Day: January 11, 2025

BANGKOK — Nearly all of the world’s 35,000 online pharmacies are being run illegally and consumers who use them risk getting ineffective or dangerous drugs, according to the U.S. Trade Representative’s annual report on “notorious markets.” The report also singled out 19 countries over concerns about counterfeit or pirated products.

The report also named about three dozen online retailers, many of them in China or elsewhere in Asia that it said are allegedly engaged in selling counterfeit products or other illegal activities.

The report says 96% of online pharmacies were found to be violating the law, many operating without a license and selling medicines without prescriptions and safety warnings.

Their websites often look like legitimate e-commerce platforms, often with false claims that they are approved by the Food and Drug Administration, said the report, released Wednesday. The FDA and U.S. Drug Enforcement Administration have both issued warnings about risks of buying prescription medicines from such sources.

It cited a survey by the Alliance for Safe Online Pharmacies’ Global Foundation that found nearly one in four Americans who have used online pharmacies reported having encountered substandard, fake or harmful medicines.

Last year, federal prosecutors reported that a network of illegal drug sellers based in the U.S., the Dominican Republic and India had packaged potentially deadly synthetic opioids into pills disguised as common prescription drugs and sold millions of them through fake online drugstores, federal prosecutors said Monday. At least nine people died of narcotics poisoning between August 2023 and June 2024 after consuming the counterfeit pills, the indictment said.

Apart from the risks of using drugs that may contain inert ingredients or those that could cause allergies, the medicines are sometimes made in unsanitary conditions, said the report, which did not give annual statistics for those who may have died or otherwise been harmed.

Progress in fighting counterfeit and pirated goods

The USTR’s annual report cited examples from inside the United States, but and also mentioned risks of imported ingredients including fentanyl from China. Many of the illicit online pharmacies are based outside the U.S.

The “Notorious Markets List” did laud progress in fighting counterfeit and pirated goods.

In one case, U.S. authorities, industry groups and the police collaborated in shutting down a Hanoi, Vietnam-based piracy ring, Fmovies, and other related piracy sites, in July and August.

The report said the world’s then-largest pirated movies site had drawn more than 6.7 billion visits from January 2023 to June 2024.

In another Vietnam-linked case, two people operating pirate television platform BestBuyIPTV were convicted and ordered to pay fines and forfeit property.

The report also cited crackdowns on online piracy in Brazil and the United Kingdom and busts of sellers of counterfeit purses, clothing and shoes in Kuwait.

But problems remain with cyberlockers that thwart efforts to restrict piracy of movies and other content and of so-called “bulletproof” internet service providers, or ISPs, that promise people using them leeway for using pirate sites, it said.

One such ISP is Avito, a Russian-based ad platform that allegedly lets sellers advertise counterfeit products.

Baidu Wangpan, a cloud storage service of China’s largest search engine provider, Baidu, was named for allegedly failing to enforce or being slow to act on copyright protection.

The report also pointed to social-commerce site Pinduoduo and to Douyin Mall, a Chinese online platform owned by Tiktok owner ByteDance. It said the shopping platforms have sought to build up protections but that they still host many counterfeit goods.

It also named Shopee, a Singapore-based online and mobile e-commerce site, saying some country-focused platforms serving Southeast Asia and South American had better track records in fighting piracy than others.

IndiaMART, an big business-to-business marketplace in India, still offers a slew of counterfeit products, it said.

While a large share of theft of intellectual property has moved online, the report also highlighted real world locations notorious for selling counterfeit products, including markets in Turkey, bazaars in the United Arab Emirates and Saigon Square Shopping Mall in Vietnam’s Ho Chi Minh City.

The report said Bangkok’s MBK Center, a huge mall of about 2,000 stores, had actively cracked down on counterfeiting, though such products still can be found there. 
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NEW YORK — The 13-year-old boy came to the clinic with a rapidly ballooning neck. Doctors were puzzled.

Testing ruled out their first suspicion. But further tests pinpointed what they — and the boy — had been missing: iodine.

A century ago, iodine deficiency affected kids across large swaths of the country. It essentially disappeared after some food makers started adding it to table salt, bread and some other foods, in one of the great public health success stories of the 20th century.

But today, people are getting less iodine because of changes in diet and food manufacturing.

Although most people are still getting enough, researchers have increasingly been reporting low levels of iodine in pregnant women and other people, raising concerns about an impact on their newborns. And there is also a very small, but growing, number of reports of iodine deficiency in kids.

“This needs to be on people’s radar,” said Dr. Monica Serrano-Gonzalez, a Brown University doctor who treated the boy in 2021 in Providence, Rhode Island.

What is iodine?

Iodine is a trace element found in seawater and in some soils — mostly in coastal areas. A French chemist accidentally discovered it in 1811 when an experiment with seaweed ash created a purple puff of vapor. The name iodine comes from a Greek word meaning violet-colored.

Later that century, scientists began to understand that people need certain amounts of iodine to regulate their metabolism and stay healthy, and that it’s crucial in the development of brain function in children.

