Counterfeit Pharmaceuticals: A Global Problem
AEI Newsletter

Dora Akunyili
Dora Akunyili

In 2001, when Dora Akunyili was appointed director general of the Nigerian National Agency for Food and Drug Administration and Control (NAFDAC), over half of all drugs in the Nigerian market were counterfeit. Under Akunyili's leadership, NAFDAC reduced that number to under 20 percent in 2006. AEI and the Heritage Foundation recently hosted Akunyili to discuss the problems counterfeit drugs pose to the international community and the strategies that have made NAFDAC's efforts successful thus far.

Counterfeit drugs--those with none of the active ingredient, that have expired and been relabeled, or that have a different active ingredient than what is stated on the label--pose grave risks not only to the health of those who take them but also to public health. Substandard drugs--those not willfully mislabeled but containing an insufficient amount of the active ingredient--are, according to Akunyili, even more dangerous since they rarely cure the patient but build resistance across populations, fostering strains of diseases that require increasingly powerful and costly drugs to treat them.

Counterfeiters and distributors in Nigeria are attracted to the counterfeit drug trade because it is lucrative and relatively low-risk, Akunyili said. Those who are caught usually get a slap on the wrist and immediately return to their illegal activities. To combat these criminals, NAFDAC has cracked down on dealers and hawkers, closed drug outlets where fake drugs are sold, and confiscated drugs from sellers who refused to report the origin of their goods. "We also have a strategy of mopping up what is already in circulation--true, sustained, systematic surveillance and testing and retesting what we had already registered," she said.

At AEI, Akunyili discussed several other strategies that she implemented that have seen positive results, including staff training and retraining, regulatory restructuring, and an extensive "public enlightenment" campaign. "We realized that the first step in solving a problem," she said, "is to sit down and accept that there is a problem; to tell people that there is a problem so that people will stop being deceived; to sensitize people to be vigilant about what they buy, what they use, and what they eat." She has also beefed up surveillance at seaports and airports, monitored drug manufacturers in Nigeria, and streamlined registration of legitimate drugs. China and India are the main sources of the fakes found in Nigeria, and NAFDAC has independent analysts monitoring these countries in an effort to reduce the number of counterfeit drugs they export to the Nigerian market.

The problem of counterfeit drugs is global, Akunyili said. Other countries are complicit in shipping counterfeit and substandard drugs to developing countries, and these drugs are even reaching markets in developed countries. While Nigeria is doing its part to eradicate fake drugs, it cannot manage the situation alone. Akunyili called for international collaboration: "The negative impact of counterfeit drugs knows no boundaries. Resistant strains of microorganisms do not need a visa to travel."

The event was moderated by AEI's Roger Bate, who has done extensive field research on counterfeit drugs in the developing world. Bate is the author of Making a Killing: The Deadly Implications of the Counterfeit Drug Trade (AEI Press, May 2008), which explores how the worldwide market for fake drugs works--and how to arrest the trade.

Making a Killing is full of vivid and disturbing anecdotes, such as the Russian pharmaceutical oligarch who made millions distributing fake drugs through legitimate supply chains and the vendors openly selling unlicensed drugs to unwitting consumers in a Senegalese street market. Bate goes beyond mere anecdotes, however; Making a Killing assembles all the known official estimates of this shadowy practice.

How can counterfeiters be stopped? By improving health infrastructures and improving access to essential medicines, developing countries can reduce the incentives for patients to buy the cheaper fakes. Developed countries can step up inspection of supply chains and devote more resources to investigations. Bate also describes multilateral efforts to coordinate individual countries' actions. Furthermore, he writes, "the private sector has powerful incentives to stem the deluge of fakes," and pharmaceutical companies and pharmacists are developing verification technology to protect the supply chain.

To further stem the flow of counterfeits, Bate recommends "embrac[ing] free trade with patent protection," making the supply chain transparent, increasing postproduction drug surveillance, and educating consumers about avoiding fakes.

For video and audio of this event and an interview with Akunyili, visit For more information about Making a Killing, visit

Also Visit
AEIdeas Blog The American Magazine

What's new on AEI

AEI Election Watch 2014: What will happen and why it matters
image A nation divided by marriage
image Teaching reform
image Socialist party pushing $20 minimum wage defends $13-an-hour job listing
AEI on Facebook
Events Calendar
  • 27
  • 28
  • 29
  • 30
  • 31
Monday, October 27, 2014 | 10:00 a.m. – 11:30 a.m.
State income taxes and the Supreme Court: Maryland Comptroller v. Wynne

Please join AEI for a panel discussion exploring these and other questions about this crucial case.

Tuesday, October 28, 2014 | 9:30 a.m. – 12:15 p.m.
For richer, for poorer: How family structures economic success in America

Join Lerman, Wilcox, and a group of distinguished scholars and commentators for the release of Lerman and Wilcox’s report, which examines the relationships among and policy implications of marriage, family structure, and economic success in America.

Tuesday, October 28, 2014 | 5:30 p.m. – 7:00 p.m.
The 7 deadly virtues: 18 conservative writers on why the virtuous life is funny as hell

Please join AEI for a book forum moderated by Last and featuring five of these leading conservative voices. By the time the forum is over, attendees may be on their way to discovering an entirely different — and better — moral universe.

Thursday, October 30, 2014 | 2:00 p.m. – 3:00 p.m.
A nuclear deal with Iran? Weighing the possibilities

Join us, as experts discuss their predictions for whether the United States will strike a nuclear deal with Iran ahead of the November 24 deadline, and the repercussions of the possible outcomes.

Thursday, October 30, 2014 | 5:00 p.m. – 6:15 p.m.
The forgotten depression — 1921: The crash that cured itself

Please join Author James Grant and AEI senior economists for a discussion about Grant's book, "The Forgotten Depression: 1921: The Crash That Cured Itself" (Simon & Schuster, 2014).

No events scheduled this day.
No events scheduled this day.
No events scheduled this day.
No events scheduled today.
No events scheduled this day.