A new report has exposed a major health crisis across Africa, revealing that nearly one in every three medicines circulating in the continent is fake, with conflict-hit areas recording rates as high as 80 percent.

The report, Securing the Medicine Distribution Network in Africa, by pharmaceutical distributor CFAO Healthcare and the OPALS Foundation, warns that falsified medicines are affecting all types of treatments including antibiotics, vaccines, and cancer drugs.

According to the World Health Organisation, falsified medicines are those whose identity, composition, or source are intentionally misrepresented. The report outlines how both patented and generic drugs, as well as medical devices, are being counterfeited—posing serious health and economic threats to communities and countries.

“All medicines, both patented (princeps) and generics, as well as vaccines and medical devices, are impacted. The risks are both individual and collective,” said Ken Accajou, CFAO Healthcare Deputy CEO and Head of English and Portuguese-speaking Area Retail.

The report reveals that essential medicines such as HIV antiretrovirals, antimalarials, painkillers like tramadol, and antibiotics are the most frequently targeted by counterfeiters.

As chronic diseases like diabetes, hypertension, and cancer rise across Africa, so too has the black market for these costly treatments.

Accajou noted that the problem runs deeper than criminal activity.

“The proliferation of fake medicines in Africa is not just a criminal issue, it’s a consequence of systemic gaps in access to quality healthcare. When pharmacies are scarce, prices unaffordable, and supply chains unreliable, desperate populations turn to street markets, creating a fertile ground for traffickers to thrive.”

Most of the falsified drugs originate from India and China, with Dubai often used as a transit hub to hide the origin. Nigeria is identified as the main African gateway, with Lagos serving as the largest entry point into the Gulf of Guinea region.

The counterfeit products are then smuggled into neighbouring countries including Chad, Togo, Cameroon, Niger, and Benin.

Globally, the counterfeit medicine trade is worth between $75 billion and $200 billion annually and is said to be up to 45 times more profitable than drug trafficking.

The effects are deadly. “It is because of falsified antimalarial drugs that we are losing 100,000 Africans. Of the one million annual deaths caused by malaria, 200,000 could be avoided if patients were treated with genuine medicines,” Accajou said.

Aside from causing death, fake drugs contribute to treatment failure, disease resistance, and worsening health conditions—leaving African health systems stretched and citizens more vulnerable.