One sign of insufficient iodine is a swelling of the neck, known as a goiter. The thyroid gland in the neck uses iodine to produce hormones that regulate the heart rate and other body functions. When there’s not enough iodine, the thyroid gland enlarges as it goes into overdrive to make up for the lack of iodine.

At the beginning of the 20th century, goiter was very common in children in certain inland parts of the United States, especially in a “goiter belt” that stretched from Appalachia and the Great Lakes to the northwest United States. Some of the kids were unusually short, deaf, intellectually stunted and had other symptoms of a syndrome once known as “cretinism.”

Adding iodine to salt

Public health experts realized they couldn’t solve the problem by feeding everyone seaweed and seafood, but they learned that iodine can essentially be sprayed on table salt. Iodized salt first became available in 1924. By the 1950s, more than 70% of U.S. households used iodized table salt. Bread and some other foods also were fortified with iodine, and iodine deficiency became rare.

But diets changed. Processed foods now make up a large part of the American diet, and though they contain a lot of salt, it’s not iodized. Leading bread brands no longer add iodine. In the case of the 13-year-old boy, he has mild autism and was a fussy eater, mostly only eating specific brands of bread and peanut butter.

And for people who do salt their food, the fashion now is to use kosher salt, Himalayan rock salt or other noniodized products.

“People have forgotten why there’s iodine in salt,” said Dr. Elizabeth Pearce of Boston Medical Center. She is a leader in the Iodine Global Network, a nongovernmental agency working to eliminate iodine deficiency disorders.

She noted a reported 50% drop in U.S. iodine levels in surveyed Americans between the 1970s and the 1990s.

How much iodine is enough?

Though iodine consumption is falling overall, most Americans are still getting enough through their diet, experts say. But doctors worry that’s not the case for women and children, who are most vulnerable to iodine deficiency.

The American Academy of Pediatrics and other medical societies recommend that all pregnant and breastfeeding women get 150 micrograms of iodine each day. You can get that from one-half to three-quarters of a teaspoon of iodized table salt.

In the last 15 years or so, U.S. researchers have increasingly reported seeing mild iodine deficiency in pregnant women. A Michigan State University study of about 460 pregnant women in the city of Lansing found about a quarter of them were not getting enough.

Many prenatal vitamins don’t contain iodine, noted Jean Kerver, the study’s lead author. That’s why doctors recommend that pregnant or breastfeeding women check labels to ensure they are taking multivitamins or prenatal supplements with iodine.

Some studies have linked even mild iodine deficiency to lower IQs and language delay in children, although there is debate about at exactly what levels problems start, Pearce said.

Experts say there hasn’t been enough research to establish what impact that iodine deficiency has actually been having on the U.S. population in recent years.

Serrano-Gonzalez said she and her colleagues have seen four other cases in children in their clinic in Providence.

“We’re concerned this may be increasing, especially in patients with restricted diets,” she said. 
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WASHINGTON — Taiwan Semiconductor Manufacturing Co. has begun producing advanced 4-nanometer chips in Arizona for U.S. customers, a milestone in the Biden administration’s semiconductor efforts, Commerce Secretary Gina Raimondo told Reuters.

In November, the Commerce Department finalized a $6.6 billion grant to TSMC’s U.S. unit for semiconductor production in Phoenix, Arizona.

“For the first time ever in our country’s history, we are making leading-edge 4-nanometer chips on American soil, American workers — on par in yield and quality with Taiwan,” Raimondo told Reuters in an interview, saying it had begun in recent weeks.

“That’s a big deal — never been done before, never in our history. And lots of people said it couldn’t happen,” Raimondo said of the previously undisclosed production start.

A spokesperson for TSMC, the world’s largest contract chipmaker and a major supplier to Apple and Nvidia, which reports earnings next week, declined to comment Friday.

In April, TSMC agreed to expand its planned investment by $25 billion to $65 billion and to add a third Arizona production facility by 2030.

Congress created a $52.7 billion semiconductor manufacturing and research subsidy program in 2022. Commerce persuaded all five leading-edge semiconductor firms to locate production facilities in the United States as part of the program.

Raimondo told Reuters earlier that Commerce had to persuade TSMC to boost its U.S. plans.

“It didn’t happen on its own. … We had to convince TSMC that they would want to expand,” Raimondo said.

TSMC will produce the world’s most advanced 2-nanometer technology at its second Arizona factory, expected to begin production in 2028. TSMC also agreed to use its most advanced chip manufacturing technology, called “A16,” in Arizona.

The TSMC award from Commerce also includes up to $5 billion in low-cost government loans.

Raimondo wants the United States to make 20% of world’s leading-edge logic chips by 2030 — up from the 0% before TSMC began production in Arizona.

In April, Commerce said TSMC expects to begin high-volume production in its first U.S. fab by the first half of 2025.

Last month, Commerce finalized an award of $407 million to help fund Amkor Technology’s planned $2 billion advanced semiconductor packaging facility in Arizona, which is set to be the largest of its kind in the U.S.

When fully operational, Amkor’s Arizona plant will package and test millions of chips for autonomous vehicles, 5G/6G and data centers. Apple will be its first and largest customer, with the chips produced at a nearby TSMC facility.
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