Fake medicine is real business in Africa

There’s nothing covert about Roxy, a huge market in Abidjan selling counterfeit medicine, the cause of about 100 000 deaths annually in the world’s poorest continent, according to the World Health Organisation (WHO).

Located in the bustling Adjame quarter of Côte d’Ivoire’s main city and commercial hub, the haven for fake medicine has been targeted time and again by authorities and stockpiles burnt.

But it resurfaces every time.

“The police hassle us but they themselves buy these medicines,” said Mariam, one of the many vendors who hawk everything from painkillers and antibiotics to antimalaria and antiretroviral treatments.

“When we are harassed we always come to an arrangement with them to resume our activities,” she said.

Fatima, another hawker, said: “Many people come here with their prescriptions to buy medicine, even the owners of private clinics.”

She said there was a “syndicate” controlling the sector, which held regular meetings to fix prices and control supply levels.

The illicit sector has a turnover of at least 10% of the world’s pharmaceutical business, meaning that it earns tens of billions of dollars a year, the Switzerland-based World Economic Forum estimates, adding that the figure has nearly tripled in five years.

“To sell fake medicines, you need a clientele. The ailing poor are more numerous in Africa than anywhere in the world,” said Marc Gentilini, a specialist in infectious and tropical diseases and a former head of the French Red Cross.

Gentilini said some meningitis vaccines sent a few years ago after an outbreak in arid Niger were fake. The disease kills thousands every year in the arid West African nation.


The WHO estimates that one in 10 medicines in the world is fake but the figure can be as high as seven in 10 in some countries, especially in Africa.

The American Society of Tropical Medicine and Hygiene estimated in 2015 that 122 000 children under the age of five died because of taking poor-quality antimalarials in sub-Saharan Africa, which, along with antibiotics, are the medicines most likely to be out of date or bad copies.

Interpol in August announced the seizure of 420 tonnes of counterfeit medicine in West Africa in a huge operation that involved about 1 000 police, customs and health officials in seven countries: Benin, Burkina Faso, Côte d’Ivoire, Mali, Niger, Nigeria and Togo.

Geoffroy Bessaud, the head of anti-counterfeit co-ordination at French pharmaceutical giant Sanofi, said fake medicines were the biggest illicit business in the world.

“This phenomenon is spreading. It’s financial attractiveness draws criminal organisations of all sizes,” he said.

“An investment of $1 000 can bring returns of up to $500 000, while for the same kind of investment in the heroin trade or in counterfeit money the amount will be around $20 000.”

Ivorian authorities in May burnt 40 tonnes of fake medicines in Adjame, the biggest street market for fake medicines in West Africa, which accounts for 30% of medicine sales in Ivory Coast.

Offenders remained largely unpunished worldwide and were mainly targeted for breaching intellectual property rights instead of being held responsible for the deaths of hundreds of thousands of people, the Paris-based International Institute of Research against Counterfeit Medicine said.

Experts have called for a global fight against the sale of counterfeit medicine.

Sanofi said in 2016 it had helped to dismantle 27 clandestine laboratories, including 22 in China and the rest in Indonesia, Ukraine and Poland.

In countries where medical expenses — from medicine to being admitted to hospital — are not even partly reimbursed by the state, the cheap street price trumps the risk factor for many.

The outstanding exception on the continent in fighting the illicit drug trade is South Africa, which has a strictly enforced licensing system. — AFP

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Christophe Koffi
Christophe Koffi
Social and environmental scientist, focused on forest, food security and climate change adaptation.
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