With his trademark skullcap on his head and name plaque displayed ostentatiously behind him, Dr Onn Akbar Ali sits behind a desk with a big box of herbal tea in front of him.
Purported to be amazing at controlling one’s diabetes, the tea that the consultant cardiologist is hawking in rapid-fire speech can treat the disease “tanpa ubat, tanpa suntikan, tanpa kesan sampingan (without medicine, without injections, without side effects).”
But there is one problem.
Despite his mannerisms and the ring on his right pinkie, it is not Dr Onn in the video. Instead, it is a deepfake video of him – generated by artificial intelligence (AI).
“It disturbed me quite a bit,” Dr Onn told Bernama in his office at KPJ Kajang Specialist Hospital in Kajang, Selangor.
Over the years, he has built a following of hundreds of thousands on his various social media accounts, answering many of his patients’ questions in a straightforward and easy-to-understand manner.
His case is on the extreme side of things, where fraudsters are using his face and voice to make fake claims to sell dubious health and wellness products. Along the spectrum of medical fakes on social media and online platforms, often fuelled by AI, are impersonators posing as influential doctors, established brands or sellers to promote fake products or defraud consumers.
Be it fake news or fake products, the Internet has a dishonesty problem. With the advent of AI, there has been an international surge of fraudulent claims and activities within the health and wellness industry, according to medical professionals, associations and experts. While the scams may hurt the reputation of and reduce confidence in health practitioners and brands, the biggest concern is that these products and claims could put patients’ health and safety at serious risk.
“It’s dangerous in a way that people are assuming … (the product) is effective for a medical condition that they have when it does nothing for their condition,” said Dr Onn.
“(The tea) could contain things … like sugar or caffeine that people may consume excessively and cause (their) sugar or caffeine (levels) to spike. Not only does it (tea) fail to treat the condition (diabetes) but causes other harms.”
COUNTERFEITERS AND IMPERSONATORS
The health and wellness industry has a long history of medical quackery. While there are many legitimate sellers and products, it is also an industry that attracts snake oil salesmen eager to prey on desperate people. The US Trade Office projects the Malaysian nutritional market to be worth US$1 billion by 2030, up from US$600 million in 2022.
With the availability of social media, AI and e-commerce, finding easy prey has become simpler, which makes efforts to protect consumers and ensure online companies enforce their standards, even as Big Tech profits from the transactions, seem insurmountable.
In a written statement, the Ministry of Health (MOH) told Bernama that it has been challenging to curb the sale and distribution of unregistered supplements and counterfeit pharmaceuticals due to advances in digital technology and online platforms.
"Sales through e-commerce platforms, social media and messaging apps allow illegal products to be widely marketed, while sellers use fake identities and switch their accounts often to avoid enforcement action," it stated.
From 2023 till June 30 this year, MOH conducted 2,839 raids on unregistered supplements and confiscated 1.5 million products worth more than RM75 million. MOH has also carried out 93 raids on counterfeit pharmaceutical products and confiscated more than 4,000 units worth about RM85,000.
Pharmacists have also seen a spike in sellers using AI to impersonate them online to sell unregistered or counterfeit health and wellness products. They told Bernama that many of these fraudsters would create accounts with similar names, which sometimes involve using trademarked signage on the account. Often, the signage would be prominently displayed, but when the seller’s name is checked, it is found to be registered under a different name. Some of the fake sellers also display AI-generated letters from MOH with the necessary logos and registration numbers to convince consumers of their authenticity.
Rachel Gan of Alive Pharmacy, an independent pharmacy chain based in the Klang Valley, said she found a seller on an online e-commerce platform using their brand.
“Some of the things (the impersonator) sells are not familiar to me. But they are using our brand. And then people are buying from (the impersonator) because they think they’re buying (from us),” she said via Google Meet.
Buying from fake sellers brings a host of problems. Some, like 54-year-old Chan Wai Mun, may end up receiving counterfeit products. While many may not suffer adverse effects from taking fake products – counterfeiters make the biggest profit by not causing obvious harm to their victims – Chan was not so lucky.
As a cancer patient newly in remission, he had been taking BioNerv by BREGO Life Sciences, a supplement to help remove numbness caused by his cancer treatment. He told Bernama in a phone interview that the supplement he received initially from the hospital worked well. His troubles began when he bought the supplement online after finishing the boxes he purchased from the hospital.
“A few months down the road, when I went (for my) checkup with my haematologist, you know, he was very alarmed… all my liver enzymes had shot up through the roof. I had liver inflammation,” he said.
Chan had to be hospitalised until his levels dropped.
Looking back, he said he should have suspected something because the price was lower than the standard price at pharmacies.
Upon hearing about his experience, BREGO issued a warning to patients and consumers not to buy any of their products online.
