The illicit trade in medical drugs is booming in Central Africa, with over 251 tons of medical products seized between 2020 and 2025 in Cameroon, Republic of Congo, Gabon, Central African Republic, and Chad. The seizures, which include antibiotics, malaria treatments, painkillers, and opioids, highlight the growing problem of illicit medical drugs in the region. The United Nations Office on Drugs and Crime (UNDOC) released a report on the issue, detailing the scope and complexity of the trade.
The report reveals that annual seizures rose from about five tons in 2020 to nearly 116 tons in 2024, before exceeding 97 tons in 2025. Cameroon accounted for nearly all of the seizures recorded in 2025, with 96 tons intercepted, compared with just 2.5 tons five years earlier. The products intercepted across the region range from antibiotics, antimalarial and anti-inflammatory drugs to painkillers and psychoactive substances such as tramadol and pregabalin.
The roots of the trade are partly beyond the reach of law enforcement, according to the report, which was produced with the World Health Organization (WHO) and the Economic and Monetary Community of Central Africa (CEMAC). Malaria, tuberculosis, and HIV remain widespread across the region, while public health systems often struggle to provide treatment. In 2023, the WHO’s universal health-coverage index placed all six countries in the Central African economic bloc among the world’s poorest performers.
Distance and cost compound the problem, with more than half the population in the Central African Republic and Chad living at least two hours from a public hospital providing emergency care. In Chad, a prefilled insulin syringe costs the equivalent of nearly 16 days’ wages for the lowest-paid government employee. Under these circumstances, buying medicine on the street can become a necessity, with consumers in the Central African Republic telling researchers that informal sellers allow them to “buy one or two tablets for about 100 CFA francs” – roughly 20 cents.
The result is a marketplace where legitimate, falsified, and substandard medicines can be difficult to distinguish. From 2013 to 2025, WHO’s surveillance system recorded incidents involving 228 medical products in the Central African economic bloc. Of those, 71 percent were classified as falsified and 11 percent as substandard. A third of the incidents were detected in regulated supply chains, suggesting that buying medicine from an authorized outlet does not eliminate the risk.
The trafficking routes largely follow the arteries of legitimate regional commerce, with the ports of Apapa in Nigeria and Douala in Cameroon, along with river ports in Brazzaville and Bangui, identified as major entry points. Authorities also seized 7.3 tons of medical products at airports across the region from 2020 through 2025. The criminal networks behind the trade are equally varied, including clandestine manufacturers, wholesalers, informal vendors, couriers, health care workers, corrupt public officials, and online sellers.
For patients, the consequences can be dire, with medicines containing the wrong ingredients or incorrect doses causing poisoning, treatment failure, and death. The report calls for countries to harmonize their laws, strengthen controls, and improve cross-border cooperation. It also argues for expanding access to safe and affordable medicines, as the illicit market is responding to a demand the formal health system has failed to meet.
Key points
- Over 251 tons of medical products seized in Central Africa between 2020 and 2025.
- Illicit medical trade fueled by fragile health systems and high costs of medicines.
- Report calls for expanded access to safe and affordable medicines to combat illicit trade.
