Rania, 24, did not expect preparations for her wedding to bring such a bitter experience. Searching online for cosmetics and products for her skin and hair, she found a tempting Facebook advertisement: everything she needed at half price. An unknown seller reassured her about quality and effectiveness. She paid EGP 1,200 through an electronic wallet and waited eagerly for the parcel.
Within a week of using the products, she began experiencing repeated nausea and a skin rash. Checking the dates on the packaging, she discovered that every product had expired more than a year earlier. When she contacted the business page, the seller stalled, then ignored her, and finally blocked her. Rania posted a warning in a women’s group to stop others falling into the same trap.
Shimaa had another unsettling experience after a doctor prescribed Arcalion for fatigue. A year before this investigation, she bought it from a pharmacy in El Maragha, Sohag. The price was slightly lower than usual, but she did not question it. After taking it for a week, she noticed that its expiry date had passed more than a year earlier.
She returned to demand an explanation and discovered that the seller was an unlicensed assistant rather than a pharmacist. He tried to evade her questions but called the pharmacist after she threatened to expose what had happened. The pharmacist arrived, apologised and refunded her money, claiming that the medicine had lost only 10% of its effectiveness and was harmless. That was his assertion, not a safety assessment established by this investigation.
Shimaa resolved never to trust a medicine without checking its expiry date herself. Months later, her seven-year-old developed a throat infection and was prescribed an antibiotic. Her husband bought it from another pharmacy. She checked the box immediately: it had expired six months earlier.
What if she had not checked? What if her child had taken it? For Shimaa, the problem extended beyond a single pharmacy to a market in which expired medicines could be sold without effective deterrence.
Ali Auf, head of the pharmaceutical division at the Federation of Egyptian Chambers of Commerce, has previously said that unlicensed factories buy expired medicines from pharmacies, repackage them with false dates and return them to sale. He said the Consumer Protection Agency had uncovered facilities replacing expiry dates on some cancer medicines before distributing them through warehouses and pharmacies. He estimated the illegal trade at EGP 3 billion.
Auf also said pharmaceutical companies had not removed their expired products from the market for seven years, giving informal traders more room to operate. In February 2025, Deputy Prime Minister and Health Minister Khaled Abdel Ghaffar issued a decision requiring medical facilities to return expired medicines and medical supplies to their suppliers and preventing destruction without the required legal procedures and approvals. Whether such measures can effectively control the market remains a central question.
Medicines sold in street markets
For months, Zeinab searched for blood-pressure and diabetes medicines for her elderly mother. Health-insurance facilities repeatedly told her the treatment was unavailable. Pharmacy prices doubled, and sometimes the medicines could not be found at all. Her late husband’s pension barely covered food and utility bills; black-market prices were beyond her means.
Then, while walking through Wekalet El Balah market in Cairo’s Boulaq Abul Ela district, she saw a woman sitting on the pavement with boxes and blister packs spread before her. “Any strip for five pounds, any box for ten,” the seller called.
Zeinab hesitated, but recalled seeing medicines at the Friday market too. She asked neither where they came from nor whether they had expired. Her mother’s urgent need outweighed everything else. She paid and left with the boxes in a black plastic bag, relieved to have found a solution without considering the new risk it might carry.
Her circumstances reflect the pressures facing many poor households. The economic crisis, a local exchange rate of around EGP 50.60 to the dollar and annual urban inflation of 24.1% in December 2024 eroded purchasing power. Central Bank data put annual core inflation at 23.2% that month. The original article cited 23.3% without distinguishing these measures.
An economic analysis cited in the original report described households reducing health expenditure by 43% and turning to lower-quality brands at a rate of 70%. These figures describe the behaviour reported in that analysis; they should not be read as measurements specific to Zeinab’s household.
On January 19, 2025, a young man posted a photograph on Threads of medicines being sold at Wekalet El Balah’s Sunday market. He said he had noticed expired packages. The post spread widely across social media.
On January 27, the Egyptian Drug Authority (EDA) announced a joint operation with security authorities following complaints and online reports of unlicensed medicine sales at a Cairo market. It said non-pharmacists had been found selling expired vitamins and cosmetics.
Inspectors seized cosmetics, skincare products, vitamins, small quantities of medicines, unregistered products and expired dietary supplements. Around 700 packages were confiscated, most without a visible expiry date. The EDA said six reports had been prepared for referral to the prosecution.
A market for expired stock
Zawia3 observed an active trade in expired medicines through Facebook groups and pages associated with unidentified businesses claiming to work in pharmaceuticals. Names used included Life Pharm, El Hamd Pharma, El Mostafa and Overseas for exchanging expired stock.
Representatives and anonymous accounts posted in pharmacy and medicine-trading groups, offering to buy infant formula, supplements, cosmetics and damaged medicines that distributors refused to take back. In exchange, they offered sexual-performance products such as Viagra, Erec, Virecta and Nabi Fit, pharmacy supplies such as syringes and toothbrushes, and common medicines including Panadol, Cataflam, Bi-Alcofan, Dexa, Zurcal, Oplex, effervescent products, lozenges and Vitacid C.
Some pharmacists reject these offers and absorb the cost of destroying expired stock. Others agree to sell it at discounts reaching 75% or exchange it for goods they can sell profitably. Some actively seek buyers in pharmacy groups.
Pharmacist Hanaa Mohamed tells Zawia3 that distributors accept returns equivalent to only 1% of a pharmacy’s monthly purchases and require complete packaging. This encourages pharmacists to buy less to avoid losses. Some try to sell products approaching expiry as alternatives to medicines in high demand.
