Drug dealing remains an important public health issue in Sierra Leone. Medications are often sold openly on the streets, in buses, and in parks without any professional oversight, leaving residents vulnerable to counterfeit, expired, or improperly used drugs. According to the World Health Organization (WHO), approximately 10% of medicines globally and up to 25% in low-income countries are substandard or falsified, a reflection of the challenges faced by fragile health systems like Sierra Leone. Despite ongoing efforts by the Pharmacy Board of Sierra Leone (PBSL) to regulate medicines, drug peddling continues because vendors still source medicines directly from importers, wholesalers, or even licensed shops. This policy perspective suggests actionable strategies to disrupt the supply chain that fuels drug peddling. Major recommendations include establishing a licensing system for retail outlets authorized to buy from wholesalers or importers, limiting large, suspicious bulk purchases that could indicate peddling activity, and tracking and penalizing suppliers identified through arrests of peddlers. By expanding accountability beyond the Pharmacy Board to include the Pharmacy Business Association and importers, this paper advocates for a collaborative, supply-side approach to curb drug peddling. Disrupting this access will not only boost pharmaceutical regulation but also safeguard public health, prevent misuse, and help rebuild trust in Sierra Leone’s healthcare system.

Breaking, Supply chain, Peddling, Pharmacy board, Licensed shops, Medicines.

Drug treatment has become a prominent health issue in Sierra Leone today. It is quite common to see people openly selling medicines on the streets, buses, and markets. These practices are very risky because many of the medicines sold are counterfeit, expired, or of poor quality, and are often used without professional supervision. Misusing medicines leads to antimicrobial resistance, treatment failure, and sometimes preventable death. According to the WHO, at least 1 in 10 medicines in low- and middle-income countries are fake or substandard.[1] In Sierra Leone, research shows that unregistered medicines are widely circulated. For example, while only 37 antimalarial brands are officially registered, over 60 different brands are found in circulation, indicating weak regulation and control.[2] This problem is exacerbated by the country’s more than 1,000 unmonitored border crossings, which allow illegal medicines to enter the market. For years, the PBSL has worked diligently to regulate medicine sales and stop illegal trading. However, PBSL alone cannot fully address this issue. The Pharmacy Business Association of Sierra Leone, especially importers and wholesalers, plays a critical role. These groups are key players in the distribution of medicines and, whether intentionally or not, supply peddlers with drugs.

Problem statement: The livelihoods of drug peddlers depend heavily on their ability to access medicines. Through volunteer work at various pharmacies, many peddlers obtain medicines directly from importers and wholesalers, often in large quantities. Licensed pharmacies also contribute by selling unusually large amounts to individuals, who then resell them in unregulated settings. For many in rural or low-income urban areas, these outlets might be the only point of healthcare. Unfortunately, these unregulated sellers often deal with poor-quality or counterfeit medicines, which pose serious health risks. Media reports have warned that such unsafe sales could cause thousands of deaths if not controlled.[3] Unless the supply chain is broken, drug peddling is likely to grow, harming public health and damaging the reputation of pharmacy professionals.

Objectives: This initiative aims to:

• Disrupt the supply chain linking importers and wholesalers to peddlers.
• Accounting among stakeholders in the pharmacy sector should be increased.
• Support PBSL’s regulatory efforts by encouraging shared responsibility with the pharmacy business community.
• Safeguards the public from unsafe medicines and irrational drug use.

