Observers

A pharmacist in Cameroon went undercover, posing as a customer and using a hidden camera to film medicine being sold illegally -- a dangerous trade that he says is rampant in the country.

The footage filmed using a hidden camera shows several Cameroonian traders, who seem happy to sell medicine at cut-rate prices to customers without asking for a prescription.

This underground industry is completely unregulated, with no oversight as to the provenance or conservation of the medicine, and whether or not the vendors have any medical training or knowledge about the products. This kind of industry poses a serious public health risk -- and it’s widespread. An estimated 1 in 10 medical products in low- and middle-income countries is substandard or falsified, according to the World Health Organisation (WHO).

Landry Kouam, a pharmacist in Baham and a member of the Collectif des pharmaciens du Cameroun, a nationwide organisation of pharmacists, recently decided to document this widespread problem himself. He bought a tiny camera, which he fitted onto a button of his shirt. Then posing as a customer, he went and tried to buy medicine without a prescription in shops in several different cities around Cameroon.

Above are two excerpts from the footage that Kouam captured with his secret camera. In the first clip, a saleswoman is happy to sell him a Cytotec pill at a shop in Bafang in November 2018. The second clip shows a shop in Bandjoun where medicine is sold illegally.

"Only pharmacists should sell medicine”

It’s extremely easy to buy Cytotec, a medicine that treats stomach ulcers but that is often used illegally to end a pregnancy or to induce labour. In 2018, Cytotec was taken off the market in France because it was found to have serious side effects.

Because Cytotec is extremely dangerous, pharmacies won’t sell it without a prescription. So young girls who are trying to secretly end a pregnancy often purchase it in a market, where no questions are asked.

You can also buy anxiolytics [Editor’s note: medication that inhibits anxiety] like Rivotril or Diazépam in the street. It’s crazy! Only pharmacists should sell medication. I also made secret recordings in hospital pharmacies, which sometimes use the same suppliers as traders who sell pills in the streets.

I also made these videos because I wanted to compare the prices [of medicine bought in pharmacies with medicine sold illegally]. Unsurprisingly, medicine goes for much cheaper rates on the street. For example, I sell Efferalgan [Editor’s note: A paracetamol-based drug used as a mild painkiller] for 1,300 CRA francs CFA but someone could easily buy it in the street for 800 francs before they even reach my pharmacy!

This medication is for sale in the Yaoundé market. (Photo taken by Kouam Landry in July 2019).

It’s also possible to buy one pill at a time in the street, which is obviously cheaper. Pharmacists aren’t allowed to do that because you can’t cure an illness by taking a single capsule. However, some people don’t understand these price variations and accuse us of being too expensive.

On July 10, 2019, the Minister for Public Health, Malachie Manaouda, announced the creation of a “brigade tasked with the systematic seizure and destruction of these medicines and products”. On July 16, Manaouda met publicly with street vendors who sell medicine in Yaoundé and started using the slogan "street medicine kills". In August, he told FRANCE 24 that he wanted to “disturb [the] peace” [of street vendors].

Kouam supports the minister’s new initiative. He hopes that pharmacists will be able to play a more active role in getting illegal medicine off the market.

I used a hidden camera because I didn’t want the vendors to know what I was doing. They are fully aware that they are running an illegal business. It could be dangerous to cross them -- they are like a drug cartel.

According to the French branch of the International Institute of Research Against Counterfeit Medicines (IRACM), a criminal organisation that invests a thousand dollars into the illegal medicine trade can make up to $500,000 in profits. That means it is 10 to 25 times more profitable than drug trafficking.


Article by Pierre Hamdi (@PierreHamdi)