Growing fake medicine epidemic fueling a spiralling public health crisis in Africa's cities

Tens of thousands of people in Africa die every year from taking fake drugs. According to the World Health Organization, these are the world’s most lucrative counterfeit goods, with a global market worth roughly $200-billion. Africa accounts for around 42% of this demand because of the continent’s badly monitored borders, weak legislation and poor healthcare services. 

Gabon has recently emerged as a major destination for these drugs. In January 2020, over seven tonnes of counterfeit pharmaceuticals and cosmetics were destroyed in Libreville during a joint operation between the Gabonese Directorate of Medicines and Pharmacy and the Competition and Consumer Affairs Directorate against the illicit sale of counterfeit products. 

On 23 December 2021, Gabonese customs officials seized a large shipment of prohibited pharmaceutical products from Cameroon and bound for Libreville. In January, Gabon’s judicial authorities prosecuted traffickers from Congo-Brazzaville who had smuggled several boxes of counterfeit drugs, estimated at approximately $34,000 (nearly 20 million francs), intended for sale in Gabon’s main cities. Other products including dietary supplements and pharmaceutical stimulants were also listed in the cargo. 

Gabon’s government has tried to stem the tide of counterfeit medicine sold in urban markets, but criminals have managed to circumvent these measures.

The smuggling of fake drugs has a long history in the country. Unlicensed medicinal drugs first appeared on Libreville’s streets decades ago and have increased in range and accessibility. They were smuggled in from Benin, Côte d’Ivoire, Ghana, Nigeria and India, where genuine products are substituted with a substandard drug that excludes an active ingredient or contains a toxic substance. Tablets made in Nigeria appeared in corner shops before spreading to Libreville’s main markets of Mont-Bouët and Nkembo. 

Criminals selling counterfeit medicine include wholesale smugglers, cigarette vendors and street hawkers. They openly peddle fake painkillers, tranquillisers, cough syrups and rheumatism medication. Counterfeit drugs are frequently found at roadside stalls, which are common in cities but rarely regulated. 

Most customers buy from roadside hawkers because fake drugs are cheaper and easier to obtain than authentic medicines. Consumers disregard professional medical warnings against taking them, not always realising the dangers these products pose to their health. In Gabon’s major cities, medical experts have reported many deaths, severe stomach and kidney ailments, and neurological disorders resulting from counterfeit medicines.

The government has introduced several measures to curb the sale and use of these drugs. At the regional level, Gabon and 15 other African countries adopted the Rabat Resolution in 2018 — a new framework to address the problem. On the domestic front, anyone convicted of facilitating the purchase, sale, use, marketing, transport, import, processing, supply and distribution of counterfeit medicines can be imprisoned for up to 10 years or fined up to $1,719,940.

Awareness campaigns have been rolled out to alert authorities and the general public to the threats posed by fake drugs. The government has organised prevention campaigns in high schools in larger cities, and Libreville’s mayor has banned their sale in the city’s streets. 

Despite these initiatives, counterfeit products are still being sold at markets across the Gabonese capital. Weak law enforcement fails to deter those manufacturing, selling and administering the medicines, so the trade in fake drugs continues. 

Counterfeit medicines are a public health crisis for Gabon, and measures must consider the dangers of consuming these drugs. The capacity of police and prosecutors to detect, investigate, arrest and prosecute smugglers must be improved. This includes better border security and the use of improved surveillance and technology. 

In partnership with pharmaceutical companies and digital service providers, Gabon should develop a technological solution that enables consumers to quickly and cheaply verify the authenticity of drugs purchased. The Mobile Authentication Service is a strategy in Nigeria that uses scratch codes and text messaging to empower consumers to check the quality and validity of medicines at the point of purchase.

The Association of Gabonese Pharmacists’ central office, together with city mayors, need to sustain these efforts. Public education and awareness campaigns on the dangers of counterfeit drugs must be ongoing and rolled out more widely. These initiatives should complement police action that detects and disrupts major manufacturers and distributors in Gabon. 

These actions go hand in hand with a new holistic strategy developed by the United Nations Office on Drugs and Crime to combat offences related to fake drugs in Central Africa. The strategy’s five pillars are awareness, legislative assistance, innovation, capacity building and cooperation. All those involved in the manufacture, distribution, regulation, law enforcement and consumption of medicines must work together to solve Gabon’s counterfeit drugs problem. DM

Oluwole Ojewale, Regional Organised Crime Observatory Coordinator – Central Africa, ENACT, Institute for Security Studies (ISS).

This article was first published by ENACT. ENACT is funded by the European Union (EU). The contents of this article are the sole responsibility of the author and can under no circumstances be regarded as reflecting the position of the EU.

By First published by ISS Today.