BY EVELYN OKONMA/JUMAI NWACHUKWU/FAVOUR IDUBOR/OGORAMAKA AMOS
When 31-year-old Adaobi Nwaju rushed her child to the clinic for what seemed like a routine bout of malaria, she never imagined the nightmare that would follow. “We were given antimalarial syrup. But instead of getting better, the whole thing became worse,” she recalled.
Adaobi’s experience is not an isolated incident. A silent epidemic is taking root — the circulation of fake, substandard, or adulterated drugs. These drugs, which range from painkillers to antibiotics and even life-saving medications, are infiltrating markets, hospitals, and pharmacies, endangering countless lives.
This was recently brought to the fore by the Association of Community Pharmacists of Nigeria (ACPN), over 50 per cent of medicines currently in circulation are counterfeit. According to the ACPN National Chairman, Pharm Ezeh Igwekamma, ‘’Our usually reliable and dependable research-based efforts indicate that we are back to the days of over 50 per cent of drugs in circulation being fake and substandard.’’
He highlighted the vast economic scale of the fake drug and beverage industry, describing it as a “tens-of-billion-naira business championed by modern-day merchants of death’’ even as he attributed the alarming trend to weakened regulatory enforcement, noting that both the Federal and State Task Forces on counterfeit medicines have become largely inactive.
To this end, The Pointer reached out to victims, pharmacists, medical professionals, policymakers, civil societies, and ordinary consumers, from Asaba to Port Harcourt, Benin to Akure — all of whom echoed one message: the fight against fake drugs is urgent, complex, and far from over.
For 45-year-old Chidi Opara, a routine dental infection spiralled into a nightmare of excruciating pain, permanent damage, and crushing financial loss — all because of fake drugs. A father of three and an electrical technician in Port Harcourt, Nnamdi had little reason to suspect that his purchase from a local medicine vendor would leave him physically and emotionally scarred.
“I bought antibiotics from a nearby chemist,” he recounts. “It looked exactly like Augmentin — same packaging, same tablets, same everything. I thought I was doing the right thing.”
But the relief he expected never came. Instead, the pain intensified. “My gums began to swell, my face puffed up, and the pain was unbearable. I couldn’t eat or sleep,” he told The Pointer. “I went back to the chemist and they told me to keep taking it — that it would soon work.” days turned into weeks.
By the time Chidi got a second opinion from a private hospital, the infection had spread dangerously. Lab results later confirmed his worst fear: the antibiotics he had been taking were counterfeit. They contained no active ingredients.
“I lost one of my teeth. The infection almost went systemic. My doctor said if I had waited another week, it would have been worse, Chidi said, shaking his head. “I spent some amount of money for proper treatment and it went down just like that. And still, no one has been held accountable.”
Chidi’s story is far from unique. In many parts of Nigeria, especially in urban centres like Port Harcourt, counterfeit drugs continue to slip through the cracks of regulation and enforcement, posing a grave threat to public health. For people like Nnamdi, the damage is deeply personal — and permanent.
“Every time I see antibiotics now, I hesitate. I have to double-check with pharmacists. I don’t trust any medication unless it comes straight from a hospital pharmacy,” he adds. “It’s terrifying to think this can happen to anyone.”
Grace Worlu, a Primary school teacher gave her experience of how fake drugs almost blinded her. “It all started with a simple headache. I went to a small pharmacy near my house in Rumuodomaya, and the headache made me restless. When I got to the pharmacy, the man assured me it was strong and effective.
“I took them as prescribed, but instead of getting better, the headache worsened. My eyes began to ache and I couldn’t see properly. I had to go to the hospital, where the doctors ran tests and told me to bring the packet of the aspirin I had taken previously for the headache only to discover that the drugs I had taken were fake. By then, my eyes became watery, so I had to go for an eye check and glasses were prescribed for me which I use up to date.”
Reacting to the prevalence of counterfeit drugs in Nigerian markets, a consultant physician at a private hospital in Port Harcourt, Dr Ifeoma Kenechukwu described fake drugs as a “biological time bomb.”
She described the frustration of treating patients whose conditions deteriorate despite following prescriptions only to later discover they were given counterfeits. “Imagine prescribing drugs for a patient and instead of the patient’s health improving the condition worsens due to the intake of fake drugs”.
