the supply chain
The Counterfeit Problem Is Older Than the Internet
Two centuries before anyone shipped a vial from a website, a German chemist in London opened a bottle of pickles and found copper. The history of fake medicine is the history of the instruments that could finally see it.
In 1820 a German chemist working in London published a book with a skull on the title page and a line from scripture underneath: there is death in the pot. Frederick Accum had spent years quietly analysing what was being sold in the shops around him, and the catalogue he produced was appalling. Pickles greened with copper. Confectionery coloured with lead and mercury compounds. Bread stretched with alum. Beer bittered with substances that had nothing to do with hops. Tea leaves that had already been used once, dried, re-dyed and sold again 1.
The book sold a thousand copies in its first month. Within a year Accum had left England under legal pressure and spent the rest of his life teaching in Berlin. That is the shape of this story from the beginning: the analysis is the easy part, and naming the results is what costs you.

The century of the microscope
Accum's contemporaries did not doubt him because they were credulous. They doubted him because, before analysis, adulteration was essentially unfalsifiable. A shopkeeper who claimed his flour was pure and a customer who suspected otherwise had no way to settle the disagreement except by taste and reputation, and reputation is exactly what a determined adulterator manages.
What broke the deadlock was an instrument. In the early 1850s a physician named Arthur Hill Hassall began systematically examining shop-bought samples under the microscope for The Lancet's Analytical Sanitary Commission, and — crucially — publishing the names of the traders whose goods he had examined. The collected reports ran to thousands of analyses of foods, drinks and drugs 2. Chicory in coffee was visible as chicory. Foreign starches in arrowroot were visible as the wrong starch grains. The argument was over, because the evidence no longer depended on anyone's palate.
British food adulteration legislation followed in 1860 and was strengthened repeatedly through the 1870s. Note the order of events, because it repeats: an analytical method becomes available, someone applies it systematically and publishes, public alarm follows, and the law arrives last. Regulation has never in this field been the thing that discovers the problem.
Analysis as the enabling technology
It is tempting to read the nineteenth century as a moral story about Victorian greed. It reads better as a technical one. Each generation of analytical capability defined which frauds were possible and which were not, and the fraudsters moved to whatever the current instrument could not see.
There is a second asymmetry worth naming. Analysis has always been expensive and adulteration cheap. Hassall's programme required a trained observer, an instrument, reference material and a journal willing to publish the names; the fraud it exposed required only a sack of chicory. That ratio has never really improved. A modern confirmatory analysis costs more than most of the individual units of product it might be run on, which is why surveillance is always sampling and never census, and why the deterrent effect depends entirely on somebody publishing what the sample showed.
The microscope caught substitution of one visible material for another. Gravimetric and titrimetric chemistry caught the wrong quantity of a known component. Chromatography, arriving in force after the Second World War, caught mixtures that looked homogeneous. Mass spectrometry caught the wrong molecule even when it behaved like the right one. Every advance closed a category of counterfeit and, by closing it, redirected the trade toward whatever remained unmeasured.
When the stakes became lethal at scale
The twentieth century changed the arithmetic. Industrial production meant a single bad decision could be distributed nationally before anyone noticed, and the American elixir disaster of 1937 — a sulfa drug dissolved in an antifreeze component, tested for taste but not for safety — turned that abstraction into more than a hundred deaths and a new federal law within a year.
Nothing about that episode was counterfeiting in the strict sense; the manufacturer's name on the bottle was its own. But it established the principle that would organise everything afterwards: a medicine is not a substance, it is a substance plus a documented history, and without the history the substance cannot be trusted whoever made it.
Deliberate falsification returned to international attention in the 1980s and became undeniable in the 2000s. The clearest case was antimalarial. Across mainland South East Asia, packets labelled as artesunate were circulating that contained no artemisinin at all, or too little, wrapped in holograms that were themselves being counterfeited and revised in successive generations. An unusual international investigation combining chemical analysis, packaging forensics, pollen analysis of the tablets and criminal intelligence traced the trade and prompted a criminal case 3. People died of malaria holding what they believed was treatment.
