Rwanda’s Illicit Drug Market: A Growing Threat to Public Health

In June this year, Rwanda’s Food and Drugs Authority (Rwanda FDA) announced a ban on the importation, distribution, and use of all tablets marketed under the brand name RELIEF, declaring them unregistered and unauthorized for use in the country.

From 2019 to 2023, Rwanda FDA removed numerous substandard or illegally imported drugs from the market. According to its 2023–2024 reports, the agency withdrew 14 drugs and two specific drug categories, including tetracycline eye medications, due to safety and quality concerns. Between 2019 and 2023, a total of 106 drugs were withdrawn. Of these, 33% posed serious health risks, 50% had minor quality issues, and 26.4% were pulled due to contamination or failure to meet regulatory standards.

Despite these efforts, the illegal sale of unregistered medicines persists in various parts of the country, particularly in households where unauthorized vendors sell drugs to treat multiple conditions. Worryingly, some of the drugs previously removed from the market are finding their way back through illicit channels, putting public health at risk.

A shortcut driven by different arguments

This situation is especially prevalent in border districts like Rusizi and Kirehe, where access to healthcare services remains limited for rural populations. Residents often resort to unauthorized vendors due to the cost and distance associated with visiting certified pharmacies or health facilities.

In Kirehe district, a resident  shared: “In our village, there’s a woman who provides different medicines based on what people describe. She once gave me headache pills and deworming tablets. Although she has no formal medical training or license, she helps us, and we get better.”

Another resident, Alfred Habimana, attributed the practice to poverty and poor access: “We live far from pharmacies and clinics. A trip to town can cost over 6,000 Rwandan Francs on a motorcycle. Instead, we buy medicine from someone we trust locally, even if they’re not a certified doctor.”

Residents told local media that these illegal vendors often operate door-to-door or sell in local markets. Kirehe district mayor Bruno Rangira acknowledged the challenge, stressing the dangers of self-medication with unverified drugs: “We have cases of illegal treatment happening in secret. We follow up on reports and prosecute offenders, but continuous education is necessary.”

He added that the district is expanding access by increasing the number of health posts: “We currently have 42 health posts and are constructing more to ensure every cell has one within the next two years.”

Similar patterns are seen in Rusizi district in Western Rwanda, particularly in sectors like Nyakabuye, Bugarama, Gikundamvura, and Mururu, where residents report household sales of drugs including malaria tablets, painkillers, antipyretics and even antiretrovirals.

Some of these drugs are believed to be smuggled in from the Democratic Republic of Congo, including medications previously banned in Rwanda.

In response, the Rwandan government has stepped up enforcement efforts, tightening regulations, increasing border inspections and launching public awareness campaigns about the dangers of substandard drugs.

Combating the black market through collaboration

Dr. Janvier Mukiza from Rwanda FDA explained that the agency works closely with pharmacies to track unauthorized medicines: “We inspect all imported drugs and issue certification before they enter the market. If a product appears without our approval, it’s considered illegally imported and must be removed.”

He emphasized that inspections cover both illegal imports and previously banned drugs, including those already in pharmacies: “The law requires us to trace all products pulled from the market, but this becomes difficult when we don’t know how much has been smuggled in or where it is being sold.”

Due to these challenges, Rwanda FDA relies heavily on public cooperation. Citizens are encouraged to report suspicious drug sales via the toll-free number 9707, email (info@rfda.gov.rw), or WhatsApp at +250788457545.

The health dangers of banned drugs

Internal medicine specialist Dr. Menelas Nkeshimana warned of the serious health risks posed by using banned or substandard medicines.

“You could unknowingly take toxic substances due to poor manufacturing. Not only will your illness persist, but the side effects could worsen your condition.” He explained that people may unknowingly continue using such drugs because they were once effective, unaware that new batches may be unsafe: “This puts lives at great risk.”

Over the years, Rwanda National Police has confiscated various illegally sold drugs found in homes, including Indocid, Omeprazole, Coartem, Lufedol, Pracetamol, Amoxicillin, Ibuprofen, Ampicillin, and Calcium, many of which were not approved for sale in Rwanda.

Dr. Menelas urged citizens to avoid self-medication and instead seek care from certified health facilities: “Life is priceless. The cost of treating complications from unsafe drugs far outweighs the cost of visiting an authorized health center.”

SOURCE: umuringanews