Two government agencies. A 60-percentage-point gap. Twenty years without a credible survey. And millions of Nigerians are swallowing medicines that no one can guarantee are genuine.
TheDigger Intelligence Unit
Nigeria has a counterfeit drug crisis. On that much, every agency, every pharmacist, and every patient advocate agrees. What nobody agrees on — and what no government has had the courage to settle with independent, current data — is how bad it actually is.
Is it 11 per cent of all medicines in circulation? That is what the National Agency for Food and Drug Administration and Control (NAFDAC), the agency responsible for regulating and controlling drug quality and safety in Nigeria, told the public in 2023.
Is it 71 per cent? That is what the National Primary Healthcare Development Agency (NPHCDA), which oversees primary health care delivery and surveys related to health facility standards in Nigeria, found in 2022 — just one year earlier.
This gap isn’t a minor statistical difference. It’s a 60-point gulf exposing a key question: Does Nigeria’s food and drug regulator know the true scale of counterfeit medicines—or is it hiding the truth?
THE NUMBER THAT STARTED IT ALL
The 16.7 per cent figure has circulated in Nigerian public health discourse for two decades. It originates from a 2005 study conducted by NAFDAC in collaboration with the World Health Organisation and the UK’s Department for International Development — and it represented, at the time, a significant achievement. The prevalence of counterfeit medicine had fallen from 40 per cent in 2001 to 16.7 per cent in 2005, driven by NAFDAC’s aggressive enforcement campaigns under the late Director-General, Dora Akunyili.
That reduction was documented. The progress was recorded. And then surveys ceased.
In 2019, NAFDAC made a public admission that has received almost no attention in the Nigerian media. In a statement on its own website, the agency acknowledged: “The last data we have on prevalence of substandard and falsified medicines in Nigeria is 16.7%, but that was about 14 years ago. Thus, it is high time we did the survey on the prevalence.”
Nigeria’s drug regulator publicly called for a new prevalence survey in 2019. Seven years later, officials have neither conducted nor published the survey nor taken any action. The 2005 16.7 per cent figure is still the last official baseline for a nation of 242 million people and a pharmaceutical market worth billions of naira annually.
THE WAR OF NUMBERS
In the absence of updated official data, competing figures have filled the vacuum — and the divergence between them is staggering.
NAFDAC recently stated that counterfeit medicines now make up 11–15 per cent. This is lower than the 2005 figure and is presented as evidence of continued regulatory progress.
But in 2022, the National Primary Healthcare Development Agency — a separate federal government body — did its own study. It found a figure of about 71 per cent. Not 16 per cent. Not 11 per cent. Seventy-one per cent.
If the NPHCDA figure is right, nearly three out of four medicines in Nigeria are fake or substandard. If NAFDAC’s figure is right, NPHCDA is wrong. One of these agencies—NAFDAC, the drug regulator, or NPHCDA, in charge of primary healthcare—is either underreporting or exaggerating a deadly crisis.
Twenty years after the last independent survey, the Nigerian public still lacks reliable, independently verified data on how many medicines in pharmacies, market stalls, and hospital dispensaries are fake.
That is not a data gap. It is a governance failure.
WHY CANCER PATIENTS ARE THE MOST EXPOSED
The counterfeit medicine crisis presents increased risks for cancer patients, a link supported by a recent global investigation.
The International Consortium of Investigative Journalists’ Cancer Calculus investigation — published in April across 47 media partners in 37 countries — documented how Merck’s blockbuster cancer drug Keytruda, priced at thousands of dollars per dose, is driving desperate patients in lower-income countries toward cheaper, counterfeit alternatives. In Mexico, at least one patient died after being administered a counterfeit batch. Merck’s own vice president for global security confirmed the death.
The ICIJ‘s central finding is clear: when cancer drugs cost more than patients and health systems can afford, counterfeits enter the market. In Nigeria, the average monthly income is below $200. Cancer kills an estimated 78,000 people each year. A single dose of Keytruda costs the equivalent of years of earnings. Here, the gap is significant.
