The alarming proliferation of fake, expired, and substandard drugs across Nigeria has once again drawn public attention following disturbing findings and continued crackdowns by regulatory authorities. In this investigative report, SUNDAY STANDARD correspondent KENNETH DARENG explores the scale of the problem, the challenges faced by the National Agency for Food and Drug Administration and Control (NAFDAC) and the disturbing levels of public indifference
A health system under siege
A recent report by the Initiative For Public Policy Analysis (IPPA) disclosed that 70 percent of medicines in Nigeria were either fake or substandard. Similarly, the National Agency for Food and Drug Administration and Control (NAFDAC) estimates that 41 percent of drug consumption stems from counterfeit sources. These figures underscore a deep-rooted crisis that has plagued Nigeria’s healthcare system, fuelled by endemic corruption and weak regulatory enforcement.
The most commonly affected drugs include multivitamins, anti-malarials and nutritional supplements. These are medicines frequently relied upon for the treatment of mild illnesses and widely used by the general population.
Over the past decade, successive leaderships of NAFDAC have battled the menace. Notably, under the leadership of late Prof. Dora Akunyili, Prof. Paul Orhi, and now Prof. Mojisola Adeyeye (currently in her second term as Director-General), efforts have been intensified to combat this public health threat.
Regulatory efforts under pressure
Prof. Adeyeye’s tenure has seen a deliberate push to restructure NAFDAC into a customer-focused, agency-minded institution. Her administration also strengthened governance and regulatory systems, enabling Nigerian pharmaceutical firms to meet international standards and best practices with emphasis on local manufacturing.
These reforms led to NAFDAC securing ISO 9001:2015 recertification by the World Health Organization (WHO) in 2022. Nonetheless, the challenge of fake drugs remains daunting.
Despite innovations like scratch codes for verifying medicine authenticity and feedback mechanisms for consumer safety, counterfeit medicines still saturate pharmacies and market shelves across the country. Sophisticated criminal cartels continue to outwit regulators by using advanced labelling machines to alter expiry dates on expired drugs.
Cartels thriving amidst weak enforcement
NAFDAC’s statutory mandate includes regulating the importation, exportation, and manufacture of medicines based on globally accepted safety standards. The agency has recorded major breakthroughs in cracking down on counterfeit drug networks and has continued to advocate for severe penalties, including life imprisonment and even the death sentence for offenders.
A notable example was in March this year, when NAFDAC, following a six-week raid in Lagos and two other southern states, seized and destroyed counterfeit drugs valued at ₦100 billion. Prof. Adeyeye described the haul as a major threat to national security, warning, “What we have found could ruin a nation and could destabilise a government.”
Still, counterfeit drugs remain a booming underground industry. This is largely driven by greed, lax medicine legislation, a parallel unregulated import chain and a glaring lack of political will to combat corruption in the health sector. Nigeria’s porous borders have also become free-trade routes for smuggled, fake drugs sold openly in major markets without scrutiny.
Markets in Kasuwan Kwari in Kano, Lagos, Onitsha, Port Harcourt and other urban centres openly trade medicines like codeine, penicillin, ampicillin, tetracycline and various cough syrups as if they were everyday household items — often sold by untrained individuals.
Indifference among consumers and gaps in awareness
Although NAFDAC is credited with several significant milestones in its anti-counterfeit campaign, the problem persists in many parts of the country, including Jos, the Plateau State capital. SUNDAY STANDARD visited five pharmacies within Jos metropolis and three others outside the city centre to assess public awareness. Shockingly, it was found that 90 percent of customers did not bother to check expiry dates when purchasing medications.
When asked why, a customer, Nicholas Chime, responded, “Honestly, I have never given this a thought because the drugs I always buy here for my ulcers have been quite effective.”
Another customer, Gloria Mang, shared similar sentiments: “This is a society where everything about us is fake — from the water we drink to food and medicines. But it is God that is saving us, not man. If you go on checking everything, you’ll be scared to death. The system allows people to buy drugs without prescriptions, so what else do you expect a poor person to do in times like this.”
