Counterfeit medicine crisis grows in Zimbabwe's informal markets

In the crowded, makeshift stalls of Hopley's open market - an informal settlement just south of Harare - buyers can find almost anything: rat poison, cleaning supplies, and even medicine. But behind the everyday hustle, a shadowy and dangerous trade thrives - counterfeit pharmaceuticals sold without prescriptions, diagnoses, or regulatory oversight.

Gladys Chihozhwa, a resident of Hopley, is one of many who rely on these unregulated vendors for medical supplies. She regularly buys contraceptive pills from the market and turns to vendors for diagnoses when she falls ill, despite knowing the risks.

"I buy them because they are cheap," she explains.

This informal and often illegal trade in medicine is booming, exposing Zimbabweans to fake or expired drugs and heightening public health dangers in a country already battling economic and healthcare challenges.

Zimbabwe is grappling with a flood of counterfeit drugs, fueled by economic desperation, porous borders, and limited access to affordable healthcare. The Medicines Control Authority of Zimbabwe (MCAZ) confirmed that unregulated pharmaceuticals have become widespread - with some counterfeit drugs mimicking legitimate products. In one recent example, fake rabies vaccines mimicking imports from India were discovered in circulation earlier this year.

"The danger is real," says Dr. Grant Marewanhema, a public health expert. "These drugs can be fatal or lead to long-term consequences, like antibiotic resistance."

The United Nations Office on Drugs and Crime estimates that over 250,000 people die annually in sub-Saharan Africa due to counterfeit medicines. A 2020 study by the Pacific Research Institute pegged the global counterfeit medicine trade's value between US$200 billion and US$431 billion, with Africa disproportionately affected. According to the World Health Organization, nearly half of global reports of fake and substandard medical products from 2013 to 2017 originated in Africa.

Zimbabwe's economic instability has rendered much of the public healthcare system non-functional. Hospitals often run out of essential drugs, pushing patients to seek alternatives on the black market. Portifa Mwendera, a pharmacist with 25 years of experience, says many patients leave hospitals with only prescriptions and no access to actual medication.

"People are told to go find the drugs themselves - but at pharmacies, prices are high and most simply can't afford them," he says.

Zimbabwe imports around 70% of its essential medicines. With the official supply chain strained and pharmacy costs out of reach for many, cross-border smuggling has stepped in to fill the gap.

Sanudi, a cross-border truck driver who asked to use only his middle name, has smuggled medicine from Zambia into Zimbabwe for two decades. For a price, border officials or guards turn a blind eye.

"It's a risky operation, but I do it for the extra money," Sanudi admits.

At the Hopley market, vendors like Gozo - who also declined to use her full name - sell everything from painkillers to antibiotics like ciprofloxacin, often at half the price of licensed pharmacies. Ten pills can cost as little as US$1.

Gozo, who has no medical training, also offers diagnoses based on customer descriptions. She says her clients trust her, and most return after feeling better. But she's aware of the risks: arrest, hefty fines, or jail time. Police conduct periodic raids, forcing vendors to stash drugs out of sight and rely on loyal customers who know who to ask.

"I always take the risk," she says. "It's how I survive."

Despite enforcement efforts - including joint raids by MCAZ and police, and occasional border interceptions - the demand for low-cost medicine continues to outpace regulatory capacity. MCAZ spokesperson Davison Kaiyo says they're working hard to stop the trade, but "as long as demand remains, the supply keeps coming."

Zimbabwe's counterfeit drug problem is a complex web of poverty, weak regulation, and regional trafficking. Addressing it will require not just policing vendors and smugglers, but also rebuilding trust in the public health system and ensuring affordable, legitimate medicine is available to all citizens.

Until then, millions like Gladys Chihozhwa will continue to gamble with their health - choosing survival over safety in a system that has long failed them.