Anyone who has bought medicine online may have wondered whether what arrived in the post was really what they’d paid for. They are not alone. A recent global survey found that around 60% of people fear their medicines could be fake – and the unsettling truth is that they have good reason to. About one in ten medicines sold worldwide is thought to be either counterfeit or substandard.

This is not simply a hazard for people buying weight-loss injections through a dubious Instagram link. It can just as easily catch out a traveller picking up antibiotics abroad, or anyone drawn to an online pharmacy by the promise of convenience.

Counterfeit medicines are made to resemble the real thing while containing the wrong ingredients, the wrong dose, or – in the worst cases – no active ingredient at all.

Some are simply expired stock, repackaged. Others contain substances that should never enter the body. The packaging is often good enough to fool a pharmacist, let alone a patient: convincing logos, plausible regulatory stamps, boxes that look, at a glance, entirely legitimate. The harm this does ranges from a treatment that simply doesn’t work to outcomes that are fatal.

Britain’s regulatory system is among the more robust in the world, but that has not been enough to keep criminals out. The UK’s Medicines........

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