A thriving but illegal trade in unlabelled medicines has been exposed in Ghana's Volta Region, with hawkers selling tablets, syrups, and herbal mixtures alongside food and clothing in markets and along highways. The trade, which is widespread across major market centres in the region, including Keta, Anloga, Akatsi, Agbozume, Aflao, and Ho, is putting thousands of lives at risk, according to Ghanaian regulators. The products on offer range from common painkillers to antibiotics, antimalarials, cough syrups, multivitamins, contraceptives, and herbal preparations marketed as aphrodisiacs.
The trade is not limited to fixed market stalls, but also thrives at bus stops, church programmes, funerals, festivals, and through door-to-door sales and social media. One hawker, who spoke on condition of anonymity, said she has sold drugs without authorisation at Aflao market for over ten years to support her four children as a single mother. She buys stock in bulk from local pharmacies and sometimes smuggles supplies across the border from Togo through bush routes. The ease with which she operates is a testament to the challenges faced by regulators in enforcing laws governing the sale of medicines.
The practice of selling unlabelled medicines is tied directly to economic hardship and the particular pressures of life near Ghana's busiest land frontier at Aflao. Fishing and farming livelihoods along the coast remain vulnerable to erosion and seasonal disruption, pushing some residents toward hawking as an alternative income source, especially for women supporting families. Many residents turn to roadside sellers because the formal healthcare system feels too expensive, too far away, or too slow. This has created a culture of self-medication, with many buyers seeing no meaningful difference between purchasing paracetamol from a licensed pharmacy or from someone's tray at a lorry station.
Ghana's Public Health Act, 2012 (Act 851), restricts the sale of medicines to licensed pharmacies, registered chemical sellers, and registered health facilities. Enforcement falls to the Food and Drugs Authority (FDA) and the Pharmacy Council, which licenses and oversees pharmacy practice nationwide. Street hawking of medicines is prohibited under the law, with offenders facing prosecution, fines, imprisonment, and seizure of their goods. The FDA's Head for the Volta and Oti Region, Mr Gorden Akurugu, said penalties for breaching the law can reach up to 25 years' imprisonment.
Despite the laws, the trade persists, and health officials warn of significant risks. The indiscriminate sale of antibiotics without prescription is fuelling antibiotic resistance, a global health concern that undermines the effectiveness of essential medicines for entire communities. Deaths and long-term disability linked to drug misuse, allergic reactions, and delayed diagnosis have reportedly occurred in several districts. The trade also costs the state tax revenue, undercuts licensed pharmacies, and spreads health misinformation through unverified claims made by untrained sellers.
Certain groups, including pregnant women, children and infants, and the elderly, are especially vulnerable to the risks associated with the unregulated sale of medicines. Pregnant women are at risk of drugs that can harm foetal development, while children are at risk of incorrect dosing. Elderly residents in areas with limited transport are at risk of dangerous drug interactions from self-medication. People managing chronic conditions, such as diabetes and hypertension, also risk complications when they cut costs by relying on unregulated sellers instead of consistent, supervised treatment.
Local authorities have pledged to take action against the trade, with police and town councils vowing to remove unauthorised sellers. The FDA and Pharmacy Council have been tasked with periodic raids, public education campaigns, and better logistics for enforcement personnel near Aflao. While there are no specific dates or timelines for these actions, the authorities' intent to act is clear. The Paramount Chief of the Amugo-Vego Traditional Area, Togbi Tenge Dzokoto Gligui VII, has cautioned chiefs under his jurisdiction against entertaining uncertified medicine or herbal dealers.
Key points
- The unlicensed street drug trade in Ghana's Volta Region is a significant public health concern, with thousands of lives at risk.
- The trade is widespread, with hawkers selling unlabelled medicines alongside food and clothing in markets and along highways.
- Regulators face challenges in enforcing laws governing the sale of medicines, particularly in areas with limited access to formal healthcare.
