Israel has been ranked 10th on the list of countries counterfeiting pharmaceuticals, according to Population Services International (PSI), an organization dealing with health problems in developing nations. The list was compiled based on the number of cases of drug counterfeiting uncovered by the legal authorities in each country in 2006.

In Israel, there were 45 documented cases of the manufacture or distribution of such drugs last year.

The PSI ranking appeared in a document prepared by the Knesset research center and distributed to the Health, Labor and Social Affairs Committee for a special meeting on drug counterfeiting.

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Among drugs being counterfeitted are impotency drugs and diet drugs, as well as life-saving drugs like Dimiton for heart failure. Last week, following the discovery that a shipment of Dimiton was counterfeit, Teva Pharmaceuticals, which markets the drug, had to open a special consumer hotline.

A Health Ministry official involved in the struggle against counterfeit drugs said "95 percent of the drugs sold in pharmacies are absolutely fine, but I am worried about the other five percent."

Counterfeit drugs at best contain less active ingredients, and at worst, do not contain active ingredients, or contain ingredients that can worsen a patient's condition.

The counterfeit drugs originate with dealers in Israel operating under a Health Ministry license. Such businesses purchase real drugs along with the counterfeit ones from various sources and distribute them to pharmacies, the official said. Neither the pharmacies nor the patients know the drugs they are selling are counterfeit.

"If we find counterfeit drugs in the pharmacies, they will tell us they are doing their job by purchasing from a licensed dealer and the Health Ministry should be checking to see whether the dealer is 'clean'," said the official. "But those pharmacies get discounts in some cases on certain drugs. Why don't those pharmacists ask why the drugs are being sold cheaply?"

The Knesset research center document states that the police believe it should conduct intelligence operations in suspected illegal distribution centers.

Last year, according to the document, counterfeit drugs worth NIS 56 million were discovered in Israel, NIS 40 million of which were veterinary drugs. Police said the real figures were likely to be much higher.

The Finance Ministry has allocated only three positions in a new unit to fight pharmaceutical crime, established a few weeks ago by the Health Ministry.

In fact, there are only two people holding positions in the unit: its head, Miki Arieli, a pharmacist; and retired police superintendent Aharon Grundman. A Health Ministry official said that for a unit to be effective in fighting counterfeit drugs, it should have at staff of at least eight.

The document states that the Justice Ministry, the police and the Health Ministry have noted that sentences for drug counterfeiting are too light to act as deterrents. The law allows for a maximum three-year sentence and a fine of more than NIS 1.4 million for drug counterfeiting.

"In one case, an individual received a sentence of three months' community service," an official said.

Arieli said he would be holding a meeting of police and other officials to seek harsher penalties