‘’Let’s take malaria drugs for instance. There are a lot of antimalarial drugs everywhere. Some of them don’t have the right components to fight off the parasite. Some of these substandard drugs are made by quacks who may not be licensed and these drugs they produce are doing a lot of harm. How many more will suffer because of greed? “
Another medical practitioner, Pharm Godwill Ibiso, a licensed pharmacist has seen first-hand how fake drugs infiltrate the system. “It’s devastating,” he says. “Patients arrive in despair as their condition worsens, often because they’ve taken fake antimalarial medications, believing them to be real—yet their health doesn’t improve. Most times, when we analyze these drugs, we discover they’re nothing more than powdered chalk packaged in foil.”
He explained how fake drugs bypass regulatory checks through illegal supply chains, often sold in unlicensed pharmacies or street markets. “The packaging looks identical—same colours, same logos—but inside, it’s poison. Some contain traces of the real drug, giving false hope, while others have toxic substitutes like heavy metals or industrial chemicals.”
‘’Worse still, some patients unknowingly take under-dosed antibiotics and their infections linger, mutate, and become untreatable. I’ve watched people die from infections that should have been curable, all because someone wanted to make a quick profit.”
Mercy Ihuoma, a healthcare worker at Rivers State Government Health Center in Port Harcourt, highlighted how misinformation and scepticism worsen the crisis. “Patients often suspect us of giving them counterfeit drugs in the health centre, not realizing the real threat comes from unregulated markets. That’s why we encourage our patients to get drugs outside the health centre. We often refer them to trusted pharmacies she explains.
Mercy said, “The producers of these fake drugs must realize this isn’t just about illegal trade—it’s about lives. Every fake pill risks someone’s family. To combat this, stricter regulations, public education, and severe consequences for counterfeit drugs are essential. This battle isn’t just against fake drugs,” Mercy stressed. “It’s about preserving trust in healthcare. When people doubt treatment, they avoid help—and that’s how epidemics take hold.
Mrs Vivian Okonkwo, inside her small but busy pharmacy in Rumuokoro, Port Harcourt, told our correspondent, “There are days I don’t even know which supply is real,” she said, pointing to a shelf of antibiotics. “We try to buy directly from manufacturers or certified distributors, but fakes are so good these days — they mimic everything.”
Vivian said she once unknowingly sold fake Paracetamol to a patient. “I felt terrible. The man came to complain about the drug. My pharmacy reputation was at stake so I am extra careful who I buy drugs from.’’
Many pharmacists now invest in costly authentication tools and training. But Vivian believes it’s not enough. “If the source is compromised, we’re all at risk. Regulatory bodies need to do more. They should protect us and the public.”
At a private clinic in Rumuokoro, a nurse, Kate Ebi said they often see signs of fake drug usage: patients returning with recurring infections, worsening symptoms, or unexplained side effects. “It’s heart-breaking. We give the best care, but if the drugs are fake, our hands are tied,” she said.
Nurse Kate wants hospital procurement systems overhauled. “I want to advise Hospitals not to be sourcing drugs through middlemen. It should be from verified government channels only.”
According to Pharmacist Gideon Ezechukwu, who runs a registered pharmacy in GRA, the problem begins with the uncontrolled importation of medicines and poor regulatory oversight at the nation’s borders. “Drugs from China, India, and other countries are imported by some dishonest agents without undergoing the necessary screening or quality assurance procedures,” he explains. “In some cases, the drugs are outright counterfeits; in others, they’re expired or poorly stored generics that have lost potency.”
He adds that some fake drugs are now manufactured locally, using substandard ingredients in hidden factories. “They mimic the original packaging so well that even trained eyes can miss the difference. It looks like medicine, but the contents are either toxic or completely ineffective.”
Ezechukwu attributes the widespread distribution of fake drugs to inadequate border control and poor enforcement mechanisms. “Detecting pharmaceutical fraud isn’t something customs officers are trained to do. Their focus is often on items like firearms or contraband goods. But fake drugs are even more dangerous because they kill slowly and silently.”
He laments that regulatory bodies like the National Agency for Food and Drugs Administration and Control (NAFDAC) and the Pharmacists Council of Nigeria (PCN) are overstretched and underfunded. “They cannot possibly monitor every entry point or patrol all the open drug markets across the country. The system is porous, and bad actors know how to exploit the loopholes.”
According to him, the rise of open drug markets and unlicensed drug vendors has worsened the crisis. “People buy drugs from roadside stalls. Many don’t know that these sources are unregulated and the drugs they’re buying could be fake or dangerous.”
He stresses the need for stronger collaboration between health regulators, law enforcement, and the pharmaceutical industry. “We need stricter laws and better technological tools, such as barcoding and mobile authentication systems, to verify genuine drugs. But enforcement is key. Without it, fake drugs will continue to thrive.”