“Currently, we only sell to official retail partners (such as) Big Pharmacy and Caring Pharmacy… and also clinics and hospitals. So these are the only three channels that sell this product. We try not to sell online because once it’s online, it’s very hard to control,” said Valerie Lu, medical and regulatory affairs manager at BREGO Life Sciences.
However, the benefit of having the items delivered to one’s doorstep is something that makes online shopping so attractive, which keeps feeding new victims to opportunistic sellers.
EASE OF BUSINESS
Shaz, 30, who did not want to disclose her full name, is the primary caregiver to her bedridden father, so finding five cans of a meal replacement powder being sold online at RM370 seemed too good to be true.
“Cheapest, but not too cheap. Just suspiciously cheap,” she told Bernama via Google Meet. So she did what she thought was due diligence. She checked out the seller, and the rating and history on the e-commerce platform and thought it was legitimate. Stressed and too busy with caregiving duties to go to the store, she purchased the product online soon after.
What she got was five cans of avocado powder. When she filed a complaint on the platform, the seller rejected her claim that she was defrauded and the platform closed her case. She is now pursuing her case via the Ministry of Domestic Trade and Cost of Living.
Shaz is angry that e-commerce platforms do not seem to take any responsibility for their third-party sellers’ actions. This dissatisfaction is echoed among all consumers of digital marketplaces, including social media.
E-commerce platforms told Bernama they prohibit the sale of counterfeit items.
“We work closely with the Malaysian Pharmacists Society to verify pharmacies and actively remove listings that violate our rules. We also use proactive monitoring and work with brands, law enforcement and the Ministry of Health to detect and take action against sellers who breach our policies, including account suspension, permanent bans and, where appropriate, legal action. Users are encouraged to report any suspicious or counterfeit product via the ‘Report this Product’ option,” said Shopee in a written statement.
Lazada said they have a layered verification system in place to cut down on incidents, but, as with any large marketplace, potential violations may still arise, which is why preventing, detecting and addressing potential violations remain an ongoing priority.
“Lazada receives reports through several channels, including buyer complaints, seller escalations and reports submitted by brands and rights holders through our Intellectual Property Protection platform, or IPP, and internal monitoring and escalation processes.”
Social media platforms also have a report button for fraud and impersonation, but patients, consumers and industry experts said the resulting action has been mixed.
To lessen counterfeit products, MOH requires holographic labels on all authentic and registered health and wellness items. Each authentic product also carries a QR code that the ministry’s MyUbat app will check and verify.
However, many believe that the existing safeguards and enforcement measures are still inadequate. According to Malaysian Community Pharmacy Guild president Sarah Abdullah, pharmacists are calling for stricter measures, including requiring third-party sellers to verify that they are licensed pharmacies.
She also said that current laws and regulations need to be updated to reflect offline requirements.
“I have to go through all these rigorous processes (if I want) to advertise (medical products). But why is it so easy to do it on an e-commerce platform? Where is the rigorous process in the e-commerce platform? Why is it different from the print (media) or a news agency? Why are they governed differently?” she asked.
Harris Zainul, director of the Centre for Responsible Technology, takes it a step further. He said the onus should not be only on customers to do the verification, detection and enforcement of counterfeit claims and items.
“Prevention here is the responsibility of the platforms to better screen who they allow to list medicines and supplements on their platforms,” he said via WhatsApp.
While consumers and patients need to be vigilant while purchasing health and wellness products online to prevent buying counterfeit items, Harris admitted it may not be so easy to address the issue of deepfake doctors endorsing dubious or ineffective products, or making unsubstantiated medical claims, which may lead to people purchasing the products.
WHAT IS REAL?
Detecting deepfakes can be difficult. There are a few tell-tale signs that the videos featuring Dr Onn are not on the up and up. In one video, one of the posters on the wall misspells exercise as ‘EXERRCISE’. Three wooden plaques – one of them bearing his name – seem to hang on a curtain. The words and the lips do not match up. Another red flag is the name on the account, which spells the doctor’s name as ‘Dr. On Ali’. In another video, the deepfake was much better, with the only tell-tale sign being his eye blink rate.
Overall, the signs are subtle and for the most part, many would miss them if they are not on the lookout.
One of those fooled was Dr Onn’s brother-in-law, who saw the reel on Facebook.
“He believed that I was promoting this tea for kidney stones. He then sent the link to a few of his friends, and some of them bought it. One of them happened to be my patient… he bought it, used it and then told me about it,” he said.
Dr Onn told Bernama that he has reported the deepfakes and fake claims to social media platforms many times, with mixed results. He has also asked his followers to do mass reporting of such accounts.
Sometimes, the posts would be taken down. At other times, the platform would inform him that they saw nothing wrong with the post.
According to Dr Onn, he decided against reporting to the other authorities after seeing his colleague’s experience. Apparently, his colleague had reported a deepfake video impersonating her to various authorities.
“They told her to report to Facebook,” he said, smiling wryly.
NIMM REMA REMA
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