Healing or Hustle? Smuggled Meds Are Big Draw in Zimbabwe’s Hidden Markets

HARARE, ZIMBABWE — It’s possible to buy pretty much anything at the market in Hopley, an informal settlement south of this capital city: rat poison, mops — even medicine.

That medicine is sold without prescriptions, to buyers who don’t have a diagnosis from a doctor in hand. Some vendors even offer diagnoses to their customers, even though they don’t have any medical training. And in many cases, the medicine is fake. At any moment, police could swoop in for a raid. Vendors keep the medicine out of view, and buyers know who to ask.

Gladys Chihozhwa buys contraceptive pills from one of them, and even turns to the vendors for diagnoses when she’s sick. She knows the drugs might be expired, or even fake. That doesn’t deter her.

“I buy them because they are cheap,” she says.

Zimbabwe is overwhelmed with counterfeit medicine, driven by the expansion of informal markets and consumer demand for cheaper products. Police routinely impound pharmaceuticals. In just one example, the Medicines Control Authority of Zimbabwe in January discovered counterfeit rabies vaccines in circulation. Their packaging mimicked that of legitimate imports from India, a big supplier of Zimbabwe’s medicine.

The vaccines’ pathway into the market remains unclear, but some products pour into Zimbabwe’s informal markets through its leaky borders with Zambia, where counterfeit medicines from India are easily available, and cheap.

The consequences of this trade can be fatal. According to a 2022 report by the United Nations Office on Drugs and Crime, in sub-Saharan Africa alone, counterfeit medicines kill just over a quarter of a million people each year.

Even when not immediately fatal, they can cause long-term harm, including increasing antibiotic resistance, says Dr. Grant Marewanhema, a public health expert.

In a written response, public relations officer Davison Kaiyo says the Medicines Control Authority of Zimbabwe has tried to address this problem by conducting raids with the police and intercepting counterfeit medicines at borders. They also conduct regular inspections at pharmacies. Those caught are prosecuted, and the medicines confiscated, he says.

But demand is high, so new shipments keep pouring in.

A global problem

Distribution of fake and substandard medicines is a global, highly profitable criminal enterprise. One 2020 study by the Pacific Research Institute estimated that the counterfeit medicine market is worth somewhere between US$200 billion and US$431 billion annually.

Many of the counterfeit drugs are produced in India, where a mix of highly reputable drug manufacturers and unregulated producers creates serious challenges for oversight and quality control.

Africa is particularly affected. According to the World Health Organization, 42% of globally detected cases of counterfeit and substandard medical products between 2013 and 2017 were in Africa.

In Zimbabwe, porous borders facilitate the movement, but a combination of other factors fuels the trade. The country’s decades-long economic problems have left the health care system hanging by a thread. Many public hospitals simply don’t have medicine supply, says Portifa Mwendera, a pharmacist of 25 years. Most times, patients are given prescriptions and told to source the medication elsewhere, he says.

But Zimbabwe produces only 30% of its essential medicines. The rest is imported and costly in pharmacies. Many people in the country are too strapped for cash, and these vendors offer options that are easier on the pocket, Mwendera says.

Cross-border trade

Sanudi, a cross-border truck driver, has for two decades smuggled medicine into the country through the Chirundu border post, a key trade and travel point between Zambia and Zimbabwe. He knows many other truckers who do the same. Sanudi asked Global Press Journal to use his middle name for fear of arrest.

It’s easy, he says. At the border, if the bag is small, he leaves it with a security guard as the truck undergoes scanning. He pays the guard US$50 to US$60, then charges the traders about US$200 to transport two small bags. If the consignment is too big to stash with the guards, he simply bribes the officials scanning the trucks.

“It’s a risky operation, but I do it for the extra money I get,” he says.

Global Press Journal reached out to officials at the Zimbabwe Revenue Authority, but they did not respond to interview requests.

‘I always take the risk’

Gozo, a vendor who also asked Global Press Journal to use only one name for fear of arrest, sells pharmaceuticals without a license, and offers diagnoses. Once the customer describes their symptoms, Gozo says she knows what to sell them. Two years in this trade have sufficiently equipped her, she says, especially in prescribing antibiotics.

“The people I sell the drugs to get better,” she says.

Antibiotics such as ciprofloxacin are popular at her stall, and many of them come from a supplier who gets them from Zambia. Ten antibiotics pills go for US$1 at her stall. In licensed pharmacies, the cost can be twice as much.

If arrested, she could face high fines or even imprisonment. Police conduct raids at the market from time to time, but sellers like her depend on this trade for a living.

“I always take the risk,” she says.