Tons of alt causes to counterfeiting.

Main reasons for the prevalence of counterfeit products throughout the world are (a) high demand for less expensive drugs, (b) low availability of medical products, (c) social tolerance for counterfeit products, (d) globalization and consumer access to the internet (e-commerce), (e) complex and fragile supply chains, (f) limited technical capacity to monitor products throughout the supply chain, (g) complex import-export mechanisms, (h) the use of free and special economic and trade zones, (i) lack of law enforcement, (g) weak national regulatory policies on the manufacturing and marketing of medications, and (k) lack of adequate financial and political commitments [3], [4], [5], [11], [14], [15], [16], [17], [18], [19]. For these reasons the penetration of counterfeit products is generally higher in developing countries with West Africa and South America being reported as the areas mostly affected [11], [20], [21]. In 2017, the WHO after reviewing laboratory results on medical products from 75 low- and middle-income countries (LMIC), reported that 33.6 % of hypertension, cancer, epilepsy, analgesic uterotonics and immunosuppressants drugs, 11.8 % of antimalarial drugs, 7.2 % of antibiotics and anti-infective products, 6.7 % of tuberculosis medicines, and 4.2 % of HIV medicines were falsified or substandard, while approximately 10.5 % of all pharmaceuticals may be falsified in those countries [20].