The Counterfeit Drug Economy: How Fake Antimalarials And Regulatory Chaos Are Undermining Nigeria’s Malaria Fight -By Aliyu Baba Mohammed

According to a report by The Guardian Nigeria on 11 September, 2025, NAFDAC officials raided a Lagos warehouse, and found 277 cartons of fake antimalarial drugs disguised among bicycle parts and tyres; nearly 500,000 doses worth ₦1.2 billion that could have killed thousands of Nigerians. This seizure revealed just one corner of a deadly trade that is sabotaging Nigeria’s fight against malaria. While the country accounts for nearly one-third of global malaria deaths, a perfect storm of counterfeit medicines, regulatory bottlenecks, and economic chaos is making genuine treatment increasingly hard to find and afford.

A Silent Killer in the Medicine Cupboard

According to WHO’s World Malaria Report 2024 (which presents data for 2023), Nigeria carries the heaviest malaria burden on Earth. Out of 597,000 global malaria deaths in 2023, Nigeria alone is said to have accounted for 30.9%; that is roughly 184,000 deaths in a single year, of which a reasonable percentage of these deaths are said to be children under five. However, fake drugs make this crisis far worse than one can imagine. A research by the United Nations Nations Office on Drugs and Crime (UNODC) titled “Trafficking in Medical Products in the Sahel” shows that counterfeit and substandard antimalarials cause an estimated 200,000 to 267,000 additional deaths annually in sub-Saharan Africa, with Nigeria bearing a massive share due to its large population size and import dependence.

“These are not mere substandard goods; they are potential instruments of harm that could devastate families and derail our nation’s progress,” Professor Mojisola Adeyeye, NAFDAC’s Director-General, said after destroying ₦985 million worth of fake medicines in 2024. The counterfeit drugs often contain no active ingredients for effective treatment at all. A 2025 NAFDAC alert warned about fake varieties of antimalarial drugs imported fraudulently from India that were completely ineffective. Some counterfeits use incorrect dosages or substitute cheaper ingredients that fail to treat malaria. Patients who take these fake medicines/drugs believe they are getting treatment while the disease continues destroying their bodies.

The High Cost of Doing Business Legally

While fake drug dealers operate in the shadows or underground, legitimate pharmaceutical companies are faced with burdensome regulations that drive up costs and cause delays. The Guardian Nigeria reported that Pharmaceutical Society of Nigeria’s Lagos State branch has accused NAFDAC of imposing fees that make genuine medicines unaffordable for Nigerians. In 2019, NAFDAC increased drug registration fees by 350%, a move that pharmacists warned would push prices up by 100% within six months.

“This draconian policy will incentivise fake drug dealers who will bring in their deadly merchandise at cheaper rates relative to expensive registered products,” said Mrs. Bolanle Adeniran, then-chairman of PSN Lagos, at a 2019 industry event.

The registration process itself can take 6 to 12 months or longer, while NAFDAC officially promises 120 working days for drug registration, industry insiders report the process often stretches beyond two years due to bureaucratic delays. Foreign manufacturers must work through local representatives, submit extensive documentation, pass facility inspections, and pay fees calculated in dollars, including an $11,000 Good Manufacturing Practice (GMP) inspection fee. And for importers trying to follow the rules, every delay means medicine shortages. For patients, it means either paying higher prices or turning to unregulated markets where fake drugs thrive.

When Currency Collapses, Medicine Prices Explode

The Naira’s collapse has turned pharmaceutical imports into a financial nightmare. An article by The Guardian Nigeria, another one by Punch’s “Healthwise” pointed out that investigations have shown only about 20 to 30 per cent of drugs are manufactured locally, while about 70 to 80 per cent are imported from countries like India and China. Even locally manufactured drugs rely entirely on imported raw materials to survive, especially in the aspects of Active Pharmaceutical Ingredients (APIs) and other raw materials used in manufacturing drugs. According to Nairametrics and Reuters reports, between February 2022 and September 2023, the naira crashed from ₦416 to between ₦740 and ₦790 per dollar at official rates, and hit ₦925 on the black market. By early this year (2025), rates exceeded ₦1,500 per dollar.

