Top Takeaways
- Enforcement lags behind the law. Most economies have regulatory frameworks on paper, but enforcement (de facto application) consistently falls short — only the U.S. scored above 75% on IP enforcement, while 9 of 12 economies scored under 40%.
- Africa is hit hardest. The five African economies sampled (Egypt, Ghana, Kenya, Nigeria, South Africa) face the greatest impact from unsafe medicines while having the weakest legal infrastructure to fight it.
- It's a global supply chain problem. India and China (including Hong Kong) remain the dominant source of unsafe medicines worldwide, with secondary transshipment hubs like Singapore, Egypt, and the UAE compounding the challenge.
The trade and proliferation in unsafe and illicit medicines has long been recognized as a threat to global public health. Every year, counterfeit, substandard, and diverted medicines cause hundreds of thousands of preventable deaths and negatively affect the health of many thousands more. Further, this trade damages national health systems, strengthens organized crime, and undermines public confidence and trust in government and the rule of law.
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Less than 50%
The average Index score across all 12 economies.
International institutions and national governments are not blind to these threats. The World Health Organization (WHO), the World Customs Organization (WCO), INTERPOL, the Organisation for Economic Co-operation and Development (OECD), the European Union Intellectual Property Office (EUIPO), and most national governments have established programs and dedicated efforts to combat this trade. Yet as damaging as these products are to public health and national economies across the globe, significant gaps remain in our understanding of how to define this trade and its scale.
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10.5 percent
of medicine supply chains in low/middle-income economies are counterfeit or substandard.
The U.S. Chamber of Commerce’s Global Innovation Policy Center (GIPC) strives to fill this information gap with the Trade in Unsafe Medicines Index. By highlighting and benchmarking the growing menace of the trade in all forms of unsafe and illicit medicinal products, the Index offers national and international policymakers a more complete and actionable picture of the threat. Importantly, the findings highlight a persistent gap between existing regulatory frameworks and their effective implementation. The Index demonstrates how this undermines efforts.
