Kenya's struggle with fake medicines has escalated from a health emergency to a major business, regulatory and financial crisis that endangers lives and undermines investor confidence.
With an estimated 30 percent of medicines in Africa believed to be counterfeit, Kenya's weak enforcement structures, fragmented supply chains and policy gaps are fuelling the growth of an underground drug economy.
Just how big is Kenya’s pharmaceutical market, and who dominates it?
As of 2024, Kenya’s pharmaceutical market was valued at approximately $765.6 million (Sh98.6 billion), with projections suggesting it could exceed $1,091.62 million (Sh130 billion) by 2030 using the current conversion rate.
This positions the country as one of the largest pharmaceutical hubs in the Common Market for Eastern and Southern Africa (Comesa) region, contributing around 50 percent of the region’s pharmaceutical output.
The market is a mix of local makers and international firms, with domestic production accounting for around 30 percent of the total market, mainly through generic medicines.
Nairobi is the leading city in terms of consumption and importation, with the majority of branded, high-value drugs being sourced from India, China and Europe.
What is the financial impact of counterfeit medicines?
According to estimates from the Anti-Counterfeit Authority (ACA), Kenya loses at least Sh15 billion each year due to the trade in counterfeit and substandard medicines.
The World Health Organization (WHO) has previously warned that one in 10 medical products in low- and middle-income countries is substandard or counterfeit. Some reports indicate that this figure could be as high as 30 percent in parts of Africa.
The impact of these fake drugs extends beyond lost revenue. They result in increased deaths and treatment failures, as well as a decline in trust in the healthcare system.
How is the medicine supply chain structured in Kenya?
Kenya’s medicine supply chain begins with importers who bring in finished products or active ingredients, primarily from Asia. Local manufacturers then produce mostly generic medications, which are distributed through wholesalers and national medical stores.
These products ultimately reach retail pharmacies, hospitals or e-pharmacies.
However, the supply chain is fragmented and inadequately regulated, creating loopholes for counterfeiters to introduce fake or substandard drugs at various levels.
The informal market, comprising backstreet vendors, unlicensed chemists and unauthorised online sellers, pose a significant challenge that regulators are struggling to address.
"By collaborating with the government, regulators, and private sector players, we can create a safer and more transparent pharmaceutical supply chain," said Gavin Pearson, chief executive officer of CFAO Healthcare Kenya.
How is Kenya’s legal framework responding to the fake medicine trade?
The Pharmacy and Poisons Board (PPB) is primarily responsible for managing this crisis. The board is responsible for licensing, product registration, and market surveillance. It also encourages use of the Mobile Authentication Service (MAS), which enables consumers to verify the authenticity of a drug via SMS.
However, enforcement of these regulations remains inadequate.
Where are the biggest vulnerabilities in the supply chain?
Vulnerabilities in the supply chain are particularly evident at the import and wholesale levels. For example, customs inspections at entry points such as the Port of Mombasa are inconsistent, which allows unregistered importers to exploit lapses in oversight.
During the distribution phase, wholesalers often lack transparency and effective tracking mechanisms. The situation worsens at the point of sale, where counterfeit medicines can be sold in packaging that appears legitimate, either in person or online, targeting unsuspecting customers.
Are regulations on online drug sales keeping up?
While online drug sales offer a potential solution for improved access to medications, they also present a double-edged sword.
While some legitimate e-pharmacies are licensed and adhere to proper regulations, many operate outside the bounds of the law.
What logistical challenges does Kenya’s supply chain face?
Poor road infrastructure, insufficient temperature-controlled storage and unreliable transport services put sensitive medicines, including vaccines and biologics, at risk of degradation.
Consequently, ethical suppliers face increased compliance costs, creating a pricing gap that counterfeiters can exploit by offering cheaper, dangerous alternatives.
These logistical weaknesses can lead to stock shortages, delayed deliveries and inefficient drug recalls, all of which create opportunities for fake medicines to enter the supply chain.
In what ways is the internet playing an increasingly significant role in the sale of fake drugs?
Criminal networks are increasingly using unregulated websites, spam advertisements, social media platforms and peer-to-peer applications for this purpose. These platforms are difficult to monitor and often operate outside the jurisdiction of Kenyan authorities.
Consumers, particularly those in rural or underserved areas, are at risk of falling victim to these digital scams due to the allure of cheaper or faster access to medicines.
What effect do fake drugs have on Kenya’s health indicators?
Substandard antibiotics directly contribute to the rise of antimicrobial resistance, which poses a growing threat across the region. Falsified antimalarials, HIV medications and cancer therapies result in treatment failures, prolonged illness and unnecessary deaths.
According to WHO, fake medicines account for over 100,000 deaths each year in sub-Saharan Africa, and Kenya contributes significantly to this alarming statistic.
The economic burden is also substantial, with patients incurring higher costs from repeated hospital visits, ineffective treatment cycles and potential loss of income or life. This situation undermines national health advancements and exacerbates inequality.
What is the long-term solution to Kenya’s fake drug crisis?
According to CFAO Healthcare, the medicine distribution crisis in Kenya is not merely a supply chain issue; it is a matter of life and death.
Although the country benefits from a robust private sector, it needs to enhance official channels and empower local health systems to better protect its population.
