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The cheaper cobra anti-venom is often used with fatal consequences. During Burma’s socialist era, there was only one registered drug producer, the Burma Pharmaceutical Industry (BPI), and its products had a solid reputation with consumers. Since then, it has been renamed Myanmar Pharmaceutical Factory (MPF), while other private ventures, including Yangon Pharmaceutical Factory and FAME Pharmaceuticals, also contribute to Burma’s medicinal drug market. But domestic pharmaceutical production falls well short of the huge internal demand. Hospitals suffer from a shortage of drugs and patients have no choice but to buy medicines at inflated prices from private drug sellers, where quality is not reliable. "Fake drugs were found in the private sector, as well as in government hospitals," says Krongthong Thimasarn, a medical officer working on the WHO’s Mekong Roll Back Malaria Initiative. Producing fake drugs is much easier than it may first seem. "The process is not very hard, because packaging machines are widely available in Burma," explains Dr Thein Myint of the NHEC. Inside Burma, fake drug makers are able to produce anything from vitamins to anti-venoms and antibiotics. According to the WHO report, "Financing Drugs in Southeast Asia", over 50 percent of drugs on the market in 2000, including those domestically produced, had not been registered with Burma’s Food and Drug Administration. With ongoing shortfalls, patients in Burma must also rely on imported drugs and most of the unregistered medicine on sale in Burma is smuggled from factories in China and India. Local reports suggest that 95 percent of illegal drug imports cross Burma’s western border with India and Bangladesh. It is big business, and for producers, fake drugs mean real profits. China’s Yunnan province, bordering Burma to the north, is an important production point for the bogus medicines found in Burma. The most sophisticated manufacturing plants in China can pump out thousands of pills a day, but many outfits are small-scale operations in village homes. Public health experts in Burma have looked at cheaper, more traditional alternatives to overcome the drug shortage. Traditional herbal treatments have always played a vital role in health care for rural people in Burma. A few years ago, the junta launched a program to produce and research traditional remedies, and now research is being conducted in universities and colleges. "Traditional medicines usually require a smaller dosage and have fewer side effects than fake drugs," explains Dr Thein Myint. But authorities need to do more, says Krongthong of the Mekong Roll Back Malaria Initiative. He believes the selling and production of fake drugs should be considered a more serious crime. In Vietnam, likely prison terms for convicted fake drug producers and peddlers extend to 20 years, but in Burma the maximum fine for crimes related to counterfeiting drugs is just 50,000 kyat (less than US $50) or seven years in prison. And punishment seems to be easily avoided with a bribe offered to junta officials. To this day, no one has been charged for producing or peddling fake drugs. "Eradication of counterfeit drugs needs the support of policy makers and drug regulatory authorities, as well as medicine producers and distributors," Dr Min Swe argues. With increasing demand and the reluctance of authorities to put an end to the trade, the fake drug business has boomed as Burma’s malaria problems have only worsened. Inside Burma, the media is all too quiet on the issue of fake drugs while there is no effort or funding to improve public education. One Rangoon drug trader warns that the problem runs deeper: "The flow can’t be stopped. Too many people are making big profits."