ADELANI ADEPEGBA and LARA ADEJORO
The ‘Organised Crime: West African Response to Trafficking,’ a project of the Economic Community of West African States has said illicit and counterfeit medical products from China and India are taking over the drug markets in Nigeria, Ghana, Benin Republic, Togo, Guinea and other countries in the sub-region.
The OCWAR-T in a study observed that the illegal drugs were often shipped from Guangzhou in China and cleared through the ports in Apapa, Tema, Cotonou and Conakry using intermediaries.
It observed that West Africa had become a hotspot for the trafficking of medical products, estimating that the illicit market makes up to 80 per cent of medical products in Burkina Faso and Guinea.
The ECOWAS report estimated that smuggled medical products make up between 20 per cent and 60 per cent of the formal market across the region.
This was contained in the 2023 OCWAR-T report titled, ‘Bad pharma: trafficking illicit medical products in West Africa.’
OCWAR-T is implemented through indirect management by European Union member state agency, Deutsche Gesellschaft für Internationale Zusammenarbeit, in collaboration with International Centre for Migration Policy Development, United Nations Development Programme, United Nations Office on Drugs and Crime and Mines Advisory Group.
The ECOWAS Commission is the steering and coordinating body, together with the EU Delegation and the GFFO.
In carrying out the research, the OCWAR-T said it conducted more than 60 interviews and four focus group discussions, involving international organisations, national authorities, civil society groups, public and private sector experts, pharmacists, doctors and their respective boards and associations, as well as consumer groups.
It said interviews were also held with individual manufacturers, consumers and sellers of illicit medical products to gain insights from those involved directly in the market and to ensure that the voices of communities affected by the trade were placed at the centre of the analysis.
The research also drew on the Global Initiative Against Transnational Organised Crime’s Hotspots Mapping Initiative on hubs of illicit economies, including illegal medical products markets, across West Africa as well as an extensive literature review of grey, academic and media sources.
In February, the UNODC in its organised crime threat assessment estimated that fake drugs killed almost 500,000 persons in sub-Saharan Africa with as many as 267,000 deaths per year linked to falsified and substandard antimalarial medicines.
In addition, up to 169,271 were linked to falsified and substandard antibiotics used to treat severe pneumonia in children.
The UN agency declared that the sale of counterfeit medical products in West Africa was worth about $1bn, more than the combined value of the crude oil and cocaine trafficking markets.
The World Health Organisation estimates that caring for people who have used falsified or substandard medical products for malaria treatment in sub-Saharan Africa costs between $12m and $44.7m every year.
The WHO equally found that one in every 10 products sold in low- and middle-income countries is either “substandard or falsified and almost half of reported counterfeits are from Africa, where limited local production of genuine medical products has contributed to a market penetration rate of 30 per cent compared to one per cent in more developed countries.”
In its 30-page report published last month, OCWAR-T also found that within the sub-region, Nigeria and Ghana are the major manufacturers of both legal and illicit medical products, whereas large-scale production is more limited in Francophone West Africa.
Of the 172 pharmaceutical manufacturers based in ECOWAS countries, it said 120 were in Nigeria and 37 in Ghana and that they operate alongside a raft of illegal labs, some of which were recently dismantled in Niger and Guinea.
The report read, “India and China are the principal source countries for the illicit and licit medical products that find their way into West Africa. Most medical products are imported by sea through the main ports in Conakry (Guinea), Tema (Ghana), Lomé (Togo), Cotonou (Benin) and Apapa (Nigeria).
“Typically, illicit manufacturers do not export their medical products directly and instead use intermediaries in local freight companies connected to the West African diaspora – for example the Nigerian contingent in the city port of Guangzhou in China. The journey can take several months, involving a number of transit points popular with traffickers, including the free trade zones in the United Arab Emirates and Egypt, as a means of concealing the original source of the shipment.
