Guinea’s new military authorities are trying to put an end to the illicit trade in prescription medicines (illicit medicines). The country is a hotspot for pharmaceutical trafficking in West Africa, with around 70% of medicine sold in Guinea reportedly illicit.
Conakry’s Madina market is considered the epicentre of the illicit medicines trade in Guinea and is an important storage and redistribution centre for West Africa. While some of the illicit medicines are sold within the country, many are transported to other countries in the sub-region, such as Senegal, Mali, Mauritania, Guinea-Bissau and Côte d’Ivoire.
There have been several efforts to combat this trade over the years. In 2009, for example, the National Council for Democracy and Development under Moussa Dadis Camara launched a campaign against ‘clandestine factories manufacturing pharmaceutical products in and around the capital’. While large quantities of illicit medicines were seized, a few months later the black market in illicit medicines quickly reappeared.
In 2015, under former president Alpha Condé, several more measures were taken to address the problem. After adopting the MEDICRIME Convention in 2015, Guinea’s authorities established a MEDICRIME brigade in 2019. Following pressure from pharmacists and private pharmacies in Guinea, the government drastically reduced the number of private, wholesale importers from 104 to 58 in 2019 and then again from 58 to 10 in 2021.
Despite this dramatic decrease in the number of importers, the trafficking of illicit medicines through the port of Conakry continued. Customs officials told ENACT that the modus operandi of criminal groups included making false declarations at the port or concealing the drugs in other merchandise, such as packages of cookies. ENACT was told by a wholesaler at the Madina market that some authorised private importers also imported medicines on behalf of illicit wholesalers operating at the market. Once the illicit medicine arrived in Conakry, the wholesalers organised their distribution.
Since coming to power in September 2021, the National Committee of Reconciliation and Development (CNRD) under Mamady Doumbouya has taken several measures to curb the trafficking and sale of illicit medicines. They describe the trade as a ‘real public health problem in Guinea.’
The CNRD issued a communiqué ordering the closure of all stores and unauthorised points of sale for illicit medicine by 15 September 2022. On 14 September, Aly Touré, Special Prosecutor of the Court of Repression of Economic and Financial Offences, warned that anyone found to be involved in the trade after the closure would be arrested and prosecuted. Touré had previously issued arrest warrants against 18 people involved in the trade, following the seizure of over 200 containers of illicit drugs at Conakry’s port in July 2022.
The gendarmerie also conducts daily patrols to ensure that stores specialising in the sale of illicit medicines remain closed. Consequently, the illicit trade in medicines is no longer visible in the neighbourhoods where illegal pharmacies used to abound, according to MEDICRIME brigade officials and civil society organisations.
Despite this, some sources say the problem is not over. A Conakry resident told ENACT that she recently obtained illicit medicines from the same market that she had bought them from before the ban. She added that medicines sold on the black market are much cheaper, and locals believe that some of most effective medicines can only be found on the black market.
According to Dr Manizé Kolié, secretary-general of the union for pharmacists and private pharmacies in Guinea, all officials and community leaders must report any violation of these regulations or face jail time. This includes governors, mayors, neighbourhood heads, imams and market organisers. This intense crackdown explains the relative success of the CNRD’s actions.
Another reason for their success is that while civilian governments are often reluctant to take unpopular measures for fear of alienating voters, the ruling CNRD doesn’t rely on public support. This has enabled them to enforce unpopular rules.
In Guinea, not all community members want the illicit medicine market closed. According to an investigative journalist interviewed by ENACT, Condé avoided imposing a strict crackdown on the trade because he was afraid of angering his community in Kankan. Residents here are known to consume vast quantities of illicit medicines. Specifically, miners use a lot of tramadol as it reduces appetite, reportedly makes them feel stronger and allows them to work longer hours without feeling tired. They also use other opioids.
However, there is no indication that the junta’s success in curtailing illicit medicine trafficking will be sustainable in the future – including after the scheduled return to civilian government, currently set for January 2025. This is because the trafficking and illicit manufacture and trade of pharmaceuticals is deeply rooted in Guinea and has become a lucrative business, with many families dependent on it for their survival.
But crackdowns should be only one component of a multi-faceted response to the illicit medicine trade. Due to the scale of the criminal economy, the high dependence of many people on it and the likelihood that the trade has gone further underground, more steps are needed.
Guinean health authorities told ENACT that they had taken the lead in supplying medicine to all pharmacies and health facilities, but there are still shortcomings. According to a civil society organisation that requested anonymity, state provision of medicine is ineffective in many areas, including Siguiri, Kankan and in Guinea’s forests. The government’s capacity to provide medicine to all cities, towns and villages is limited.
Ideally authorities should ensure a continuous supply of legal medicines countrywide, while increasing the number of pharmacies and public health facilities. The pricing of legal medicines also requires urgent solutions as affordability is a key factor driving the illicit market. So, too, is finding alternative income-generating options for black market traders – an important longer-term initiative.
Guinea’s government’s focus on strengthening cooperation and border control with neighbouring countries that were previously destinations for illicit medicines needs to be an ongoing priority to prevent and detect emerging hotspots.
Mouhamadou Kane, Analyst, GI-TOC