The impact of this phenomenon on medicine costs has been devastating. Data from a survey by SBM Intelligence and THISDAY LIVE reports showed that between 2020 and 2023, essential drug prices jumped by nearly 50%. Some antibiotics saw 60% increases, blood pressure medications surged by 70%, and antimalarial drugs rose by 50% or more. During peak periods, some medicines increased by over 100%. Four major Nigerian drug manufacturers saw their combined cost of raw materials nearly double; surging 88% from ₦15.5 billion in the first quarter of 2024 to ₦29 billion in the first quarter of 2025. These companies had no choice but to raise prices to survive.

“There is a limit to what companies can do regarding the rising cost of drugs,” said Pharm. Patrick Ajah, Managing Director of May & Baker (Nigeria) Plc. “Most materials used in drug production are imported, and with the current forex situation, companies have little room to manoeuvre,” he added during an interview with Pharmanewsonline on the 26th of November, 2024.

Meanwhile, pharmaceutical imports that cost Nigeria ₦475 billion in 2022 were projected to reach over ₦900 billion by 2024 simply because of currency devaluation; buying the same volume of medicines but paying double in naira. This is according to a report made available by BizWatch Nigeria.

Supply Chain Breakdown

The exit of major pharmaceutical companies has made the supply crisis worse. In 2023, GlaxoSmithKline shut down its 51-year old operation in Nigeria, switching to third-party distribution. French pharmaceutical giant Sanofi followed, transitioning to a distribution model in 2024. These exits pushed Nigeria to rely even more heavily on imports just as currency problems made imports more expensive. Drug availability in public health facilities dropped, with up to 40% of commonly used medicines frequently out of stock. I had a personal experience at ABU Zaria hospital/Clinic, where Flutex; a drug for emotional disorder patients, went out of stock in the mid 2023 and never got restocked up to the time I left the university in October, 2024. During our interview session with the managing director of the University’s Medical Center, Prof. Muhammed Dauda Maigatar also attributed the unavailability of some drugs to the nation’s currency issues. This phenomenon has forced many students to purchase some drugs outside the university clinic where they would have to spend more.

In the same vein, legitimate pharmacies struggle to compete. Nigeria’s pharmaceutical market is worth only about $2.1 billion despite a population exceeding 200 million, because local manufacturing is said to contribute less than 2% to GDP. However, when genuine medicines become scarce and expensive, desperate patients turn to open drug markets where counterfeit products flood in unchecked. It is said that more than 70% of drugs entering Nigeria pass through unregulated open markets, creating opportunities for counterfeits to slip into the legitimate supply chain. These markets supply medicines to licensed pharmacy outlets, hospitals, and retailers across the country.

The counterfeit economy thrives in this open market chaos, where fake drug networks exploit Nigeria’s porous borders, weak enforcement, and price-sensitive market. The World Health Organization estimates that counterfeit drugs make up 10% to 41% of pharmaceuticals in Nigeria. Meanwhile, the supply chain for fake medicines entering Nigeria is sophisticated. According to industry reports, unauthorized importers request laboratories; both legal and illegal in India and China, to produce drugs with reduced active ingredients to cut costs. The network includes employees at distribution centers, pharmacists, depot sellers, government officials, and others involved in healthcare corruption in the country. These counterfeiters face little competition from legal operators because legitimate companies carry massive overhead; registration fees, facility inspections, quality control, import duties, and compliance costs that fake operators simply ignore.

“If this draconian policy is not reversed, Nigeria will experience at least a 100% increase in drug prices in about six months with grave consequences,” warned PSN Lagos when NAFDAC raised fees in 2019. The prediction came true, creating a pricing gap that counterfeiters eagerly filled.

The Human Cost

The economic impact of this sad situation extends beyond individual patients. The World Health Organization estimates it costs between $12 million and $44.7 million yearly to treat malaria patients in sub-Saharan Africa who used fake or substandard medicines. A study by Beargie, S.M., Higgins, C.R., Evans, D.R., Laing, S.K, Erim, D., and Ozawa, S. (2019) titled “The Economic Impact of Substandard and Falsified Antimalarial Medications in Nigeria” estimated that 12,300 deaths annually in Nigeria; about 16% of all malaria deaths in children under five result from poor quality antimalarials. Unarguably, these deaths are preventable. Unlike malaria parasites that develop drug resistance naturally, fake medicines kill simply because someone somewhere in Nigeria chose profit over human life.

“Hospitals in Nigeria over the past years admitted more than a thousand victims of adverse drug reactions such as rashes, pain, difficulty in breathing, and even death due to fake drug use,” Dr. Michael Omoke told the Organized Crime and Corruption Reporting Project in 2024.

