The contaminated cough medicine provides a clear illustration of the worrying problem of substandard and falsified medical products, a problem that appears to be growing as global supply chains become more complex and e-commerce spreads. This report, based on data gathered by the World Health Organization (WHO) Global Surveillance and Monitoring System for substandard and falsified medicines, vaccines and in vitro diagnostic tests (GSMS) during its first four years of operation, up to 30 June 2017, examines the issue in greater detail.