globalization, international trade has been rapidly concentrated and the procedures necessary to control the products passing through the borders have not been made at the same pace.
5. Internet providing anonimity: In recent years, it has opened up a new door for counterfeit drug dealers, giving them the opportunity to use the internet for the counterfeit drug sales and giving them anonimity
6. Sensitivities of the supply chains: The more complex the supply chains get, more ways the counterfeit drug sellers can find into the system.
7. Parallel trade: Parallel trade is possible because of the principle of free movement of goods in the EU countries, whereby counterfeit and illegal drugs are introduced into the countries.

These factors that we mentioned are only part of the fact that counterfeit medicines still do appear in the market. With the laws and sanctions imposed by each country, the distribution of counterfeit medicines on the market is going through different ways and costs hundreds of thousands of people’s lives.

Source: https://www.drugtrackandtrace.com/counterfeit-medicine-kills/