Counterfeit drugs in Africa have global health risk.

WHO estimated as far back as 1991 that half of the world’s population at that stage did not have regular access to essential drugs, with this number reducing to 33% in sub-Saharan Africa.14 Although counterfeit drugs are an important issue in Africa, there are also a number of other constraints to the regular supply of essential drugs, including geographic location, logistics, ensuring the integrity of the supply chain, and financing the supply of essential drugs. It must also be noted that some of these constraints also play a role in compounding or impacting the issue of counterfeit drugs in Africa.14 There are a number of factors which make medicines a viable and attractive option for counterfeiters, particularly in the developing world. These factors and their importance in developing countries as well as the risk rated as mild, moderate, or high, are listed in Table 1. Drug products lacking in quality, safety, and efficacy, and that are not under regulatory control, may result in prolonged therapy, promote resistance, and cause adverse effects, which are then not reported on or monitored. This has potential to significantly impact on global public health.