authorities have found fake versions of drugs purporting to come from companies including Sanofi, Eli Lilly and AstraZeneca.
LAW TOUGHER ON TOBACCO THAN FAKE DRUGS
The need for action seems clear enough - but advancing the debate involves navigating some big divides.
India, whose large drugs industry produces cheap generic versions, is concerned that Western governments backed by Big Pharma are using the fight against fakes as a cover to restrict trade in unpatented medicines much needed by the world's poor.
Some health activists support New Delhi's charge that worries about counterfeit drugs are being hijacked by Big Pharma global pharmaceutical companies to protect their profits and patented products against legitimate generic competitors.
In east Africa, for example, international drug companies have taken advantage of anti-counterfeiting laws that are sometimes poorly drafted to curb sales of otherwise legitimate generics, threatening the availability of essential drugs.
India is particularly resistant to any role for pharmaceutical firms in setting the agenda, and Brazil has expressed similar concerns in the past.
Given the distrust, the authors of the paper in the BMJ - who include leaders of nursing, pharmacy and public health bodies - argue there is a need to find neutral ground to address what appears to be a gaping hole in international law.
They point out that thanks to a new convention on tobacco control, international law is now tougher on counterfeit cigarettes than it is on fake medicines.
We hope that this will form the basis for getting some consensus on a definition of counterfeit drugs, which would then be transferable into a legal instrument, said another of the paper's authors, Martin McKee of the London School of Hygiene and Tropical Medicine.
The lack of a treaty means there is no agreement on which medicines are illegal and criminals can do business in countries where laws or enforcement are lax. There is also no requirement for police and prosecutors to cooperate across borders.