NAFDAC has confirmed it. In March 2026, the agency issued alerts on fake Avastin and Tecentriq in Nigeria’s supply chain. Patients bought these drugs for ₦180,000–₦350,000, well below the real price.
A separate alert documented counterfeit batches of Phesgo — a breast cancer drug — with complaints originating directly from Lagos University Teaching Hospital. The fake batch was linked to a coordinated international distribution network operating simultaneously across Nigeria, Turkey, and the Philippines.
The counterfeits are not coming. They are already here. In a country where even the rate of fake medicines—11 per cent or 71 per cent—is in dispute, cancer patients in a broken system cannot know if their treatment will save their lives or end them.
THE REGULATORY ACCOUNTABILITY GAP
NAFDAC’s duty is clear: regulate food, drugs, and more. That includes knowing, through current data, how much of the medicine supply is fake.
It does not know. In 2019, it said so publicly.
NAFDAC aimed to cut substandard and falsified medicines to below five per cent by 2025. That deadline has passed. No published survey shows whether the target was achieved, missed, or dropped.
Meanwhile, the NPHCDA, responsible for primary healthcare and health data, reported a 71 per cent figure—over fourteen times the target set by NAFDAC, the official drug regulator. NAFDAC has not publicly disputed, reconciled, or investigated this number. Both figures remain unresolved and unaddressed in the public domain.
THE QUESTIONS NAFDAC MUST ANSWER
TheDiggerNews.com is seeking an audience with NAFDAC, the NPHCDA, the Federal Ministry of Health, and the National Health Insurance Authority on the following:
To NAFDAC: When was the last comprehensive, independent survey of counterfeit medicine prevalence conducted in Nigeria? Why has the 2019 call for a new survey not resulted in published data? How does NAFDAC reconcile its 2023 figure of 11 per cent with the NPHCDA’s 2022 figure of 71 per cent? Has NAFDAC met its strategic target of reducing the prevalence of counterfeit goods to 5% by 2025?
To the NPHCDA: What method produced the 71 per cent figure? Was it shared with NAFDAC? What action came next?
To the Federal Ministry of Health: Does the Ministry accept the NPHCDA’s 71 per cent finding? If not, what is the Ministry’s official position on the current prevalence of counterfeit medicines in Nigeria? What is being done to commission an independent, current, nationally representative survey?
To the NHIA: Counterfeit cancer drugs are in Nigerian hospitals. What is the NHIA doing to protect beneficiaries of the Basic Health Care Provision Fund from fake medicines?
EDITORIAL POSITION
This is not a story about whether NAFDAC is doing its job. NAFDAC has achieved real, documented progress in reducing counterfeit medicine prevalence from the catastrophic 40 per cent recorded in 2001. That progress deserves acknowledgement.
Progress from two decades ago, measured by data now 20 years old, does not guarantee current safety. The numbers debate—whether 11 per cent or 71 per cent—is no bureaucratic squabble. It is a real and immediate threat to every Nigerian using any medication outside a fully verified supply chain.
Nigerian cancer patients—facing high drug costs and confronting supply chains with confirmed counterfeit drugs—require more support than what a regulatory agency with outdated survey data can offer.
The 2005 data needs replacement. The dispute over prevalence must be addressed. Until then, Nigerians make important medical choices amid uncertainty.
#CounterfeitDrugs #NigeriaHealthCrisis #RegulatoryCoverUp #CancerPatients #HealthScandalTheDiggerNews.com is seeking an audience with NAFDAC, the National Primary Healthcare Development Agency, the Federal Ministry of Health, and the National Health Insurance Authority. Responses will be published in full upon receipt. This is part of TheDiggerNews.com‘s continuing investigation into Nigeria’s cancer drug crisis and counterfeit medicine epidemic. Read previous reports in this series at www.thediggernews.com