UN agencies warn of growing trade in illicit medicines across Central Africa

A growing trade in counterfeit, substandard and unauthorized medicines is posing a major public-health threat across Central Africa, according to a report by the United Nations Office on Drugs and Crime, the World Health Organization and the Central African Economic and Monetary Community.

The report links the illicit market to gaps in access to safe and affordable medicines in the six CEMAC countries: Cameroon, the Central African Republic, Chad, the Republic of Congo, Equatorial Guinea and Gabon.

Those countries face a high prevalence of infectious diseases, including tuberculosis, malaria and HIV. However, the agencies said treatment and reliable medicines are not always readily available, while high prices can place them beyond the reach of many people. The resulting gap between healthcare needs and access to treatment is helping fuel demand for illicit medical products.

251 tonnes seized

At least 251 tonnes of medicines were seized across the six countries between 2020 and 2025, the report said. It did not provide a country-by-country breakdown of that total.

Traffickers are reported to divert prescription medicines from regulated supply chains and national health programme stocks. They also sell products that are counterfeit, below required quality standards or not officially approved for use.

The medicines identified in the trade include antibiotics, antimalarial drugs, painkillers, anti-inflammatory medicines, tramadol and pregabalin.

UNODC said the trade can result in treatment failures, poisonings and avoidable deaths. It also said illicit medicine trafficking fuels organised crime, weakens public institutions and encourages the recreational use of addictive psychoactive substances.

Routes and distribution networks

According to UNODC, most trafficked medicines enter the region through sea and river ports, by air freight or in passengers’ luggage. From there, they are transported inland along major trade roads.

Some illicit products also reach official healthcare facilities, which patients generally regard as safe. That creates additional risks for people who may have no reason to suspect that the medicines they receive are counterfeit, substandard or unauthorized.

The report describes links between medicine trafficking and armed activity in the Central African Republic. Armed groups there are said to earn money by looting health centres and imposing taxes on shipments moving through territories under their control.

In Gabon, customs officials said they seized 17,000 tramadol tablets late in the previous month. The officials blamed the shipment on cross-border narcotics traffickers from neighbouring Cameroon.

Wider regional health risks

The report also cited a 2017 WHO estimate illustrating the possible consequences of poor-quality medicines in sub-Saharan Africa. WHO estimated that falsified or substandard antimalarial drugs could be associated with between 72,000 and 267,000 deaths each year.

It further estimated that poor-quality antibiotics used to treat childhood pneumonia could be linked to as many as 169,271 deaths annually.

Those figures are regional estimates of deaths that could be associated with poor-quality medicines. They are not confirmed death counts from the six CEMAC countries.

The agencies’ warning places medicine trafficking at the intersection of public health and organized crime. Alongside stronger action against trafficking networks, the report identifies the lack of affordable and dependable access to legitimate medicines as a factor sustaining the illicit market.