Ezechukwu also called on the public to be more vigilant and patronise only licensed pharmacies. “If a drug is significantly cheaper than usual or lacks proper labelling, that’s a red flag. Your life could depend on where and how you buy your medicine.”
As the fake drug crisis deepens, legal expert Barr Emeka Okoro has called for urgent, coordinated action to protect public health and restore confidence in the medical system. “Every tablet of fake medication is a loaded gun pointed at the heart of society,” Okoro said in a recent interview. “We’re not just dealing with a regulatory issue — this is a matter of life and death.”
According to him, tackling the scourge requires more than routine crackdowns. “We must go beyond surface-level enforcement. The solution must be multi-pronged — involving the law, technology, the pharmaceutical industry, and the public.”
“Let’s start where the problem often begins — at the borders,” he said. “Customs officers must be properly equipped and trained to detect counterfeit shipments. We need modern scanners, forensic testing labs, and collaboration with international regulatory bodies. Without that, these criminals will keep exploiting our porous systems.”
He advocates for the widespread deployment of track-and-trace systems like the Mobile Authentication Service (MAS), which allows consumers to verify drug authenticity with a simple SMS code. “Every registered drug must carry a digital fingerprint. If technology can help detect fraud in banking, why not pharmaceuticals?”
Okoro insists that only licensed pharmacists should dispense drugs. “We must empower these professionals while also holding them accountable. It is dangerous to have roadside vendors or unqualified persons playing pharmacists in communities. We need regular inspections and licensing audits.”
“The average person on the street doesn’t know how to tell the difference between a real drug and a fake one,” Okoro said. He called for government-led campaigns using radio, market outreaches, and schools to educate people on signs of counterfeit drugs, the risks of patronising unlicensed medicine sellers, and how to report suspicious products.
“We need laws with teeth,” he said emphatically. “Right now, the penalties for drug counterfeiting are too lenient. People are dying, and someone walks away with a slap on the wrist? That must change.”
Okoro also recommended creating a safe and rewarding system for whistle-blowers. “Even though I don’t encourage money to be at the forefront of actions, there are insiders who know where fake drugs are being produced or distributed — warehouse workers, drivers, pharmacists even. But they are afraid to speak up. Let’s give them legal protection and financial incentives to expose these syndicates.”
To fast-track justice, Okoro suggests establishing a specialised drug crime tribunal. “Cases of fake drugs shouldn’t be buried under land disputes and traffic offences. Let’s prioritise them, appoint trained judges, and speed up prosecution.”
He also called for better synergy between NAFDAC, the National Drug Law Enforcement Agency (NDLEA), the Police, and the judiciary. “A fragmented response only allows criminals to slip through the cracks. What we need is a joint task force with a central intelligence database.”
Finally, Okoro urged authorities to clean up informal drug markets. “Port Harcourt has many unregulated stalls where medicines are sold like groceries. These places are hotbeds for fake drugs. Let’s shut them down and redirect people to certified pharmacies. If we fail to act decisively, we are sentencing the poor, the sick, and the voiceless to slow, avoidable deaths,” Okoro said.
In the words of a final year medical student at the University of Medical Sciences, Ondo, Favour Ubaka, “The issue of fake drugs in Nigeria has rather become a pandemic because you see patients returning with the same illnesses they have been treated for over time”.
Miss Ubaka however noted that “the first indication that a particular drug is fake is that it would not have any therapeutic effects.
“When as a doctor, diagnosis is carried out on a patient, the next professional thing to do is to write down the list of drugs to be purchased. The patient usually has the option of purchasing the prescribed medication either from the hospital or from any recommended pharmacy by the consultant or even any pharmacy of their choice.
“Most of the time, the patients prefer to get the drugs from outside because they feel it is cheaper. And so they are often trying to be smart, not knowing that the hospitals have the most authentic drugs.
“And so you keep seeing a particular patient for weeks and you keep seeing the exact problems that have been there from onset. It gets to a point where you as a professional may begin to doubt if you gave the right prescriptions because as earlier stated, the medication lacks therapeutic effects. It is not until you then ask the patient to get the drugs from the hospital that you realize that the medication starts taking effect”.
Speaking of the dangers of exposure to fake medications, she said, “One of the major effects of fake drugs is that one keeps treating ailments without any result whatsoever.
“Another effect is that victims may experience toxic reactions from whatever substandard medications they get outside the hospital.
“Recently we received reports that about 120 trailer loads of fake drugs were confiscated somewhere in the South West. In Anambra also, we heard that there were storey buildings where they were wrapping drugs and changing their expiry dates.
