"To sell fake medicines, you need a clientele. The ailing poor are more numerous in Africa than anywhere in the world," said Marc Gentilini, an expert on infectious and tropical diseases and a former head of the French Red Cross. The WHO estimates that one out of 10 medicines in the world is fake but the figure can be as high as seven out of 10 in certain countries, especially in Africa.
The illicit sector has a turnover of at least 10 percent of the world pharmaceutical business, meaning that it earns tens of billions of dollars a year, the Switzerland-based World Economic Forum estimates, adding that the figure has nearly tripled in five years.
he American Society of Tropical Medicine and Hygiene estimated in 2015 that 122,000 children under five died due to taking poor-quality antimalarials in sub-Saharan Africa, which, along with antibiotics as the two most in-demand, are the medicines most likely to be out-of-date or bad copies.
Interpol in August announced the seizure of 420 tonnes of counterfeit medicine in West Africa in a massive operation that involved about 1,000 police, customs and health officials in seven countries: Benin, Burkina Faso, Ivory Coast, Mali, Niger, Nigeria and Togo. Ivorian authorities in May burnt 40 tonnes of fake medicines in Adjame, the biggest street market of fake medicines in West Africa which accounts for 30 percent of medicine sales in Ivory Coast.
Offenders remain largely unpunished worldwide and are mainly targeted for breaching intellectual property rights instead of being responsible for the deaths of hundreds of thousands of people, the Paris-based International Institute of Research Against Counterfeit Medicine says.
In countries where medical expenses -- from drugs to hospitalisation -- are not even partly reimbursed by the state, the relatively cheap price of street medication trumps the risk factor for many.