The institutional response built slowly through those decades, and its slowness is instructive. Counterfeit medicines were raised at international level in the mid-1980s, but for twenty years the response stalled on a question that sounds pedantic and is not: what, precisely, is being criminalised. Intellectual-property enforcement and public-health protection point at overlapping but different targets, and countries whose generic industries feared the first were unwilling to sign up to the second. The eventual settlement was to separate them — to treat falsification as a crime against health rather than against a trademark, which is the logic of the Council of Europe convention opened for signature in 2011, the first binding international instrument to criminalise the manufacture and supply of falsified medical products as such.
Measurement lagged further behind. A global reporting system for substandard and falsified products only began operating in the 2010s, and when it published its first substantive analysis in 2017 the headline estimate was that roughly one in ten medical products circulating in low- and middle-income countries failed quality testing 4. The report was careful to describe that figure as a floor rather than a rate: a surveillance system counts what somebody noticed, reported and had tested, and every one of those three steps is a filter.
What the internet actually changed
It is worth being exact here, because the online era is usually described as the cause of a problem it inherited. Counterfeiting was thoroughly established long before anyone could order anything from a screen. What changed was structural, and three things matter.
- Premises disappeared. A shop has a landlord, an address, a licence and a queue of customers who can come back. A listing has none of those, and can be replaced overnight at negligible cost.
- The chain got shorter and longer at once. A manufacturer could now reach an end user in one parcel, bypassing every intermediary that had historically carried liability — while the chain of resellers behind that parcel grew longer and less visible.
- Jurisdiction dissolved. The seller, the payment processor, the plant, the warehouse and the buyer could sit in five different legal systems, none of which had complete visibility of the transaction.
The consequence was not more fraud so much as less traceability. Analytical chemistry had spent a century and a half getting better at answering what is in this. Online distribution made the other question — where did this come from — much harder to answer, and the two questions are not substitutes.
Why peptides are a hard case
Peptides sit awkwardly in this history, for reasons that are structural rather than sinister. A lyophilised peptide is a few milligrams of white powder in a sealed glass vial, often barely visible against the bottom. It has no colour, no taste anyone should be sampling, no tablet markings, no coating, no shape. Two vials containing entirely different molecules are indistinguishable to every sense a person has. Where a counterfeit tablet can be caught by a wrong imprint or a wrong dissolution profile, a vial offers no external evidence whatsoever.
The failure modes are also unusually graded. A peptide can be the correct sequence at the wrong purity, or the correct sequence with the wrong counter-ion and therefore the wrong actual mass of peptide, or a closely related sequence differing by one residue, or a genuine peptide that has degraded because it spent a fortnight warm in transit. None of those is a straightforward fake, and none of them announces itself. Analytical surveys of confiscated material in the doping-control literature have repeatedly found exactly this spectrum — correct compounds, wrong quantities, unexpected substitutions and products bearing no relation to their labels, all within the same seizures 5.
There is a further complication that has no nineteenth-century equivalent. A peptide can be entirely authentic when it leaves the plant and materially different when it arrives, because these molecules degrade — by oxidation, by hydrolysis, by deamidation at particular residues — on a timescale that depends on temperature and time in transit. Adulteration used to be something done to a product. With this class of material, a large share of the deviation is something that simply happens to it, unattended, in a warehouse or the back of a van, and it produces a result indistinguishable on the label from fraud.
The response the industry reached for was documentation, and it is a reasonable response with a specific weakness. A certificate of analysis is a report on one batch, produced on one day, by one laboratory, on one sample. Detached from that batch and passed down a chain of intermediaries who repackage and relabel, it stops being a measurement and becomes a genre — a document that looks like every other document of its type. Accum could hold the pickles up to the light. The modern equivalent requires an instrument, a reference standard and a chain of custody, and it is the chain of custody that the last two decades have made hardest to maintain.
That is the through-line from 1820 to now. The trade has always been able to fake the product. What it has never been able to fake, for long, is a measurement made by someone with no stake in the answer — and the entire history of this problem is the history of who has been in a position to make one.
References
- A treatise on adulterations of food and culinary poisons
- Food and its adulterations; comprising the reports of the Analytical Sanitary Commission of The Lancet for the years 1851 to 1854 inclusive
- A Collaborative Epidemiological Investigation into the Criminal Fake Artesunate Trade in South East Asia
- WHO Global Surveillance and Monitoring System for substandard and falsified medical products
- Identification of black market products and potential doping agents in Germany 2010-2013