From fake cancer drugs to malaria pills: Inside Nigeria’s counterfeit medicine crisis

Recent alerts over counterfeit cancer and antimalarial medicines have renewed concerns about Nigeria’s long-running fake drug crisis. Despite repeated regulatory crackdowns, falsified medicines continue to infiltrate the pharmaceutical supply chain, exposing millions of Nigerians to ineffective and potentially dangerous treatments.

For Oladele, a Nigerian living in the United Kingdom, the call from home carried devastating news. His younger brother had taken antimalarial medication for what was believed to be a routine bout of malaria. Instead of recovering, he developed kidney complications. The family later suspected the medicines were counterfeit.

Oladele’s experience is not an isolated one. Across Nigeria, reports of suspected counterfeit medicines continue to surface, even as regulators intensify efforts to remove falsified products from circulation.

His account, shared publicly on social media in May 2026, came amid a series of alerts from a government agency responsible for overseeing drug registration, importation, manufacture and quality control in the country, the National Agency for Food and Drug Administration and Control (NAFDAC), warning of counterfeit drugs circulating within the country’s pharmaceutical supply chain.

The alerts, coupled with repeated seizures of counterfeit medicines, suggest that despite sustained enforcement efforts, falsified products continue to find their way into the hands of patients.

The persistence of fake medicines is not a new problem in Nigeria. For decades, the country has battled counterfeit and substandard pharmaceuticals that undermine treatment, erode public confidence in the health system and, in some cases, contribute to preventable deaths. However, recent incidents suggest the problem is evolving, affecting both highly specialised medicines used in hospitals and everyday treatments relied upon by millions of Nigerians.

From cancer wards to malaria treatment

In March 2026, NAFDAC issued a public alert warning healthcare professionals, distributors and the public about confirmed counterfeit versions of Avastin (bevacizumab) and Tecentriq (Atezolizumab) circulating in Nigeria.

Manufactured by Roche, Avastin is a monoclonal antibody used to treat several cancers, including colorectal cancer, non-small cell lung cancer, cervical cancer, ovarian cancer and glioblastoma while Tecentriq is used in the management of the cancers of the lung and liver. Because of their specialised use, the medicine is typically administered in hospitals under the supervision of oncologists.

According to NAFDAC, the counterfeit products were identified following reports from Roche, which detected falsified versions of the medicine in Nigeria’s supply chain. The agency urged healthcare providers to carefully verify product authenticity and immediately report suspected counterfeit medicines.

A vial of Avastin and Tecentriq cost about ₦1.1 million and ₦9.7 million, respectively, according to information from a licensed online pharmacy, HubPharm Pharmaceutical Limited, operating in Nigeria.

Barely a month later, NAFDAC issued another public alert, this time warning about the circulation of counterfeit brands of Proguanil 100 mg tablets, specifically Projeanil and Re-granil. Proguanil is an antimalarial medicine commonly used to prevent and treat malaria.

The back-to-back alerts suggest that counterfeiters are targeting medicines across vastly different therapeutic areas from expensive oncology drugs used in specialist hospitals to affordable antimalarial medicines commonly used by the general public.

While counterfeit cancer medicines can deny patients life-saving treatment or allow disease to progress unchecked, fake antimalarial drugs may lead to treatment failure, severe illness and even death. They may also contribute to the growing challenge of antimalarial drug resistance.

Enforcement continues, but counterfeit medicines persist

In May, NAFDAC announced another major enforcement operation, destroying counterfeit, expired and unwholesome products worth more than ₦1.8 billion in Abuja.

The destroyed products included banned substances and improperly stored medical products considered unsafe for public use. According to the agency, the products had been seized during raids, surveillance activities and routine regulatory enforcement.

The operation showed the scale of efforts to remove dangerous medicines from circulation. Yet the repeated discoveries of counterfeit medicines also raise difficult questions about how such products continue to penetrate Nigeria’s pharmaceutical supply chain.

Each seizure represents medicines intercepted before reaching consumers. But the recent alerts involving Avastin and Proguanil suggest that some counterfeit products continue to evade detection until they have already entered the market.

When fake medicines reach patients

Unlike the counterfeit Avastin and Proguanil cases, which were identified through regulatory surveillance, Oladele’s account illustrates what can happen when suspected fake medicines are consumed before concerns are raised.

According to his social media post, his younger brother developed kidney complications after taking counterfeit antimalarial medication. Although the precise circumstances surrounding the medicine’s purchase and authenticity remain unclear, the incident resonated with many Nigerians who responded by sharing similar experiences of medicines that appeared ineffective or caused unexpected complications.

Whether through treatment failure, toxic ingredients or incorrect dosages, counterfeit medicines can have devastating consequences. Patients may unknowingly continue taking ineffective medicines while their illnesses worsen, losing valuable time before receiving appropriate treatment.

For malaria, delayed or ineffective treatment can rapidly become life-threatening, particularly among young children, pregnant women and other vulnerable groups. For cancers and other chronic illnesses, counterfeit medicines may undermine carefully planned treatment regimens, reducing the chances of successful outcomes.

Dr Dasola Amusat while recounting her experience said she had encountered patients whose clinical response raised suspicion that they had received counterfeit or substandard medicines. In one instance, she explained, a patient failed to respond to treatment despite receiving the same medication and dosage that had produced good outcomes in another patient with the same condition.

“We used the same drug and the same dosage for another patient with the same condition, and that patient responded well. That difference in response made us suspect that the medicine may not have been genuine,” she said.

According to her, counterfeit medicines can have serious consequences for patients beyond the immediate failure of treatment. She noted that ineffective medicines often prolong illness, resulting in longer hospital stays and increasing patients’ exposure to hospital-acquired infections and other complications.