Proposed strategies:

• Authorization system: All retail pharmacies must now provide official authorization documentation (licenses) before they can purchase medicines from importers or wholesalers. This step ensures that only properly licensed and recognized outlets are authorized to buy medicines in bulk.
• Restricting suspicious bulk purchases: Large or unusual purchases should be closely monitored and limited. For example, no individual should be permitted to buy more than three boxes of Paracetamol, five boxes of fluconazole, or ten boxes of albendazole without valid reasons. Outlets that exceed these limits without clear justification should be subject to investigations.
• Tracing and penalizing suppliers: During enforcement operations, which are well known as ‘peddler’s raids’, authorities should require arrested peddlers to disclose their sources. Any importer, wholesaler, or licensed pharmacy identified as a supplier involved in illegal activities must face penalties such as fines, suspension, or license revocation.
• Shared responsibility and collaboration: The PBSL should formalize partnerships with the Pharmacy Business Association to oversee members’ sales practices. The Association should implement disciplinary actions against members who sell medicines to illegal peddlers. Public awareness campaigns are also important, educating communities about the risks of purchasing medicines from unregulated vendors.
• Anticipated outcomes: If these measures are implemented, we expect a major decrease in counterfeit and substandard medicines circulating in the market. Transparency within the supply chain will improve, and PBSL’s enforcement capabilities will be strengthened through collaboration with industry stakeholders. These strategies will also protect public health by reducing misuse-related drug resistance and help restore confidence in licensed pharmacies.
• Challenges and solutions: Resistance from importers and wholesalers can be addressed by tying compliance to license renewals and strict penalties. Fake authorization documents can be mitigated by introducing secure, verifiable digital permits such as QR-coded authorizations. [4, 5]

Weak collaboration can be strengthened through formal agreements (MoUs) between PBSL and the Pharmacy Business Association. Additionally, the preference for cheaper street medicines can be addressed by supporting affordability programs for essential medicines to reduce dependence on unregulated sellers.

Illegal drug distribution is a serious public health risk, not just a regulatory issue. Sierra Leone must dismantle the supply network enabling peddlers to access medicines. Stricter authorization protocols, limits on bulk sales, and penalties for noncompliance, combined with active engagement from the Pharmacy Business Association and PBSL, are important steps. Collective efforts and swift action are essential to protect citizens from unsafe medicines and to ensure public safety.

The authors express gratitude to the Pharmacy Board of Sierra Leone (PBSL) and the Pharmacy Business Association of Sierra Leone for providing insight into the practical difficulties surrounding pharmaceutical regulation. The contribution of various community health workers and law enforcement agents who shared their experience and knowledge further informed the development of these suggested strategies.

No specific grant from funding agencies in the public, commercial, or not-for-profit sectors was received for this policy.

Corresponding Author:
Amidu G. Torto
Department of Pharmaceutics/Microbiology
College of Medicine and Allied Health Sciences, University of Sierra Leone, Sierra Leone
Email: tortoamidugibril1925@gmail.com

Co-Authors:
Joy Johnson
Department of Pharmacology
College of Medicine and Allied Health Sciences, University of Sierra Leone, Sierra Leone

Nuhu Bah, Tamba Buffa
Department of Pharmaceutics/Microbiology
College of Medicine and Allied Health Sciences, University of Sierra Leone, Sierra Leone

Adama O. Toure
Department of Clinical Pharmacy
University Gamal Abdel Nasser de Conakry, Guinea, West Africa

Sahr E. Gbomor
Department of Information and Communication
Pharmacy Board of Sierra Leone, Freetown, Sierra Leone

Amidu G. Torto contributed to the conceptualization, writing of the original draft, and project administration. Joy Johnson was responsible for writing reviews and editing, as well as validation. Nuhu Bah, Adama O. Toure, and Sahr E. Gbomor participated in the review and editing of the manuscript. Tamba Buffa contributed to writing, review, and editing, and provided supervision for the project. All authors have read and approved the final version of the manuscript.

Not Applicable

The authors declare no conflicts of interest.

None

https://doi.org/10.63096/medtigo3061241

Torto AG, Johnson J, Bah N, Toure AO, Gbomor SE, Buffa T. Breaking the Supply Chain of Drug Peddling in Sierra Leone. medtigo J Pharmacol. 2025;2(4):e3061241. doi:10.63096/medtigo3061241 Crossref