"If I inject it into you, you die pretty quickly": Meet the researchers tracking down fake drugs in this French lab

"We must continue the fight" against the falsification of medicines, a global scourge "that has become sophisticated," declares Nathalie Tallet, head of the laboratory, wearing a full white coat, overshoes and safety glasses over her corrective pair.

A recent operation against drug trafficking in 90 countries led to the arrest of nearly 800 people and the seizure of illicit products worth €56 million, according to Interpol.

Counterfeit medicines, whose trafficking is facilitated by the explosion of e-commerce and the proliferation of unregulated sites, are products whose identity, composition or source is deliberately misrepresented, according to the World Health Organization (WHO).

They may contain either the correct ingredients but in the wrong dosage, another active ingredient, or even no active ingredient at all. Or they may contain the wrong excipients.

These can also be real drugs diverted to be resold illegally and used as doping or psychotropic drugs.

When a health authority asks the laboratory to investigate a suspect product that is the subject of an alert from customs or health authorities, verification work on traceability begins.

"We're going to query our databases, with the product name, its batch number, its manufacturing date, its expiry date ," explains the pharmacist who heads a team of 12 people.

If any inconsistencies are found, the next step is to retrieve the samples to verify their contents. If the detection system confirms that the suspected product is counterfeit, the laboratory issues a report to the relevant authorities.

Tracing the source can be difficult, as the drug may be manufactured in one place and packaged in another, often close to the source of sale.

"Protecting populations"

"We must protect populations who are not fortunate enough to have medicines," says Ms. Tallet, who has already testified before courts in Kenya, Jordan, and the Philippines about the dangers of falsification.

Everything is reviewed to detect any possible discrepancy in weight, case, serial codes, letters, packaging edging, printing techniques, nature of the product, its appearance.

Other major pharmaceutical groups, such as Servier, also have their own analysis laboratories to detect counterfeit drugs and their illicit flows.

Sanofi's receives "between 1,000 and 2,000 requests per year" for analyses and has "between 100 and 200 confirmed cases" of counterfeit medicines as well as "around a hundred cases of illicit trafficking."

"For several years now, Latin America and Southeast Asia have really been the two geographic regions that we've been working in," observes Ms. Tallet.

In 2008, the year the laboratory was founded, counterfeit drugs were "much easier to detect," she recalls. Now, with technological advances, "you can imagine anything."

Starch, glass, metals

As proof, she holds in each palm a seemingly identical box of tablets with Chinese writing on the case.

Only a machine equipped with a magnifying camera, fitted with different types of lighting and filters, can highlight the visual defects of the counterfeit box: the font is different.

Liquid samples, too, are under surveillance: "If I inject it into you, you die pretty quickly," warns another collaborator, placing a vial under a deep-depth microscope.

This specimen is one of about ten counterfeit therapeutic bottles in a foreign country, intercepted in time a few years ago.

A cheap starch derivative replaces the active ingredient, while the legitimate bottle costs "several thousand euros" to treat rare diseases.

The cause of the danger, however, lies elsewhere: floating in the solution is a plankton of "glass" particles, "scrap metal" , "fibres that can cause an embolism".

Other past cases have revealed the presence of detergents in pediatric vaccines in Indonesia , or an antibiotic in an anti-cancer drug, and microbial contamination, Ms. Tallet recalls.

"It's not just customs that reports cases to us. There may also be patients and healthcare professionals who observe oddities about the product, the selling price, or side effects," she explains.