The scourge is particularly alarming in West Africa, where authorities say knockoffs are thought to comprise more than half of pharmaceutical sales in areas where many cannot afford prescription treatments.
“You are poor, and you are spending your money on something that is going to kill you,” Faure Gnassingbé, the president of Togo, told The Washington Post in the country’s presidential palace. “Yet, it is not treated as a crime.”
The Togolese leader hosted his counterparts from Senegal and Uganda on Saturday in the capital city, Lome, where the presidents proposed laws to strengthen a collective crackdown on trafficking.
Representatives from Ghana, Congo, Niger and Gambia also signed a pact to ramp up intelligence sharing and security at the borders, among other efforts.
Peddling fake drugs is illegal in most countries, but enforcement is shaky. One raid on markets, shops, warehouses and factories across West Africa three years ago turned up more than 41 million counterfeit pills. About 150 people were arrested for selling a blend of toxic or useless tablets, Interpol reported.
Dignitaries flocked to Lome this week for a summit on counterfeit medicine, including a member of the British royal family, Prince Michael of Kent.
Armed police officers in trucks patrolled the city of roughly 830,000. Helicopters whirred overhead. Yet, people still hawked boxes of unverified antibiotics on the street.
Amele Louise Assogba, 49, used to visit roadside vendors for pills to soothe headaches and nagging coughs. Drugs at pharmacies, she said, cost three times more.
“I needed to save money for my children,” said the Togolese mother of four who supports her family by cooking for neighborhood families.
Then she caught the flu, bought an informal remedy and landed in the hospital for an emergency blood transfusion.
Assogba considers herself lucky — at least she made it to a doctor on time.
About 122,000 children die each year on the continent from fake antimalarial drugs, according to an estimate from the Brazzaville Foundation, a London group that focuses on the issue. In some areas, as many as 60 percent of drugs sold are thought to be counterfeit, the nonprofit said.
“This abject trafficking generates enormous profits for criminals and terrorists, destabilizing some of the most fragile countries in the world,” said Jean-Yves Ollivier, the foundation’s president, in a statement.
Counterfeit goods have long been linked to criminal gangs, with studies tying knockoff sales to terrorist organizations that exploit child labor.
Shipments often slip through porous borders, authorities say, and encourage corruption when traffickers pay off customs agents.
Officials aim to end this income stream at a time when Islamist violence is surging across West Africa’s Sahel region, with attacks increasing fivefold since 2016.
Extremists who have professed loyalty to the Islamic State and al-Qaeda have seized remote corners of Mali, Niger and Burkina Faso.
Those militants fund the war by ambushing towns and stealing livestock, taking over artisan gold mines and kidnapping people for ransom, officials have said.
They also profit from counterfeit drugs, said Gnassingbé, the Togolese president.
“Terrorists,” he said, “are living on fake medicine traffic.”
Sylvio Combey contributed to this report.