The production and distribution of counterfeit medications has become a significant global public health issue. Though not as rampant in the United States, the Food and Drug Administration (FDA) has seen a 10 fold increase in the number of cases investigated, particularly a rise in illegally imported and diverted medications entering our legitimate drug supply. In order to curb these illegal activities, California and the federal government have introduced various pieces of legislation to address this. In addition, international entities, State Boards of Pharmacy and the FDA have begun promoting utilization of radio frequency identification technology and other technology to effectively track the medication supply. In a recent California survey, pharmacists felt strongly that the presence of counterfeit medications poses a problem in their pharmacy practice, but they still face several challenges in identifying counterfeit medications, counseling their patients, and forging their role in implementing legislative requirements.

This presentation will aim to provide an introduction to the international and domestic counterfeit drugs situation, discuss possible factors facilitating patient exposure to counterfeit medications, examine potential sources for counterfeit medications in the United States, identifiy federal legislation issues, discuss various forms of technology being used to combat counterfeit medications, and recognize the role of pharmacists and the challenges they face in dealing with counterfeit medications.

Speaker Biography:

Dr. Elaine Law is currently a Clinical Pharmacist specializing in Adult General Surgery at UCSF Medical Center and an Assistant Clinical Professor in the UCSF School of Pharmacy. She received a B.S. in Molecular, Cell and Developmental Biology from UCLA, earned a Doctor in Pharmacy from UCSF School of Pharmacy and completed a General Practice Pharmacy Residency at UCSF Medical Center. She holds a Board Certification in Pharmacotherapy and her research interests include roles pharmacists can play in public health issues including counterfeit medications and pharmacist-based immunization programs. She is an advocate of patient care in underserved areas and reaches out regularly to the Tenderloin communities and elderly populations of San Francisco through pharmacy health outreach programs.

The decades-long political winter in the Arab world seemed to be thawing early this year as mass protests toppled Tunisian President Zine el-Abidine Ben Ali and Egyptian President Hosni Mubarak and it appeared that one Arab dictatorship after another might fall during the so-called Arab Spring. Analogies were quickly conjured to the collapse of dictatorships in Europe and Latin America in the 1970s; Korea, Taiwan, and the Philippines in the 1980s; and Eastern Europe and Sub-Saharan Africa in the 1990s—the transformative “third wave” of global democratization. Many scholars and activists reasonably imagined that a “fourth wave” had begun.  At this momentous inflection point, which may well define the future shape of the Arab world, the United States has never faced a more urgent set of opportunities and challenges there. Diamond will discuss the prospects for democratic development that exist alongside the very real risks of Islamist ascension, political chaos, and humanitarian disaster, and suggest principles and long-term strategic thinking the U.S. might employ to increase its legitimacy in the region.

Larry Diamond is a senior fellow at the Hoover Institution and at the Freeman Spogli Institute for International Studies, where he also directs the Center for Democracy, Development, and the Rule of Law. Diamond is co-editor of the Journal of Democracy and a senior consultant to the National Endowment for Democracy. Diamond served as a senior adviser on governance to the Coalition Provisional Authority in Baghdad and as an advisor to the Iraq Study Group.  Diamond, author of the Spirit of Democracy and several other works on democratic development, has also edited or co-edited some 36 books on democracy. A renowned teacher and mentor, Diamond, who teaches courses on comparative democratic development and post-conflict democracy building, was named “Teacher of the Year” by the Associated Students of Stanford University and received the prestigious Dinkelspiel Award for Distinctive Contributions to Undergraduate Education in 2007.

A. Lawrence Chickering is a political and social entrepreneur and writer whose work has focused on empowering citizens to increase their roles in public institutions from government schools to foreign policy—while also contributing to economic and social progress.

To this end, Chickering has founded or co-founded several public policy organizations that promote “transpartisan” reforms in both the U.S.and globally. His most recent organization, Educate Girls Globally (EGG), works with the government in the tribal state of Rajasthan inIndia, promoting cultural change not only in traditional communities, but also in government bureaucratic cultures.

Chickering has focused his recent writing on the challenges of policy toward the “weak states” that have become the new priority concerns of foreign policy.  At a time when the new threats to security come from non-state actors, he believes that both development and counterinsurgency warfare (COIN) need civil society organizations (CSOs) to play a greatly expanded role in promoting change by empowering citizens.

In a series of articles he has written for the Small Wars Journal (SWJ), Chickering has raised questions about the government’s capacity to reform its institutions and policies, and embrace CSOs as active partners.  A major problem, he argues, is that the foreign policy community, both inside and outside the government, knows almost nothing about civil society and how it can promote change from “inside” societies.  That explains why foreign policy continues to be directed entirely toward governments, assuming that weak states are strong, and asking them to do things they have no capacity to do.

Chickering stresses the importance of empowering people rather than only helping them.  EGG provides no financial incentives.  Both its school reform and community projects result from empowerment alone.  Together with working in government schools, this allows EGG to operate at very large, strategic scales and low costs.  This commitment, however, conflicts with the overwhelming objectives of donor and philanthropic organizations. 

Chickering believes that the troubled transition from dictatorship to democracy, now underway in Egypt and other countries, could have been largely prevented by an indigenous civil society strategy promoting trust, expanding participation in government, and building human infrastructure for transition.  He also believes that a strong civil society strategy is the essential, missing element in efforts to bring peace to the Middle East. 

To show what is possible in this arena, EGG is currently negotiating with the U.S. Central Command to implement a demonstration project in Afghanistan.  The experience in Rajasthan shows how the model empowers people to take responsibility for their own security, in addition to other forms of progress. 

Chickering’s coauthored book, Strategic Foreign Assistance: Civil Society in International Security, and his more recent SWJ writings, present the most complete statements of his thinking about how civil society initiatives can be used to promote economic, social, and political change in these tribal societies. He believes that new ways of thinking about foreign and national security policy need to be built on a combination of civil society initiatives and new thinking about the strategic uses of communication to influence people’s perceptions. 

Chickering has authored two “transpartisan” books on American politics. His book Beyond Left and Right (1993) drew wide praise across the U.S. political spectrum, and his 2008 book Voice of the People, coauthored with James S. Turner, includes two chapters on foreign policy.

Mr. Chickering is a graduate of StanfordUniversity and theYale Law School. He lives in San Francisco with his wife and son.