Global health diplomacy and the governance of counterfeit medicines: a mapping exercise of institutional approaches

RESUMO

Objective. Counterfeit medicines are a global, multi-faceted, and complex public health problem. Global health diplomacy and cooperative efforts relying on governance systems have been limited in effectively addressing proliferation of this dangerous trade. Methods. This review conducts a comprehensive mapping exercise of governance efforts by international organizations to address counterfeit medicines, including analysis of related international treaties and conventions that may be applicable to anticounterfeit efforts. This work also reviews governance and global health diplomacy proposals from the literature that addresses counterfeit medicines. Summary of Findings. A number of international organizations have become active in addressing the global trade of counterfeit medicines. However, governance approaches by international organizations, including the World Health Organization (WHO), the United Nations Office on Drugs and Crime (UNODC), Interpol and the World Customs Organization (WCO), have varied in scope and effectiveness. Treaty instruments with applicability to counterfeit medicines have also not been fully leveraged to combat this issue. Results indicate that a formalized and multi-stakeholder governance mechanism is needed to address the issue. The UNODC is uniquely situated to act as a forum for such a proposal in partnership with other international organizations. Implications of Findings. Global health diplomacy efforts to combat counterfeit medicines require multi-stakeholder and formalized governance structures that can leverage stakeholder participation and resources. Through cooperative arrangements leveraging the strengths of partners such as UNODC (combating transnational crime), Interpol (law enforcement purposes), the WCO (customs and border control), and the WHO (for public health science and analysis), the international community can mobilize a coordinated, inclusionary, health diplomacy response to the crisis of global counterfeit medicines.