For pregnant women and young children (the most vulnerable groups), fake antimalarials are particularly deadly. Nigeria recorded an estimated 35.96 million pregnancies in sub-Saharan Africa in 2023, with about 34% exposed to malaria infection in the country. Now, when these women take counterfeit medicines believing they are protecting themselves and their babies, the results can be catastrophic.

Fighting Back With Technology

NAFDAC and partners have introduced track-and-trace systems and mobile authentication services. Consumers can scratch a panel on drug packages and text the code to verify authenticity. Reputable pharmacies have signed up to scan products at each supply chain interaction, but these systems face resistance from the industry. The proposed Track and Trace policy would require complete repackaging of existing products, which PSN Lagos estimates could increase drug prices by another 70% to 85%.

“This is suicidal in a country where patients are already struggling to access basic medicines,” warned Oyekunle Babayemi, current PSN Lagos chairman, in September 2025.

In the meantime, NAFDAC’s “5 plus 5” regulatory scheme offers another approach. Companies importing drugs that local manufacturers can produce get one final five-year registration renewal. During that period, they must either migrate to local manufacturing or partner with local producers. About 30% of pharmaceutical companies have started this migration, though progress remains slow. Nevertheless, the agency has also achieved WHO Maturity Level 3 status for regulating medicines and vaccines; a recognition that Nigeria’s oversight meets international standards. This achievement has encouraged international procurement agencies like UNICEF and UNITAID to buy more locally manufactured Nigerian medicines instead of importing products.

What Comes Next

The crisis demands action on multiple fronts, especially from stakeholders. President Ahmed Bola Tinubu’s June 2024 executive order removed tariffs, excise duties, and VAT on pharmaceutical inputs to reduce costs of drugs as essential products. But industry leaders say this has not tackled the core problems: forex scarcity, regulatory delays, and high fees are still impediments that must be tackled head-on.

About thirteen (13) months after the presidential order, another statement by Lagos state PSN in September 2025 indicates that “the Federal Government’s executive order has failed completely and is worsening the country’s pharmaceutical crisis.” Obviously, the order didn’t address Nigeria’s heavy dependence on imports or the regulatory bottlenecks that make doing legitimate business so difficult.

Several solutions have emerged from industry discussions:

First, NAFDAC must streamline registration to match its official 120-day timeline instead of the two-year reality. Delays not only frustrate legitimate (drug) businesses but also create supply gaps that counterfeiters exploit.

Second, the government needs a special forex window for pharmaceutical companies at stable rates devoid of fluctuations. When exchange rates fluctuate wildly, neither manufacturers nor consumers can plan ahead. A dedicated forex facility could stabilize raw material costs and make genuine medicines more predictable in price.

Third, fees must reflect Nigeria’s economic reality. While NAFDAC needs resources to enforce standards, charging fees that push prices beyond what ordinary Nigerians can afford defeats the purpose of regulation. When genuine medicines become luxury items, fake drugs fill the gap immediately.

Fourth, investment in local manufacturing of active pharmaceutical ingredients could reduce import dependence to some extent. Currently, Nigeria imports 100% of pharmaceutical raw materials into the country. Building domestic capacity would create jobs, reduce vulnerability to currency shocks, and lower costs.

Finally, enforcement against counterfeit networks must be intensified across the board. The September 2025 seizure in Lagos shows that intelligence-led operations work perfectly. Scaling up these efforts across all entry points; ports, land borders, and open drug markets, could save thousands of lives.

The Stakes

Nigeria’s malaria fight sits at a crossroads, the disease kills a Nigerian/African child nearly every two minutes according to WHO. Fake medicines make this toll worse while legitimate companies struggle under regulatory and economic pressure.

For now, patients face an impossible choice: pay prices they cannot afford for genuine medicines, or risk their lives on cheaper products that might be fake at a lesser fee. Until Nigeria fixes its pharmaceutical regulatory system and stabilizes its currency, counterfeiters will keep thriving in the chaos medicine industry.

The ₦1.2 billion worth of fake antimalarials seized in Lagos represents just one intercepted shipment. How many others make it through, either by corruption or luck? And how many Nigerians will continue to die every year because the medicine they trusted was a lie? These are the questions the relevant authorities must provide concrete answers or solutions to. However, the Counterfeit Drug Economy is a heartbreaking tragedy that should never have become ordinary.

Aliyu Baba Mohammed, writes from Kaduna State, Nigeria

He can be reached via: aliyu0380@gmail.com