Illegal trade in killer cough syrup, fake medicines killing 500,000 Africans yearly, UN warns

• Fake antimalarial drugs kill 267,000 every year, 170,000 children die from unauthorised antibiotics

A special report by the United Nations (UN) has warned of rise in substandard and fake medicines in the Sahel.

According to a threat assessment report from the UN Office on Drugs and Crime (UNODC), from ineffective hand sanitisers to fake antimalarial pills, an illicit trade that grew during the COVID-19 pandemic in 2020 is being meticulously dismantled by the UN and partner countries in Africa’s Sahel region.

It said substandard or fake medicines, like contraband baby cough syrups, are killing almost half a million sub-Saharan Africans every year.

Recall that in the summer of 2022, 70 Gambian babies and young children died from kidney failure, after ingesting cough syrup spooned out by their caregivers.

The World Health Organisation (WHO) issued a global alert that four tainted paediatric products had originated in India, as local health authorities continue to investigate how the tragedy unfolded.

The new report explains how nations in the Sahel, a 6,000-kilometre-wide swath stretching from the Red Sea to the Atlantic, which is home to 300 million people, are joining forces to stop fake medicines at their borders and hold perpetrators accountable.

This fight is taking place as Sahelians face unprecedented strife: more than 2.9 million people have been displaced by conflict and violence, with armed groups launching attacks that have already shuttered 11,000 schools and 7,000 health centres.

Health care is scarce in the region, which has among the world’s highest incidence of malaria and where infectious diseases are one of the leading causes of death.

“This disparity between the supply of and demand for medical care is, at least, partly filled by medicines supplied from the illegal market to treat self-diagnosed diseases or symptoms,” the report says, explaining that street markets and unauthorised sellers, especially in rural or conflict-affected areas, are sometimes the only sources of medicines and pharmaceutical products.

The study shows that cost of the illegal medicine trade is high, in terms of health care and human lives.

According to the report, fake or substandard antimalarial medicines kill as many as 267,000 sub-Saharan Africans every year. Nearly 170,000 sub-Saharan African children die every year from unauthorised antibiotics used to treat severe pneumonia.

Caring for people who have used falsified or substandard medical products for malaria treatment in sub-Saharan Africa costs up to $44.7 million every year, according to WHO estimates.

According to the report, corruption is one of the main reasons the trade is allowed to flourish.

The report showed about 40 per cent of substandard and falsified medical products reported in Sahelian countries, between 2013 and 2021, land in the regulated supply chain. Products diverted from the legal supply chain typically come from such exporting nations as Belgium, China, France, and India. Some end up on pharmacy shelves.

The report found the perpetrators are employees of pharmaceutical companies, public officials, law enforcement officers, health agency workers and street vendors, all motivated by potential financial gain.

According to a UNODC research brief on the issue, traffickers are finding ever more sophisticated routes, from working with pharmacists to taking their crimes online.

While terrorist groups and non-state armed groups are commonly associated with trafficking in medical products in the Sahel, this mainly revolves around consuming medicines or levying “taxes” on shipments in areas under their control.

Efforts are under way to adopt a regional approach to the problem, involving every nation in the region. For example, all Sahel countries except Mauritania have ratified a treaty to establish an African medicines agency, and the African Medicines Regulatory Harmonisation initiative, launched by the African Union in 2009 aims at improving access to safe, affordable medicine.

All the Sahel countries have legal provisions in place relating to trafficking in medical products, but some laws are outdated, UNODC findings showed. The agency recommended, among other things, revised legislation alongside enhanced coordination among stakeholders.