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NEW DELHI — Private investigator Suresh Sati rattled off the popular brand names listed on the boxes of cough syrup, supplements, vitamins and painkillers in his basement office.

“They look real, but all these are fakes,” said Sati, head of an agency that helps police conduct raids against counterfeit- drug syndicates.

“A regular customer cannot make out if a drug is fake. . . . The biggest giveaway is when someone is selling medicines very cheap.”

India, the world’s largest manufacturer of generic drugs, has become a busy center for counterfeit and substandard medicines. Stuffed in slick packaging and often labeled with the names of such legitimate companies as GlaxoSmithKline, Pfizer and Novartis, the fake drugs are passed off to Indian consumers and sold in developing nations around the world.

Experts say the fake-drug industry, worth about $90 billion, causes the deaths of almost 1 million people a year. The health ministry launched rewards this year of $55,000 for providers of information about fake-drug syndicates.

“It is very difficult to dismantle the entire operation,” Sati said. “When we bust one operation, two more spring up elsewhere. Convictions are rare.”

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