The physician said it is not always difficult for experienced clinicians to suspect when counterfeit medicines may be involved. Over time, she explained, doctors become familiar with brands that consistently produce good clinical outcomes and often recommend those products when prescribing medications.

“It is not always difficult. Physicians become familiar with brands that consistently work, and we often insist on those brands because of our experience with their effectiveness,” she said.

To reduce the risk of purchasing counterfeit medicines, she advised patients to obtain exactly the brand prescribed by their healthcare provider rather than substituting it with another product without professional guidance.

“Patients should make every effort to buy the exact brand prescribed by their doctor instead of switching to another brand on their own,” she advised.

A long-standing problem with evolving risks

Nigeria has long battled counterfeit and substandard medicines but the problem has remained stubbornly persistent.

One reason is that counterfeiters have become increasingly sophisticated. Rather than producing crude imitations, many now replicate packaging, holograms, batch numbers and fake NAFDAC registration numbers that closely resemble genuine products, making falsified medicines difficult for consumers and sometimes even healthcare professionals to distinguish from authentic ones. 

In some cases, counterfeit medicines are designed to mimic legitimate products so closely that they are only identified after laboratory testing or verification by manufacturers.

The persistence of the problem is also driven by systemic weaknesses within Nigeria’s pharmaceutical supply chain. Counterfeiters continue to exploit gaps in importation, wholesale distribution, retail supply chains and regulatory oversight to introduce falsified medicines into the market. 

Previous reporting by HealthTabs found that policy inconsistencies, fragmented regulation, weak supply chain traceability and the country’s heavy reliance on imported medicines have also contributed to an environment that counterfeiters continue to exploit.

The recent cases involving counterfeit cancer medicines, falsified antimalarial drugs, large-scale regulatory seizures and suspected patient harm suggest that Nigeria’s counterfeit medicine crisis is no longer confined to one category of medicines or one segment of the healthcare system. 

Instead, it reflects vulnerabilities across the pharmaceutical supply chain, posing a persistent threat to the safety of millions of Nigerians who depend on medicines for effective treatment.

A community pharmacist, Pharm. Akeeb Adebayo, in a chat with New York Amsterdam News described counterfeit medicines as one of the biggest challenges facing the Nigerian pharmaceutical sector, saying virtually every category of medicines has been targeted by counterfeiters.

“The problem is enormous, he said. “There is hardly any class of drug that has not been counterfeited, from oral medicines to injectables, including induction agents used in anaesthesia. It shows just how widespread the problem has become.”

He said advances in counterfeiters’ techniques have made it increasingly difficult for pharmacists to distinguish fake medicines from genuine ones based on appearance alone. 

According to him, counterfeit drugs often infiltrate the pharmaceutical supply chain through wholesalers and distributors who fail to adequately verify the authenticity of their stock before supplying retailers. 

He therefore emphasized the importance of purchasing medicines only through authorized supply chains. He therefore warned members of the public to be cautious of medicines sold at unusually low prices, noting that significant price differences may indicate that a product is counterfeit. 

NAFDAC alert noted that the counterfeit cancer drugs were sold at significantly lower prices.

Counterfeiters have criminal networks that are highly adaptive

A pharmacy intern at NAFDAC, Pharmacist Hajara Yakubu, who clarified she wasn’t speaking on behalf of the agency, said the recent alerts  demonstrate that the counterfeit medicine problem extends beyond regulatory enforcement because the conditions that enable fake medicines to enter the market remain largely unchanged.

“Nigeria’s pharmaceutical supply chain is extensive and complex,” the intern said. “Raids and seizures remove counterfeit products from circulation, but they do not eliminate the underlying factors that sustain the problem, such as demand for cheaper medicines, weaknesses in parts of the supply chain, porous borders and the high profitability of pharmaceutical counterfeiting.”

She added that counterfeiters often operate through highly adaptive criminal networks that quickly alter their distribution channels following enforcement actions. “Addressing the problem therefore requires not only enforcement but also stronger regulation, intelligence-led operations, supply chain oversight, stakeholder collaboration and continuous public education.”

She stressed that open drug markets and community pharmacies should not be viewed in the same light. “Open drug markets present a significant regulatory challenge because medicines are often traded through fragmented and poorly traceable distribution networks, which creates opportunities for counterfeiters to enter legitimate supply chains,” the intern said.

Community pharmacies were however described as an important part of the solution rather than the problem. She noted that licensed community pharmacies are regulated by the government agency tasked with governing pharmacy education, training and practice, the Pharmacy Council of Nigeria (PCN) and NAFDAC and generally source medicines from legitimate distributors. While isolated lapses may occur, the intern said community pharmacists remain important partners in detecting, reporting and preventing counterfeit medicines.

Yakubu said there are several challenges to the fight against counterfeit drugs. She identified maintaining end-to-end visibility across Nigeria’s pharmaceutical supply chain, particularly where distribution channels are fragmented. “Regulators must also keep pace with increasingly sophisticated criminal networks that rapidly adapt to 

regulatory interventions while ensuring adequate resources for inspections, post-market surveillance, laboratory testing and intelligence gathering across a country as large as Nigeria,” she said.

She also emphasized the importance of collaboration among regulators, customs authorities, security agencies, manufacturers and healthcare professionals while also noting that public awareness remains equally critical.

For millions of Nigerians, the greatest danger is that counterfeit medicines are becoming increasingly difficult to identify. As counterfeiters grow more sophisticated and exploit weaknesses in the pharmaceutical supply chain, patients may unknowingly receive ineffective or dangerous medicines even when they believe they are doing the right thing. 

For families like Oladele’s, the consequences are measured not only in failed treatments but in prolonged illness, avoidable suffering and the devastating uncertainty of whether the medicines meant to heal have instead caused harm.

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