“In this kind of scenario, if such drugs get to a patient, such a patient should even be grateful if they do not have any therapeutic effect on him or her because one should be scared of a toxic reaction that can even lead to death.
“Another dangerous fallout we are battling in the health sector is the issue of antimicrobial resistance. A lot of people abuse antibiotics to the point that they become resistant to such drugs, and so it even gets worse when the antibiotics are fake.
“Another crucial point is the effect these drugs have on vulnerable groups like pregnant women, children under five years, HIV patients and those living with sickle cell disorder. This is quite critical because this group of persons are already immune-compromised and giving them fake drugs is the same as sentencing them to death because they depend on these (authentic) drugs for survival.
“There is also the psychological effect on patients. How does one keep treating a particular symptom or illness over and over again without improvement? It will make the individual lose confidence in the medical process after being in several hospitals”.
On how one can identify fake drugs, a medical practitioner, Pharm. Chinonso Omeiza noted that in most cases, only NAFDAC can identify fake drugs from a series of tests they carry out in the laboratory.
In the views of Pharm. Omeiza, “Some of the dangers associated with fake and substandard medications can include failure of the vital organs like the kidneys and liver which are major organs for drug metabolism”. She further explained that there could be adverse reactions from the drugs like Steven Johnson’s syndrome and other skin reactions.
On how one can avoid purchasing fake medications, she said “It is safer to get drugs from reputable pharmacies that have integrity”.
Reacting to the issue, and proffering a way forward on mitigating the rise in circulation of fake medications, an official of NAFDAC who pleaded anonymity submitted, “We have a lot of laws guiding issues of this sort. The consumer protection council should be strengthened.
“The capacity of the Standard Organisation of Nigeria SON) should be upgraded and NAFDAC should strengthen their enforcement unit. The public should be given a QR code to check every product before purchase to differentiate authentic drugs from fake”, the source said.
A Director of Human Resource Management in the Office of Edo State Head of Service, Barr Victor Okenini said, “There are fake or sub-standard drugs everywhere in the country and a lot of persons have lost their lives as a result of such drugs.
‘’Prof. Dora Akunyili of blessed memory, the former Director-General of NAFDAC fought relentlessly against this menace. I have been a victim of fake drugs. I was once given fake drugs for the treatment of malaria some years back but the ailment persisted because the drugs were fake. That sad experience made me resort to taking injections whenever I have malaria or typhoid.
‘’It’s important to state that a lot of people purchase fake drugs because they are cheap and affordable. The high degree of patronage is the reason why fake drugs are so much in circulation.
Fake drugs are very dangerous to human health. They have compounded the health problems of so many persons and as I earlier stated, a lot of persons have met their untimely death as a result of this menace.
‘’This menace can be tackled by ensuring that strict regulations and measures are put in place to curb the circulation of fake drugs; by conducting an enlightenment campaign on the consequences of taking fake drugs; by strengthening NAFDAC, the regulating and monitoring body in terms of adequate funding and personnel to enable it to fight the menace, and by ensuring that the training of aspiring pharmacists at the universities is rigorous enough.’’
A Public Health Worker, Celestine Anetekhai said, “I’m unsure of the prevalence of fake drugs in circulation. I have not been a victim of fake drugs either. However, I will categorically state that fake drugs pose a significant threat to health as they lead to the malfunctioning of major organs and cells of the body, tampering with overall health. The menace can be tackled through proper legislation for drug usage; regulation of pharmaceutical companies; and effective quality control measures.
An intern pharmacist, Eguasa Nosakhare added, ‘’Some of the dangers of fake drugs to human health include; lack of therapeutic effects; drugs may contain no Active Pharmaceutical Ingredient (API) or even the wrong API. It creates antibiotic resistance in the case of antibiotics. False sense of security; making the patient believe he’s on the right drug. This may lead to a loss of confidence in the product, prescriber and even the facility.
‘’It may worsen chronic disease. If a person who needs treatment is being placed on the drug, this leads to poor disease control and even causes life-threatening conditions like stroke. It may lead to death as some of the medications may contain harmful and unpalatable substances or chemicals. And also death from the disease since it’s poorly controlled.
‘’The menace can be controlled through the following; Consolidation of the necessary regulatory body like NAFDAC. Through the inspection of drug factories, and enforcement of strict penalties. Also, through public awareness and education, enlightening them on the danger of fake products. Reinforcement of drug supply chain to the hospital or private outlet.
‘’Improve quality control and regular inspection. Proper quality control text should be done on products from companies, and good manufacturing practices should be encouraged. Drug verification technology should be employed like scratch cards, and SMS. Training competent pharmacists and skilled workers.
