Guinea’s military authorities are trying to end the illicit trade in prescription medicines. The country is a hotspot for pharmaceutical trafficking in West Africa, with around 70% of medicine sold in Guinea being reportedly illicit.

Conakry’s Madina market is considered the epicentre of the trade and is an important storage and redistribution centre for the region. While some of the contraband is sold in the country, much of it is transported to Senegal, Mali, Mauritania, Guinea-Bissau and Côte d’Ivoire.

There have been several efforts to combat the illegal dealings over the years. In 2009, the National Council for Democracy and Development under Moussa Dadis Camara launched a campaign against factories developing pharmaceutical products in and around the capital. While large quantities were seized, the black market quickly reappeared a few months later.

In 2015, under former president Alpha Condé, several more measures were taken. After adopting the MEDICRIME Convention in 2015, Guinea’s government established a MEDICRIME brigade in 2019. Following pressure from pharmacists and pharmacies in the country, the number of private wholesale importers was drastically reduced from 104 to 58 in 2019 and again from 58 to 10 in 2021.

Despite this dramatic decrease in importers, the trafficking of illicit medicines through the port of Conakry continued. Customs officials told the ENACT project that the modus operandi of criminal groups included making false declarations at the dock or concealing the drugs in other merchandise, such as packages of cookies. According to a Madina market wholesaler, some authorised private importers also shipped in medicines on behalf of illicit wholesalers.

Since seizing power in a coup in September 2021, the National Committee of Reconciliation and Development (CNRD) under Mamady Doumbouya has made several attempts to curb the trafficking and sale of illicit medicines. Describing the trade as a ‘real public health problem in Guinea,’ authorities 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, had warned that anyone involved in the trade after the closure would be prosecuted. Touré issued arrest warrants against 18 people after over 200 containers of illicit drugs were seized at Conakry’s port in July 2022.

The gendarmerie conducts daily patrols to ensure that shops specialising in the sale of illegal medicines remain closed. Consequently, the trade is no longer visible in neighbourhoods where illicit pharmacies were common, according to MEDICRIME brigade officials and civil society organisations.

According to Dr Manizé Kolié, Secretary-General of the union for pharmacists and private pharmacies in Guinea, all officials and community leaders must report violations or face jail time. This includes governors, mayors, neighbourhood heads, imams and market organisers. This intense crackdown explains the government’s relative success. Another reason is that the junta isn’t worried about alienating voters like a civilian government would be. This enables them to enforce unpopular rules.

Despite the measures taken by authorities though, the problem persists. A Conakry resident told ENACT that she recently obtained illicit medicines from the same market she had bought them from before the ban. She said black market medication was cheaper, and locals believed some of the most effective medicines could be found only through these outlets.

Not everyone in Guinea wants the illicit market closed. An investigative journalist told ENACT that Condé avoided a strict crackdown because he feared angering his community in Kankan. Residents here are known to consume vast quantities of illicit medicines. Miners in particular, use a lot of tramadol as it reduces appetite, reportedly makes them feel stronger and allows them to work longer hours without tiring. They also use other opioids.

Is the junta’s success in curtailing the illicit medicine trade sustainable, including after the return to civilian government, currently set for January 2025? The trafficking, illegal manufacture and sale of pharmaceuticals is deeply rooted in Guinea and has become a lucrative business, with many families dependent on it for survival.

Crackdowns should be only one component of a multi-faceted response. Given the scale of the criminal economy, the likelihood that the trade has gone underground, and people’s dependence on it for their income, various approaches are needed.

Health authorities told ENACT they had taken the lead in supplying medicine to all pharmacies and health facilities, but there were still gaps in provision. 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.

Authorities should ensure a continuous supply of legal medicines countrywide. Pricing of products 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.

The government’s focus on strengthening cooperation and border control with neighbouring countries that were destinations for illicit medicines should be an ongoing priority to prevent and detect emerging hotspots.­

Written by Mouhamadou Kane, Analyst, Global Initiative Against Transnational Organized Crime, ENACT project