Why some medicines do not work?

The other day I had an opportunity to discuss with a pharmacist the reasons behind the lack of efficacy of drugs. The pharmacists sitting in his drug store in the Kalsi area of Mirpur in Dhaka City wanted to know which drug. As I told him of a once very effective anti-biotic, he said the reason might be found behind the purchase of a copied sample. He said the owners of some drug stores preferred to collect medicines from Mitford, the famous wholesale medicine market for over a century instead of taking supplies directly from their manufacturers. I was shocked Mitford has lost its glory of being the centre of genuine medicines, local or foreign. Some greedy elements are using Mitford to market spurious medicines.
About a month ago law enforcing agencies detected the preparation of spurious hand sanitizers at some of the Mitford shops. Those sanitizers, having the same fragrance of alcohol-based sanitizers were made of cheaper substitutes did not have properties to kill viruses or bacteria. The people involved were found to mix dyes used in furniture to make those look attractive. What a deception. Innocent people will buy the liquids with the hope of disinfecting their hands and articles like keys or mobile phones but those will remain infected.
Recently law enforcers also unearthed a big underground factory where spurious foreign drugs were manufactured with such precision that a buyer would in no way be able to differentiate copied strips or packets from the genuine ones. There is a marketing chain to sell those deceiving their customers. But people using those will only waste money and will not be cured.
The pharmacist said there are of course some antibiotics which have become ineffective because of their abuse. But there are effective antibiotics too. People complain of the ineffectiveness of medicines after becoming victims of deception. There are also complains about the marketing of date expired medicines. That too in a country that has made history by becoming self-reliant in essential medicine production and also by making exports.
Would it be inappropriate to think that the Drug Administration of Bangladesh has become ineffective to guard against the foul play of certain elements with medicines that are used by people for cure of life-threatening diseases? But it should not fail the people. The Drug Administration should monitor the medicine markets on a regular basis and make sure that unscrupulous people refrain from attempting to profit by putting people’s lives in jeopardy.