Bulgaria failing to tackle medicine smuggling from Asia, putting patients at risk [Advocacy Lab Content]

Local authorities are failing to crack down on illegal imports of medicines from Asia, where they are much cheaper. A truck smuggling 114,000 packages of medicines has been seized by Bulgarian authorities at the Captain Andreevo Turkish-Bulgarian border crossing.

The Bulgarian border crossing with Turkey is the second busiest land border in the world – after the US – Mexico border – making it a major route for smuggling goods into Europe from Asia, including illicit medicines.

“The smuggling of medicines is a huge risk to the health of the population,” Boryana Marinkova, the executive director of the Bulgarian Association for the Development of Parallel Trade in Medicines (BADPTM), told Euractiv.

The truck stopped at Captain Andreevo had a driver from Kosovo; it was discovered three weeks ago in a special operation by Bulgarian customs and police.

The check revealed 12 boxes of medicines for diabetes, hypertension, epilepsy, gout, and anabolic steroids: corresponding to 85,650 tablets, 17,430 capsules, 4,292 sachets and 6,810 ml.

Turkish medicine flood Bulgaria

Participation in smuggling activities is not an unusual phenomenon in Balkan countries, given citizens’ low income in comparison to Western Europe.

Even though Bulgaria plans to criminalise the illegal import of medicines by 2028, the penalties enforced now are very low despite the high health risk posed to citizens by illicit or counterfeit medicinal products.

An illegal load of 425 packages of medicines from Turkey was also seized at the same location in March.

Experts say Bulgaria is flooded with Turkish medicines, which enter illegally and are sold in illegal markets, bazaars and online on social networks.

They are preferred for their lower price and are used without a prescription. Many medicines, especially food supplements and anabolic steroids, have also managed to reach the European market.

A blind spot

According to Marinkova, the organisation has been monitoring the issue for years. The latest report of illegal imports to the Bulgarian Drug Agency was on 27 May.

“I can’t say that the Bulgarian state has lost control, but this is a blind spot. Shadow mechanisms are faster than legislative norms,” she said. The expert admits that the illegal import of medicines has grown exponentially due to shortages in Bulgaria and other markets.

The authorisation of a medicinal product is a complex procedure, but it centres around patient care and safety. Taking unauthorised medicines poses a huge health risk.

“The medicines pathway is – manufacturer – retailer – pharmacy. If it is broken, we are still talking about counterfeit medicines. In the case of Turkish medicines, they are sold everywhere – in Facebook groups, in markets, etc. This compromises their quality; it is not clear how and where they are stored,” warns the executive director of BADPTM.

She comments that Turkey has lower standards than Europe for the registration of medicines in terms of patient safety.

Many Bulgarians prefer Turkey for cancer treatment. When they return to Bulgaria, they find that the medicines they were treated with are not available.

“We advise people to consult a doctor in Bulgaria for appropriate therapy. Or, if they are going to buy them from abroad, to do so in person and not through intermediaries. Intermediaries are illegitimate entities that break the law,” Marinkova explains.

The tip of the iceberg

According to Marinkova, the Bulgarian authorities have no idea of the scale of the problem, which is evident she says, from social media posts, drug trade groups and websites.

“We have no way of knowing if this is just the surface of the iceberg and how big it is. The largest contingent of these sales are [to] healthy people. Many young people, for example, look for supplements to gain muscle mass, which is risky. In the last year, there has also been a trend by Turkish goods stores that offer various medical products, including medicines,” she said.

Responding to Euractiv, the Ministry of Health commented that Bulgaria is working closely with other member states in an attempt to track down and stop unregulated online sales of medicines.

“Unauthorised trade on the internet mainly concerns medicinal products not authorised for use in the country, with packaging and leaflets in a foreign language, often of unclear origin or counterfeit medicinal products,” the Bulgarian Ministry of Health commented.

“These medicinal products are not guaranteed in terms of quality, efficacy and safety, both in terms of their manufacture and the way they are stored, and therefore pose a serious risk to the lives and health of citizens,” they added, without giving any data on the scale of the problem.

[By Krassen Nikolov, Edited by Vasiliki Angouridi, Brian Maguire | Euractiv’s Advocacy Lab]

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