This is the VOA Special English Development Report.

Counterfeit medicines are a widespread problem in developing countries. Like other counterfeits, they look like real products. But counterfeit drugs may contain too much, too little or none of the active ingredients of the real thing.

People do not get the medicine they need. And in some cases the counterfeits cause tragic problems of their own. About a year ago, more than eighty children in Nigeria died after being given medicine for teething pain. And more than twenty children in Bangladesh died last year after being given acetaminophen. In both cases, the medications contained ingredients that looked, smelled and tasted like the real thing.

But the medicine in Bangladesh was produced by a local drug manufacturer that used a dangerous substitute to save money. And in the case in Nigeria, an illegal chemical dealer sold counterfeit glycerin to a drug company. That company then used the chemical to make the teething medicine.

The World Health Organization says the problem with counterfeit medicines is especially bad in Africa, Asia and Latin America. The W.H.O. estimates that up to thirty percent of the medicines on sale in many of those countries are counterfeit.

Counterfeit medications are also a problem in the Middle East and in many countries of the former Soviet Union.

The problem is less widespread among industrialized countries. The W.H.O. says countries like the United States, Canada, Japan and New Zealand represent less than one percent of the counterfeit drug market.

But the agency also says as much as fifty percent of the medicine sold on the Internet is counterfeit. Most people have no way to tell if medications are what they seem. The Center for Medicine in the Public Interest is a group in New York supported in part by the drug industry. It predicts counterfeit sales will reach seventy-five billion dollars worldwide this year -- nearly double the level of two thousand five.

Substandard medicines are also a widespread problem in the developing world. How are they different from counterfeits? The legal difference is that counterfeit drugs are made with the purpose of misleading people. Substandard drugs are just poorly made.

And that's the VOA Special English Development Report. Next week, learn what is being done to fight counterfeit medicines. Transcripts, podcasts and captioned videos of our reports can be found at voaspecialenglish.com.