The scourge of substandard and falsified medical products threatens to destroy confidence in Africa’s healthcare systems, in addition to threatening the lives of millions of its people, writes Wilson Chandomba
Across our beloved continent there is a silent threat that continues to undermine public health, destroy trust in medicines and steal lives—often quietly, and far from the spotlight. This is the growing presence of substandard and falsified medical products. These are not just poor-quality items; they are a serious danger to patients, a destabiliser of our health systems and, in many cases, a direct threat to national security.
In recent years, I have been privileged to work in various corners of Africa—speaking to warehouse workers, regulators, nurses, customs officers, importers and even market traders. Everywhere the concern is the same: how do we ensure that medicines reaching our people are safe, effective and trustworthy?
The African Union’s Continental Plan on Substandard and Falsified Medical Products offers hope. It is a comprehensive response grounded in four strategic pillars: prevention, detection, response and cross-cutting enablers. The plan speaks to our shared responsibility and collective commitment as a continent. It positions this issue where it rightly belongs—not only as a regulatory matter, but as a public health emergency, a criminal justice issue and a test of our collective values.
The plan also recognises that implementation must be practical and inclusive. It urges every country to strengthen regulatory systems, harmonise laws and build stronger links between health, customs, law enforcement, and judicial systems. However, to translate these strategies into meaningful action on the ground, two things stand out as critical: Good Storage and Distribution Practices (GSDP) and multi-stakeholder collaboration.
GSDP: a simple solution that saves lives
At its core, GSDP is not about expensive systems or futuristic technologies. It is about discipline, awareness, and care. It ensures that medicines are stored correctly, transported safely, handled only by authorised and trained individuals, and tracked from entry point to point of use.
GSDP is practical. It works whether in a modern warehouse with power backup or in a rural outpost with minimal infrastructure. When implemented consistently, it prevents product degradation, protects against diversion and ensures traceability. Importantly, it builds trust.
I have witnessed first-hand how frontline actors—often with very little support—are able to maintain product quality under the most difficult conditions simply by applying the principles of GSDP. I have also seen the devastating effects of failing to do so: medicines exposed to extreme temperatures, unknown suppliers entering the market with no oversight, and patients unknowingly receiving compromised products.
What makes GSDP truly powerful is that it is within reach. It does not require waiting for large budgets or advanced technologies. It requires commitment, policy enforcement and capacity building. It is one of Africa’s most accessible tools for protecting medicine quality—now, not someday.
Multi-Stakeholder Collaboration: from silos to shared responsibility
Addressing substandard and falsified medical products cannot be the responsibility of regulators alone. The supply chain involves many actors, each with a role to play—from customs agents and police officers to community leaders, pharmacists and warehouse staff—and behind each role is a person who cares deeply about their community.
Across Africa, I have seen impressive examples of collaboration. In one setting, police and regulators carried out joint inspections of informal outlets, supported by civil society. In another, traditional and religious leaders publicly spoke against unsafe medicines, reinforcing the moral obligation to protect life. In yet another, a customs officer flagged an unregistered consignment, preventing its entry into the local market.
These examples are not isolated acts of heroism. Rather, they are a sign that when people are empowered, trained and valued, then they act.
We must move from operating in silos to working in unison. Multi-agency taskforces must be revitalised—not just in national capitals, but across districts and at every major point of entry. These platforms should not only include government actors, but also youth organisations, patient groups, religious leaders, women’s cooperatives, traditional healers and local media. Each group brings a voice, a network, and a perspective that enriches the national response.
Tailoring the Approach: one continent, many realities
As we act, we must remember that Africa is beautifully diverse. Our communities speak many languages, follow different faiths and trust different information channels. What works in one region may not work in another—and that is perfectly fine. Our strength lies in our ability to adapt.
In areas where religious teachings guide behaviour, faith leaders can be instrumental in spreading messages about medicine safety and ethical health practices. In border communities where trade routes are informal, transporters must be educated and brought into the system—not simply punished. In fragile settings or conflict zones, humanitarian actors must be supported to uphold GSDP under pressure.
There is no one-size-fits-all approach. But there is a one-continent commitment: that every African, regardless of where they live, should have access to medicines they can trust.
What we can do right now
As a continent, we are not starting from scratch. The knowledge is there. The frameworks are ready. What we now need are focused, realistic and achievable actions that bring about quick wins and build long-term momentum.
We can begin by ensuring that GSDP is not a suggestion, but a legal requirement for anyone storing, transporting or distributing health products. Enforcement should be consistent, not punitive. Licensing, training and inspection must become routine—not reserved for emergencies.
We must also invest in building the capacity of frontline actors—customs officers, nurses, pharmacists, drivers and warehouse staff. These individuals are often the first and last line of defence in keeping dangerous products out of circulation.
We must engage our communities and empower citizens to report suspicious products. Hotlines, mobile platforms and anonymous reporting tools must be user-friendly, trusted and well-publicised.
We must establish or revitalise national taskforces on SFMPs, with clear mandates and inter-ministerial support. These taskforces should meet regularly, share data, respond rapidly to alerts and be held accountable for results.
Finally, we must tell our success stories—amplifying local champions, celebrating positive examples and encouraging replication across countries and regions. Stories inspire action far more effectively than statistics alone.
A Continental Response Rooted in Unity
The African Medicines Agency has a critical role to play in providing technical guidance, setting regional benchmarks and facilitating collaboration among Member States… but it cannot act alone. Regional Economic Communities must support harmonisation of laws, cross-border surveillance and joint capacity-building efforts. Countries must allocate resources, prioritise medicine safety in national health agendas and commit to regular reporting and review.
We must also not forget the power of solidarity. A medicine seized at one border may protect lives in three other countries. A public awareness campaign in one language can be translated and shared regionally. A best practice in one context may offer lessons for another. This is the very spirit of the AU Plan—it is not about uniformity, but about unity. It is not about blaming or shaming, but about protecting and strengthening. It is not about ticking boxes, but about saving lives.
Final Reflection: we must act together—and we must act now
The presence of dangerous medicines on our markets, in our health facilities and within our borders is not just unacceptable—it is preventable. We have the tools. We have the frameworks. We even have the examples of success. What we need now is action—deliberate, inclusive and sustained.
Let this be the moment we moved from plans to practice. Let this be the generation that said, with conviction, “No more fake medicines in African supply chains!” Let us protect every product, empower every actor and reach every patient with safety, dignity and care.
Africa deserves quality. Our people deserve trust. And our health systems deserve the chance to deliver both—consistently, confidently and continent-wide.
Wilson Chandomba is an Expert Member of the Africa Continental Technical Working Group on Substandard and Falsified Medical Products & Chairperson of the Communications Sub-Group.
