Development and Effective Application of AI-Based, Post-Quantum Cryptography-Enabled Counterfeit Medicine Identification Tools for Better Treatment Outcomes in Bangladesh.

A forgery does not have to be good. It only has to be good enough to hand over.

Counterfeit medicine is not a manufacturing problem that happens to involve drugs. It is a supply-chain problem: somewhere between the plant that made a genuine product and the pharmacy that sold it, something else was put in its place — and every party in between handled it believing it was the real thing.

That is what makes it hard to see. A forger does not need to replicate the medicine; they need to replicate the pack. The tablet, the vial, the carton, the batch number and the expiry date are all things that can be looked at and copied, and a copy that survives a glance at the counter has already done its job[16]. The patient is the last person in the chain and the only one with no way to check.

© The Daily Star

© The Daily Star

© The Daily Star

It is not hypothetical, and it is not rare.

The reporting below is Bangladeshi, published, and spans two decades. Every headline is the outlet’s own.

• FeatureThe Daily StarThe deadly world of fake medicineOpens on a two-and-a-half-year-old who died after being given a falsified product.Read at The Daily Star↗
• ReportThe Daily StarFlour balls for medicines!Counterfeiters targeting widely sold brands — Naproxen-Plus and others — with flour pressed into tablets.Read at The Daily Star↗
• ReportThe Financial ExpressMedicines made of flour!The same substitution reported independently.Read at The Financial Express↗
• © Dhaka TribuneFeatureDhaka Tribune · 2024-04-30Devil in disguise: Health concerns mount over rising tide of fake medicinesOn how abundant falsified product has become, life-saving medicines included.Read at Dhaka Tribune↗
• ReportNew AgeCounterfeit medicines flood markets across BangladeshSpurious, unregistered and banned medicines reaching pharmacies nationwide.Read at New Age↗
• ReportDaily Sun · 2025-12-20Market flooded with counterfeit medicinesCounterfeit trade rising alongside the price of genuine medicine.Read at Daily Sun↗
• © The Business StandardReportThe Business Standard · 2024-04-07Health sector in peril as adulterated drugs rampantNotes that no imprisonment for manufacturing adulterated drugs is on record.Read at The Business Standard↗
• © The Daily StarFeatureThe Daily StarWhy your drugs don’t workOn the storage and cold-chain conditions that degrade a genuine product before it is dispensed.Read at The Daily Star↗

How much of what is sold is not what it says it is.

Every figure below is a floor rather than a total. Counterfeit medicine is measured by what testing and enforcement happen to reach, and anything that worked well enough not to be questioned is never counted at all.

© The Business Standard

Three losses, from one substitution.

Same person. Same prescription. Two outcomes.

Hold everything constant — the condition, the molecule, the dose, the fact that the course was completed exactly as directed — and change one thing: whether the pack contained what the label promised.

© The Business Standard

Lost trust is an export.

The chain from a failed course of treatment to a drain on foreign reserves is short, and each link follows reasonably from the one before it.

© Dhaka Tribune

1. 01

   Treatment fails

   A course of medicine does not work. Neither the patient nor the prescriber can tell whether the diagnosis, the drug or the product was at fault.

2. 02

   Trust goes

   Once a failure is suspected to be the medicine itself, confidence in what is sold locally does not recover on its own.

3. 03

   Patients travel

   Those who can afford it seek treatment abroad — and buy their medicine there too, because that is the part they stopped trusting.

4. 04

   Reserves leave

   The money goes out twice: once for the treatment, and again for the medicine carried home.

Everything on the pack can be printed by whoever printed the pack.

The defences in use today are physical: a distinctive design, a hologram, security printing. Each raises the cost of forgery. None of them changes the fundamental position, which is that the feature is a thing to be looked at — and anything that can be looked at can be reproduced closely enough to pass being looked at.

One of these is genuine and one is forged. Nothing you can see distinguishes them — and nothing a pharmacist, a wholesaler or a patient can see distinguishes the real pair either.

Distinctive packaging

A pack design a buyer learns to recognise.Reproducible by anyone with the printing equipment the original was made on.

Hologram

An optical feature that is difficult to print.Difficult is not impossible, and the forgery only has to convince someone who has never held a genuine one beside it.

Security printing

Microtext, guilloche, colour-shifting inks.Verifiable only by someone trained and equipped to verify it — which is not the person buying the medicine.

Not safe enough.

Stop asking the pack to look right. Ask it to prove something only the manufacturer could.

A signature is not a feature of the packaging; it is a mathematical statement about it. A forger with a perfect press still cannot produce one, because producing one requires a private key rather than a printer — and the standards below are chosen so that this stays true once quantum computers can break the cryptography protecting the rest of the chain[17][18].

1. 01

   Hash

   Every pack gets a unique identifier bound to its batch, its strength and its date, condensed to a fixed digest that changes completely if any of it is altered.

2. 02

   Sign

   • ML-KEM · FIPS 203
   • ML-DSA · FIPS 204

   The digest is signed with a lattice-based key only the manufacturer holds. A forger can copy the code; they cannot produce a signature that verifies against the manufacturer’s public key.

3. 03

   Record

   Each custody event — release, distribution, dispensing — is appended to a shared ledger, so a code presented twice in two places is visible as exactly that.

4. 04

   Explain

   A model reads the pack and returns a calibrated verdict with the evidence for it — which features it weighed and how far each sits from the genuine population — rather than an unexplained yes or no.