Caroline Mark, a concerned citizen, challenged the public’s passive approach to the problem. “Most people in this country have a bad reading culture, just like the popular saying that goes, ‘if you want to hide anything from a Nigerian, put it in writing.’ Which to me should not be an excuse for one not to be cautious or mindful of what medicine or food product one is buying these days, especially in a situation where there are adulterated products everywhere,” she said.
The IPPA report also cited several reasons why Nigerians remain exposed to fake and substandard drugs. Among these are the high cost of genuine medications, low awareness, and the government’s failure to strictly regulate pharmacy operations. “Respondents frequently cited the high cost of medicine as explanation for the proliferation of poor quality drugs, and where people cannot afford the best medicines, they buy what they can, regardless of quality,” the report stated.
A Jos-based pharmacist, who spoke on the condition of anonymity, observed that many pharmacy operators are well aware of the dangers but are constrained by economic pressures. “Most pharmacies you see around are aware of the problem. In situations where some of them are 100 percent dependent on daily proceeds for food, clothing, school fees, rent, and transport, they might start cutting corners just to survive. It’s unfortunate,” he admitted.
Regulatory gaps and fear of enforcement
Despite the clear dangers posed by counterfeit drugs, relevant agencies at both federal and state levels have largely abdicated their enforcement roles to NAFDAC alone. Other regulatory and law enforcement bodies appear reluctant to act, allegedly due to fear of reprisals from powerful drug counterfeiting cartels who have been known to threaten or even harm officials who stand in their way.
IPPA’s report further highlights that Nigeria lacks trained healthcare personnel who can easily identify counterfeit or substandard drugs. This problem is more severe in rural areas where communities rely on unregulated health centres and local vendors.
A retired civil servant, Nathaniel Gonyok, lamented the plight of rural dwellers. “If you talk about fake drugs in urban centres, what about those in the rural communities who rely solely on community healthcare centres? They are even more exposed to quacks and counterfeit medicines,” he said.
He shared a troubling encounter from a recent visit to a village during a friend’s wedding. “It was market day, and I saw a man selling second-hand clothes alongside all kinds of medicines. Elderly villagers were queuing up to buy from him. When I asked one woman what she had bought, she said, ‘Ahh, that man named Ino [short for Innocent], has been helping me each time I have body pain. You can see the medicine I bought.’ This shows just how ignorant many people are about the sources and dangers of such drugs,” Gonyok added.
Medical consequences, professional concerns
Dr Sam Daboh, a Jos-based medical practitioner, warned of the long-term dangers of using counterfeit medications. “The flow of counterfeit and substandard medicines now in circulation is putting the public at risk of developing organ-related complications, especially to the heart and kidneys. These complications can lead to death, particularly for those who patronise unregistered medical outlets,” he said.
Another pharmacist, Ayuba Sani, acknowledged that economic hardship can tempt some pharmacies to cut ethical corners. “Although times are hard and many people now opt for cheaper alternatives, a reputable pharmacist must never risk his or her professional integrity. Selling counterfeit or expired drugs goes against everything we stand for,” he said.
Pharmacist Lohdip Domjul, Chairman of the Plateau State branch of the Pharmaceutical Society of Nigeria (PSN), blamed the persistence of fake drugs on the lack of coordination between key agencies. “These challenges are rooted in issues like the porous nature of our borders, which allow smuggled drugs to flood the country without proper checks. There’s also inadequate regulation, control, and enforcement,” he explained.
Domjul noted that the PSN in Plateau State regularly embarks on public enlightenment to help citizens identify and report counterfeit drugs. “We conduct periodic checks on our members to ensure compliance. But to truly curb this menace, the government must empower the PSN’s Disciplinary Committee to shut down illegal drug outlets. NAFDAC, NDLEA, and PSN must work together more closely to rid the society of fake medicines and consumables,” he emphasised.
A call for collective action, accountability
For Nigeria to make meaningful progress in the fight against fake drugs, there must be a deliberate and united effort across all tiers of government. Stakeholders say such a move must be supported by strong regulation, empowered enforcement, and the political will to apply the death penalty against major offenders, as recommended by NAFDAC.
Ultimately, the burden also falls on the public to take greater responsibility for their own health by being vigilant, informed, and proactive in questioning the source and quality of their medications. The failure to do so, as experts warn, may continue to cost innocent lives at the hands of unscrupulous individuals posing as medicine practitioners.