Central Africa’s Illegal Drug Trade Is Becoming a Public Health Crisis
Central Africa is facing a growing public health threat as illegal medicines move across borders, exposing patients to counterfeit, poor-quality and unauthorised drugs.
The warning comes from a new report by the United Nations Office on Drugs and Crime (UNODC), the World Health Organization (WHO) and the Central African Economic and Monetary Community (CEMAC).
The report examined Cameroon, Chad, the Central African Republic, Congo, Equatorial Guinea and Gabon, six countries described as having some of the world’s worst health indicators.
According to the report, difficulties in accessing safe and affordable healthcare products have helped create conditions for an expanding illegal medicine market.
The trade involves counterfeit and substandard medicines, unauthorised products and legitimate pharmaceutical supplies diverted from official distribution channels.
Among the medicines involved are antibiotics, antimalarial drugs, painkillers and anti-inflammatory medicines. Psychoactive drugs, including tramadol and pregabalin, are also part of the growing trade.
The scale of the illegal drug trade is reflected in seizures recorded across the region. At least 251 tonnes of medicines were seized in Cameroon, Gabon, Chad, Congo, Equatorial Guinea and the Central African Republic between 2020 and 2025.
A UNODC official said at a press conference on Tuesday that the trafficking of medicines had intensified and diversified in recent years.
For patients, the consequences can be devastating. The report warns that fraudulent and poor-quality medicines can cause treatment failures, poisoning and preventable deaths.
The problem also threatens efforts to control antimicrobial resistance. When patients receive ineffective or inappropriate medicines, infections can become harder to treat, creating risks that extend beyond individual patients.
Another concern is that illegally traded medicines do not always remain outside the formal healthcare system. Some can eventually enter authorised facilities, where patients may trust them simply because they are receiving treatment in a recognised healthcare setting.
The danger is already a wider concern across sub-Saharan Africa. In 2017, the WHO estimated that the use of fraudulent medicines in the region could be associated with hundreds of thousands of deaths each year.
The medicines reach Central Africa through several routes. According to the report, many enter through regional ports before being transported along major road networks.
Porous borders make the movement easier, while traffickers also use air transportation, including freight shipments and passenger luggage, to move pharmaceutical products between countries.
The illegal drug trade also has a security dimension. Armed groups operating in parts of Cameroon, Chad and the Central African Republic are involved in some aspects of the trafficking network.
The report says these groups may obtain medicines by looting health centres, reselling pharmaceutical products or collecting so-called taxes from convoys travelling through territories under their control.
The result is a problem that extends beyond unsafe medicines. The UNODC says drug trafficking fuels organised crime, weakens public institutions and contributes to the non-medical use of medicines associated with dependence and addiction.
A recent seizure in Gabon has provided another indication of the cross-border nature of the trade.
At the end of September, customs officials in Gabon seized 17,000 tramadol tablets. A Gabonese customs representative said narcotics continued to enter the country from neighbouring Cameroon.
For the UNODC, WHO and CEMAC, the response must involve stronger international cooperation and tighter controls across pharmaceutical supply chains.
But enforcement alone may not solve the problem. The report links the growth of the illegal medicine market to difficulties in obtaining safe and affordable healthcare.
That leaves Central African governments facing a wider challenge: protecting patients from dangerous medicines while ensuring that legitimate treatment is available to the people who need it.
Until that gap is reduced, the illegal drug trade is likely to remain more than a criminal problem. It will continue to pose a serious threat to public health across Central Africa.