“Within the sub-region, Nigeria and Ghana are the major manufacturers of both licit and illicit medical products, whereas large-scale production is more limited in Francophone West Africa. Of the 172 pharmaceutical manufacturers based in ECOWAS countries, 120 are in Nigeria and 37 in Ghana. These official producers sit alongside a raft of illegal labs, some of which were recently dismantled in Niger and Guinea.”
The ECOWAS report noted further that while the port towns of Conakry, Tema, Lomé and Cotonou were the primary entry points for medical products coming from India and China by sea, landlocked Burkina Faso plays host to a number of critical stocking and redistribution hubs, which gather and dispatch them to consumers around the region.
It added, “The town of Cinkansé, which lies at the tri-border with Ghana and Togo, is one such hub – a first step for medical products that have been either manufactured within the region (likely Nigeria or Ghana), or imported via Tema and Lomé.
“It sits just across the border from Cinkassé, one of Togo’s principal transit points for illicit commodities entering and exiting the country. Togo itself is an important corridor for goods, both licit and illicit, destined for the landlocked countries to its north, and almost all of this trade passes through the Cinkassé/Cinkansé node.
“While the biggest flow into Burkina Faso comes from the seaports of the West African coast, various sources, including a wholesaler involved in trafficking, reported that medical products also come overland from Bamako, Mali, into Ouagadougou.”
It added that ongoing violence and instability in Burkina Faso had contributed to a sharp expansion of the market, and its porous borders had emerged alongside the seaport in Conakry as major smuggling routes.
The investigation said evidence suggests that the market for counterfeit products was highly lucrative, with an estimated value between US$200bn and US$431bn, rivalling the $435bn illicit drug industry.
While no comprehensive data exist for West Africa, the annual profits of the global market range from $30bn to US$75bn and West Africa is a key market with the profit-to-investment ratio believed to be vast.
The International Institute of Research Against Counterfeit Medicines estimated that the turnover of the counterfeit medical products market is 20 times that of the heroin market, while Pfizer assessed that one kilogram of heroin had higher production cost and a lower street value than one kilogram of counterfeit Viagra.
According to the WHO, 90 per cent of African countries have between minimal and no capacity to regulate medical products due mainly to insufficient resources and understaffing in regulatory bodies and poor-quality assurance mechanisms.
In its recommendations, the study said ECOWAS has a key role to play at the regional level to enhance cross-border intelligence gathering and cooperation, as the complex supply chains feeding the illicit market for medical products dictate that responses must be international, and at the very least regional, to be effective.
It further underscored the critical roles of national authorities which it said were best placed to tackle the structural drivers – affordability and accessibility – behind the demand for illicit medical products, and should work simultaneously on awareness campaigns, as well as on wider distribution of and access to key high-demand products such as anti-malaria drugs.
“Civil society has a key role to play. In addition to supporting the awareness-raising efforts, civil society is also central to holding people accountable, including customs officials and politicians, for example, by denouncing cases of corruption and malfeasance,” the report emphasised.
The National Agency for Food and Drug Administration and Control could not be reached for comment on Saturday but the Director of Media and Advocacy at the National Drug Law Enforcement Agency, Femi Babafemi, said there was no doubt that China, India and Pakistan were the top countries where the illicit drugs come from.
Babafemi added, “We have realised that when you trace some of the opioids smuggled and seized in Nigeria, these countries have featured prominently. In our bid to curb that, we signed a Memorandum of Understanding with the Narcotics Control Bureau in India about two months ago, which allows us to share real-time intelligence and ensure that things like this are curbed.
“We also know that there has been an existing but moribund MoU with China which we have also begun efforts to reactivate. We are working with the Federal Ministry of Foreign Affairs in that regard. We are also trying to reactivate an MoU with the Pakistan government.
“All of these are to put us in a proper position to be able to work with our counterparts in those countries to ensure that we curb smuggling of illicit drugs into the country, especially the opioids which are the major ones coming from those countries.”
He said further that the agency was working with other local and international partners to curb illicit drugs from being smuggled into the country.