Large quantities of counterfeit drugs and medicines are being sold in developing countries leaving thousands of people unprotected from deadly diseases such as malaria.
Counterfeit drugs can make up half of sales in some countries
The World Health Organisation and the big drugs companies are failing to co-operate effectively to stamp out the trade.
WHO has only one member of staff working on the problem at its Geneva headquarters.
And the world health body has accused the big drugs companies of not sharing information about bogus drugs.
The Pharmaceutical Security Institute, which was set up by the industry, holds extensive intelligence on counterfeiting.
But Dr Lembit Rago, who is in charge of quality assurance at the WHO's essential drugs and medicines programme, says he has found it difficult to get access to the detail on the database.
"They are quite good at talking to us in general about the problem," he tells File on 4, "but they're not really providing concrete data. So far it has been a dialogue with not too many results."
Dr Harvey Bale, who speaks for the drugs companies, says it's always a sensitive issue to share information with officials of any international institution.
"If the WHO decides to give a very high priority to the counterfeiting issue then the basis for collaboration and information will exist," he adds.
"But what will not be shared by any company is information about an ongoing investigation where a counterfeiter or possible counterfeiting operation has been identified."
File on 4 also found worrying evidence about WHO's own track record.
In particular, the world health body promotes a list of sources for cheap pharmaceutical materials used by developing countries, which some regard as suspect.
The International Federation of Pharmacists and the organisation which speak for the medicines manufacturing industries worldwide have both condemned the service. Yet WHO continues to lend its name to it.
The list includes a Chinese chemicals trading conglomerate banned from trading in Nigeria because of a history of selling counterfeit drugs there.
The same conglomerate is implicated in the chain of supply of poisoned glycerine which was made into pain relief medicine in Haiti, killing more than 80 children.
The families who lost their children are taking legal action, but no-one's been prosecuted over the affair.
File On 4: BBC Radio 4: Tuesday 5 October at 2000 BST and repeated on Sunday 10 October at 1700 BST