‘’Encouraging local production; we should encourage the production of drugs locally by giving licence for the set-up pharmaceutical company, legally and in the right procedure. Lastly, putting strict penalties for defaulters and culprits’’ he said.
Another Victim, Mrs Adanna Uche, a 42-year-old mother of three, recounted how she was sold counterfeit antibiotics for a chest infection, a mistake that worsened her condition and nearly claimed her life.
“I bought what I thought was a reputable brand from a roadside pharmacy. Within days, my symptoms worsened. It was only after a proper hospital test that I was told the drugs were fake,” she lamented.
Similarly, Miss Deborah Joseph shared her ordeal after unknowingly purchasing counterfeit antibiotics and malaria medication for herself and her niece. The two began reacting to the medication shortly after use and only realized they had been victims of fake drugs upon returning to the hospital.
“After my niece took the malaria medicine, she began throwing up and developed itching symptoms she didn’t have before. I started experiencing a burning sensation in my chest and stomach. When I returned the drugs to the pharmacy, they apologized, replaced them, and blamed the issue on the manufacturer,” she explained.
Pharm Mrs. Iyamu emphasized that the pharmaceutical community is not only concerned but deeply alarmed by the growing prevalence of counterfeit medications. She warned that fake drugs are contributing to treatment failures, drug resistance, and preventable deaths.
“Counterfeit drugs often lack the correct active ingredients, or any at all. This delays proper treatment, complicates diagnosis, and leads to poor health outcomes. In some cases, these drugs contain toxic substances that can be fatal,” she said.
She also highlighted that antibiotics and antimalarial are among the most frequently counterfeited medications. “When patients use fake versions of these drugs, it fuels antimicrobial resistance, which is a serious global health threat,” she added.
Mrs. Iyamu called on all stakeholders to collaborate in addressing the menace of fake drugs, stressing the need for stricter regulation, improved border control, increased public education, and the adoption of technologies such as digital authentication codes on drug packaging.
In an exclusive interview with The Pointer, a health practitioner Dr. Micheal Ezeanochie raised serious concerns over the growing prevalence of counterfeit and substandard drugs in the country, warning that the issue poses a significant public health risk and continues to compromise medical treatment outcomes across various sectors of the healthcare system.
He defined fake drugs within the Nigerian context as medications that have been counterfeited, mislabeled, fraudulently extended beyond their expiry date, or manufactured with substandard dosages.
“Fake drugs include those that are meant to contain 500mg of an active ingredient but have only 15mg,” he explained. “The intent behind such drugs is clearly to deceive and defraud the healthcare consumer.”
According to him, the problem is far-reaching, particularly in low-income or limited-resource settings. “We estimate that at least 10 per cent of drugs in countries like Nigeria are fake. Some surveys even suggest that up to 50–70 percent of medications in circulation could be counterfeit, depending on the source,” he said, adding that the issue remains a pressing public health challenge.
To combat the menace, he advised consumers to buy medications only from reputable sources. “Avoid purchasing drugs from unlicensed street vendors or patent medicine dealers. Medicines that require prescriptions are less likely to be counterfeit when bought from registered pharmacies,” he said.
He also urged consumers to examine drug packaging closely. “Fake drug manufacturers often cannot replicate the quality of original packaging. Check for suspicious seals, and do not buy medications sold loosely or counted out without sealed packaging. These are more likely to be counterfeit.”
Further, he recommended buying products from well-known manufacturers, both local and international, and avoiding unfamiliar or unregistered brands. He also emphasized the importance of using available authentication tools.
“Some drugs come with scratch-off panels and SMS codes that can be used to verify their authenticity. Others have QR codes that link to the manufacturer’s website, where you can cross-check the batch number and manufacturing details,” he said.
“You could be managing a woman in labour, and when there’s no progress, you might think she needs a cesarean section. But in some cases, it’s simply because the drug wasn’t working. Switching to a different batch or manufacturer can lead to an immediate response, allowing for a normal delivery,” he said.
Dr Ezeanochie shared a real-life implications of fake drugs in clinical practice, particularly in maternal care. He recalled cases where women in labour were given medication to stimulate uterine contractions, but the drug failed to work, later revealed to be due to substandard or fake batches.
He also highlighted similar challenges in treating infections. “When you prescribe antibiotics and the drug is substandard, the infection doesn’t respond. This can lead to prolonged illness, complications, or even death in some cases.”
Dr. Ezeanochie stressed the urgent need for stronger regulation, public awareness, and technological innovations to curb the spread of fake drugs.
