A counterfeit medicinal product is one that is "deliberately and fraudulently mislabeled with respect to identity and/or source." Not all counterfeit medicinal products are toxic; many simply do not have the desired therapeutic effects. Factors that facilitate the manufacture, import, export, distribution, and use of counterfeit medicines include weak enforcement of drug regulatory measures; scarcity or erratic supply of basic medicines; relatively unregulated markets and distribution chains; price differentials; lack of effective intellectual property protection; and lack of regard for quality assurance. A comprehensive policy to deal with the trade in counterfeit medicinal products must at least include legislative framework; product registration system; licensing of pharmaceuticals manufacturers, importers, exporters and distributors; rational drug use and supply; and information sharing and public awareness. References