Getting prescription medication into developing countries is hard enough. But what if the drugs that actually make it there don’t work? Or worse, they cause further harm?

The World Health Organization (WHO) estimated three years ago that nearly one in four pharmaceutical drugs sold in the developing world is counterfeit, the New York Times reported this week. And recent discoveries suggest the war on fake drugs shows no sign of abating, as the pharmaceutical forgers wield increasingly sophisticated weaponry.

“The counterfeit drug business has become increasingly attractive for criminal syndicates,” according to the Times. “The profit potential is vast, yet punishment for those caught is typically much less severe than for illegal drugs like cocaine, law enforcement officials say.”

The more phony pills lining drug store shelves, the more treatment failures patients suffer. Not all are completely inert, either: drugs have been found to include low levels of active ingredients—too low to be effective, yet high enough to trigger drug resistance and to be detected in screening tests for fakes. Some can also contain ingredients used for irrelevant conditions. One purported antimalarial appeared to contain sildenafil, the main ingredient in the impotence drug Viagra.

But U.S. and international agencies are fighting back. Last Friday, malaria medications were confiscated in Ghana after it was confirmed that they lacked any active pharmaceutical ingredients, according to a press release from the U.S. Pharmacopeial (USP) Convention, which helped set up five sites around Ghana for the monitoring and testing of medicines.

Raids in Egypt and Nigeria this April and May resulted in the removal of “millions of potentially life-threatening counterfeit medicines worth hundreds of millions of dollars,” according to Interpol, the world’s largest international police organization. Some of the drugs seized were being sold as treatments for cancer, diabetes, heart disease, epilepsy and schizophrenia.

In addition to more organized surveillance, cutting-edge technology is also aiding the identification and sourcing of the dangerous fakes. According to the Times, an “ion gun” captures “a minute amount of the material, instantly identifying its component parts.” This device is an upgrade from mass spectrometers, which take far longer to identify chemicals. And forensic palynology—the analysis of pollen—has helped track down makers of the counterfeit drugs in China, according to a study published in February.

In hopes of more Ghana-like seizures, India has announced an award of up to 20 percent of the cost of the confiscated drugs for civilians who offer tips. “There is no dearth of good intentioned people who may wish to work for the country's interests as a whistle blower in eradicating the menace,” India’s health minister, Ghulam Nabi Azad, told the Times of India today.

Picture of antimalarial medicine by Around the World Journey | 2009-20xx - mhoey via flickr