[Update on counterfeit drugs: a growing risk for public health]

Drug counterfeiting is a growing danger, and not only in developing countries where it can account for up to 40% of the market. Counterfeit drugs can be both ineffective and toxic. They are becoming more and more common in the USA and even in Europe. France seems to have escaped this problem for the time being. The drug distribution chain (producer-wholesaler-retail pharmacist) is both the gatekeeper and the weak point of the system. Counterfeiting is more frequent in countries where drug distribution is badly organized or excessively deregulated The increasing use of the Internet for self-diagnosis and self-medication is adding to the problem, particularly in countries where social security coverage is limited The IMPACT initiative, launched in 2006 by WHO and other stakeholders worldwide (health authorities, healthcare professionals, patients, customs, police, industry), is aimed at developing precise legislative, regulatory and technical measures, and at increasing global awareness of this threat to public health.