Published on: 2026-10-07
Source: United Nations – United Nations –
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October 6, 2026 Healthcare
Over the past six years, more than 250 tons of illegal medical products have been seized in Central African countries – antibiotics, malaria drugs, painkillers, and opioids. Behind this impressive figure lies a vast black market that is growing due to the weakness of local healthcare systems.
When medicines essential for life are hard to find, too expensive, or unavailable due to the remoteness of medical facilities, the gap quickly gets filled by illegal sellers. This is the picture painted by the report published on Tuesday by the United Nations Office on Drugs and Crime (UNODC).
On the black market, one can purchase not only counterfeit drugs but also genuine medicines diverted from official supply channels, uncertified products, and medications smuggled across borders.
From 2020 to 2025, law enforcement agencies in Cameroon, the Republic of Congo, Gabon, the Central African Republic, and Chad seized a total of 251 tons of medical products. The volume of annual seizures increased from about five tons in 2020 to nearly 116 tons in 2024, and exceeded 97 tons in 2025.
The UN warns against a straightforward interpretation of these figures as an indicator of growth in illegal trade. An increase in seizure volumes can indicate both an intensification of smuggling and an enhancement of law enforcement efforts. Moreover, the quality and completeness of statistics vary significantly from country to country and from year to year.
Nevertheless, the scale of the problem is impressive. In 2025, Cameroon accounted for almost the entire registered amount of seizures in the region: 96 tons of products were intercepted, compared to only 2.5 tons five years earlier. Among the confiscated goods were antibiotics, antimalarial drugs, anti-inflammatory medications, and painkillers, as well as psychoactive substances such as tramadol and pregabalin.
“The report indicates the existence of a multi-level smuggling system that uses sea, river, air, and road routes and involves a wide range of participants,” noted Sylvie Bertrand, the UNHCR regional representative in West and Central Africa.
When the street becomes a pharmacy
The report, prepared by the UNP jointly with the World Health Organization (WHO) and the Economic and Monetary Community of Central African States, shows that the causes of the flourishing illegal trade cannot be eliminated solely by forceful methods.
Malaria, tuberculosis, and HIV remain widespread in the region, while public healthcare systems often fail to provide the population with necessary treatment. According to the universal health coverage index, all six countries of the Central African economic bloc were among the worst-performing countries in the world in 2023. Chad scored only 26 points out of 100 — compared to the global average of 71.
The situation is exacerbated by the long distances and the high – for this region – cost of medical care. According to the data presented in the report, in the Central African Republic and Chad, more than half of the population live at least two hours away by car from a public hospital capable of providing emergency care. In Chad, one dose of insulin in an automatic syringe costs the equivalent of 16 days’ wages for a low-level government employee.
Under such conditions, buying medicines on the street becomes a vital necessity for many. Citizens of the Central African Republic told researchers that informal vendors offer to sell one or two tablets of any medicine for about 100 local francs (around 20 US cents), whereas in a pharmacy people have to buy a whole pack of 12 tablets.
As a result, a market is formed in which it is extremely difficult to distinguish legal medicines from counterfeits and substandard products. From 2013 to 2025, the WHO monitoring system registered 228 incidents related to medical products in Central African countries. In more than 70 percent of cases, these were counterfeits, and another 11 percent were classified as substandard products. Specialists are particularly concerned by the fact that a third of the detected medicines were found in official supply channels, meaning that purchasing medicines even at licensed points of sale does not guarantee complete safety.
In April 2025, WHO reported the detection of counterfeit batches of amoxicillin in Cameroon and the Central African Republic, which contained none of the active ingredient stated on the packaging. In September 2026, the authorities of Cameroon seized thousands of boxes containing counterfeit medicines, repackaging materials, and psychotropic substances.
Supply routes
Routes for smuggling goods largely coincide with the paths of legitimate regional trade. Key entry points named include the port of Apapa in Nigeria, the port of Douala in Cameroon, as well as the river ports of Brazzaville and Bangui. From 2020 to 2025, 7.3 tons of medical products were seized at the region’s airports.
The criminal networks include underground manufacturers, wholesale intermediaries, street dealers, couriers, medical workers, corrupt officials, and online sellers. According to the report, armed groups also profit from this business. They rob medical facilities, resell stolen drugs, or impose a sort of “tax” on shipments passing through territories under their control.
For patients, the consequences can be tragic. Medicines with inappropriate ingredients or incorrect dosages can cause poisonings, undermine treatment effectiveness, and even lead to death. Moreover, they contribute to the development of microbial resistance to antimicrobial drugs, making existing medicines increasingly less effective. In 2023, in Cameroon, 12 children died after taking a children’s syrup that contained contaminated ingredients.
Weaknesses in healthcare systems that make patients vulnerable to illegal medicines also make it difficult to combat this market. “No single state can handle this transnational challenge alone,” emphasized Sylvie Bertrand.
The report’s authors call on countries to unify legislation, strengthen controls, and expand cross-border cooperation. At the same time, they insist on the necessity of providing the population with access to safe and affordable medicines, since the shadow market satisfies the demand that the official healthcare system has so far been unable to cover.
If illegal supply channels are blocked without addressing the problems of shortages, high prices, and geographical inaccessibility of medical care, the market for counterfeit and illegal drugs will likely continue to exist at previous levels, conclude the authors of the study.
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