Expired products that cannot be sold may be thrown in the rubbish or passed to representatives who offer steeply discounted purchases or exchanges. Once outside the pharmacy, Hanaa warns, they can reach patients through illegal channels.
Pharmacies should obtain medicines from licensed sources such as authorised distributors. Hanaa says some instead buy from illegal warehouses and makeshift operations known locally as “under-the-stairs factories.”
Egypt’s pharmaceutical market contains around 17,000 products manufactured by approximately 170 factories. The original report cited price increases affecting around 400 products: 20–30% for treatments for chronic conditions and 30–50% for non-essential and seasonal medicines.
Auf estimated sales in 2024 at EGP 215 billion, compared with EGP 154.7 billion in 2023, an increase of approximately 39%, or about 40% when rounded. In earlier press statements, he anticipated EDA price increases for around 1,000 products over the whole of 2025.
The original article also cited estimates of 213,000 pharmacists working across 80,000 pharmacies. Reported ratios included one pharmacist per 438 people in Egypt, equivalent to approximately 23 per 10,000, compared with a cited international range of one per 1,100–1,600 people, approximately six to nine per 10,000. For pharmacies, the comparison was one per 1,261 people in Egypt against one per 3,500–5,000 internationally. These are figures attributed in the cited reporting; they are not presented here as a verified universal WHO staffing standard.
Regulatory action and obstacles to returns
Mahmoud Fouad, executive director of the Egyptian Center for the Right to Medicine, tells Zawia3 that expired medicines have posed a problem internationally since the 1970s. While many countries regulate safe disposal strictly, he argues that pharmaceutical companies’ influence helps perpetuate the problem in Egypt.
Companies may refuse returns because a box lacks some blister packs or the pharmacy has no official invoice, he says. Small pharmacies often buy from informal warehouses without invoices and consequently cannot deal directly with major distributors.
Fouad also alleges that some trading companies outside the pharmaceutical industry’s representative bodies close commercial registrations or suspend operations to evade tax, leaving pharmacists unable to contact them about expired stock. By contrast, he says, foreign and multinational companies take back their expired medicines. His centre estimated expired stock in Egypt’s market at EGP 500 million in 2019.
Fouad estimates that 15,000 of Egypt’s roughly 80,000 pharmacies are owned by people outside the profession or by people posing as pharmacists. He alleges that the drive for profit encourages dealings with networks buying expired medicines cheaply, transferring them to illegal workshops, replacing production dates and selling them back into pharmacies. Both pharmacists and consumers can be deceived.
Security reports describe periodic Interior Ministry raids on such workshops. Fouad attributes 13 deaths in 2022 to expired or falsified medicines; this is his account, and the investigation does not provide individual case records establishing those causes.
He recalls a woman who sent his centre photographs of medicines sold in a street market. A joint EDA and security investigation subsequently uncovered an organised trading network operating through market sellers, he says.
The EDA launched an initiative on September 25, 2024 to remove expired medicines from pharmacies and organise safe withdrawal from the market. It warned people against buying from untrusted sources or at prices differing from the official regulated price.
On February 28, 2025, the authority publicised the arrangements under Decision No. 47 of 2025. The original text of the decision is available from the Egyptian Drug Authority.
Article 2 required companies to accept their expired products back through the supply chain, including the smallest saleable units, within 90 days of the decision taking effect. Returns were to be sorted within 30 days of receipt, with compensation settled within 180 days of commencement.
Article 4 specified destruction within 40 days of receipt by manufacturers, or notification to importers and contract-manufacturing companies. Articles 5–7 linked compensation to the joint industry agreement, provided for referral of non-compliant companies to the central operations administration, and required regulated destruction under EDA inspection at the pharmaceutical institution’s expense.
Article 8 addressed returns after the initial deadline: an invoice was required and the product had to have six months of shelf life remaining when the return was requested. This concerns stock returned before expiry, not an expired medicine somehow retaining six months’ validity. The original article’s description of the decision conflated these points.
Keeping expired products out of circulation
Dr Eslam Annan, chief executive of Accsight for pharmaceutical and healthcare research and a lecturer in pharmacoeconomics and epidemiology at the pharmacy faculties of Ain Shams and Misr universities, stresses that storage conditions matter as well as expiry dates. Heat and poor storage can spoil medicines even before their printed expiry date.
He warns that expired medicines may lose effectiveness or undergo chemical changes. He singles out the risks of antibiotics and advises consumers to discard products when their expiry date passes. For opened eye drops and antibiotics, he says the shorter period stated in the product leaflet must also be followed: in some cases one or two weeks. Prepared injections should be referred to a pharmacist for disposal.
Annan advises damaging unwanted products before putting them in the rubbish. Disposal methods nevertheless depend on the product: readers should follow its specific instructions and seek a pharmacist’s advice. FDA guidance explains that expiry can compromise safety or potency, and ineffective antibiotics can fail to treat infections; medicine take-back is preferred where available. Household disposal is not a single method suitable for every medicine or injection.
Annan notes that shortages during 2024 reduced the amount of stock held, but did not eliminate expired products. While some companies retrieve expired medicines, charities have also begun collecting them from consumers and returning them to manufacturers for disposal, he says. The aim is to prevent illegal intermediaries obtaining them and passing them to falsification workshops.
Annan emphasises that consumers should not buy medicine from unofficial online sellers or unlicensed outlets.
Alongside the EDA’s withdrawal initiative and inspection campaigns targeting pharmacies, warehouses and unlicensed factories, experts call for measures addressing the problem at its roots. They want binding rules requiring companies to retrieve and safely dispose of expired stock, and greater public awareness of the risks of expired medicines and purchases from street markets or unregulated online sellers. Rising prices and economic hardship continue to push some patients towards those sources.
