{"id":18437,"date":"2024-09-21T14:53:34","date_gmt":"2024-09-21T12:53:34","guid":{"rendered":"https:\/\/zawia3.com\/?p=18437"},"modified":"2026-10-09T00:20:09","modified_gmt":"2026-10-08T22:20:09","slug":"pbm","status":"publish","type":"post","link":"https:\/\/zawia3.com\/en\/pbm\/","title":{"rendered":"Who Controls Egyptians’ Medicine? The Black Market Takes Centre Stage"},"content":{"rendered":"

For almost a year, Amany has had great difficulty finding medicine to treat low blood pressure, which she has been unable to do without for twenty years, as she suffers from severe dizziness, migraine, shortness of breath and sometimes fainting, as well as medicines to treat kidney stones and urinary tract infections. After a long and exhausting search through pharmacies, a pharmacist told her she could get both medicines for her from the black market, but their price would almost double.<\/p>\n

“Several months ago, when the low blood pressure medicine disappeared from pharmacies, a pharmacist gave me an alternative medicine, but it caused me annoying side effects such as a coldness running through my head and body, a feeling of numbness in the brain, and pins and needles all over my body. Even that alternative is no longer available, and at the same time the kidney medicine and the effervescent salts disappeared, and I can only find them on the black market,” Amany says.<\/p>\n

Faced with her symptoms, Amany turned to the black market as a regular customer, bearing the price difference of almost double. While searching on social media, she found groups on “Facebook” selling medicines in short supply on the black market, and dealt with one of their sellers, but after buying the medicines she discovered they were counterfeit, not genuine.<\/p>\n

Over the past two years, Mohamed noticed the gradual decline in the availability of insulin injections in pharmacies, until they disappeared completely in recent months. His mother, who has type 1 diabetes, needs insulin daily, which drove him to search constantly in pharmacies in the Faisal district of Giza, to no avail.<\/p>\n

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Mohamed says that during a visit to a pharmacy in the Maryoutiya area, one of the workers whispered to him that he could get “Tresiba” insulin through the black market at EGP 700 per pen, even though its official price does not exceed EGP 300. After a phone call with an unofficial supplier, the price rose to EGP 1,200, which pushed Mohamed to pay the amount for fear of his mother suffering health complications if she did not get the medicine, avoiding the long wait at the Al-Esaaf pharmacy.<\/p>\n<\/blockquote>\n

Mohamed was not the only one who suffered from this crisis; he himself faced difficulty finding an imported medicine to treat gastritis. The medicine, which cost EGP 40, disappeared from pharmacies, and the local alternative was not effective, which drove him to search black market groups on Facebook, where he had to buy it for EGP 280.<\/p>\n

Similarly, Enas, who suffers from familial Mediterranean fever, had to buy her medicines from the black market at prices up to three times the official price. Enas explains that she used to go to pharmacies looking for the medicine but was met with unofficial offers. She says: “When a pharmacy worker told me he could provide the missing medicine from the black market, I left him my number. Half an hour later, he called to offer the medicine at three times the official price. This kept happening, and it made me face pharmacists without a conscience.”<\/p>\n

Enas shared her experience of buying “colchicine”, used to treat inflammation, for which she paid EGP 120 for a strip that previously sold for only EGP 12. She points out that pharmacies may be stockpiling missing medicines to sell them on the black market at multiplied prices, exploiting patients’ urgent need for treatment.<\/p>\n

Recommended reading:<\/strong> Medicine Haemorrhage… The Dollar Shortage Threatens Egyptians’ Health<\/a><\/p>\n

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Counterfeiting and Expiry<\/h3>\n

Recently, the black market for counterfeit or expired medicines has spread noticeably, especially in light of the acute shortage of life-saving medicines and medicines for chronic diseases such as blood pressure, diabetes, kidney disease and cancer, in addition to antibiotics and fever reducers. Some pharmacists have become involved in this illegal trade, with these medicines promoted through groups on Facebook, allowing medicines unavailable in pharmacies to be sold at three to four times the official price.<\/p>\n

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Over the past year, dozens of medicine items<\/a> used to treat most chronic diseases disappeared, such as blood pressure, diabetes, heart, gallbladder, thyroid, kidney, stomach disorders, familial Mediterranean fever and cancer, in addition to nasal drops for infants and adults and a large number of cold and gynaecological medicines. Medicine shortages in the market range between 30 and 40%, including 15% of medicines that have no alternatives, according to media statements<\/a> by the head of the Chamber of Pharmaceutical Industry at the Federation of Egyptian Industries, Gamal El-Leithy, last February.<\/p>\n<\/blockquote>\n

Pharmacist Ola Abdel Moneim<\/strong>, author of the book “Doctor’s Use<\/a>“, tells Zawia3 about the time she had to deal with the black market for medicines on behalf of a woman with a negative blood type who needed an anti-antibody injection within hours of giving birth, an injection that has been in severe shortage in Egyptian medicine markets for several years. The woman turned to her for help, but the pharmacist could only find it with a black market medicine trader. She agreed with him on the price at which she would buy the injection, but was surprised that he was arrested before the delivery date for trading and selling counterfeit medicines.<\/p>\n

She says all the medicines currently in short supply are available on the black market, whether Egyptian or imported, but their origin and source are unreliable; some are counterfeit medicines that harm the patient’s health, and some are expired and repackaged in new packaging and sold at higher prices on the pretext that they are imported or unavailable local products, exploiting the patient’s need for them. She stresses that regulatory bodies have arrested a number of owners of medicine warehouses that monopolise medicines in short supply at pharmacies and sell them to pharmacists and patients without a discount, even though they obtain them from medicine factories at a discount of up to 30% or more.<\/p>\n

Ola, who opened her pharmacy in Assiut Governorate, southern Egypt, in 2004, believes that the black market for medicines began to flourish with the spread of the COVID-19 pandemic and the disappearance of some painkillers and a number of antibiotics, which then appeared on the black market. But she believes the current medicine shortage crisis is due to most medicine factories now exporting most of their production to Arab and African countries to obtain dollars, unconcerned with the fate and suffering of patients in Egypt. She points to a closed circle of company representatives who meet their required sales targets by selling the shortage items to warehouses, which exploit this and sell them to pharmacists without a discount, and the latter are forced to buy in order to fill prescriptions, which has left medicine distribution companies unable to reach these items. She points to large foreign and local entities benefiting from these conditions, and says that officials are involved with them and that workers in the medicine sector receive commissions from selling medicines on the black market.<\/p>\n

Recommended reading:<\/strong> Shortages of Medicines and Blood Bags Deepen the Suffering of Thalassaemia Patients in Egypt<\/a><\/p>\n

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Networks of Interests<\/h3>\n

Since pharmacist Hanaa Mohamed<\/strong>, founder of the Medicine Provision Initiative<\/a>, opened her pharmacy in Beni Suef Governorate in 2012, she has come up against the black market for medicines, but it was limited to certain medicine items sold at slightly higher prices. Now, she says, it monopolises many medicine items that are in high demand or in short supply due to technical reasons at the manufacturer, and it has become extremely fierce, raising medicine prices by up to 300%.<\/p>\n

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With the spread of the COVID-19 pandemic and the black market flourishing for medicines that ran short in pharmacies due to high demand, Hanaa thought of launching a smartphone application to help patients easily find medicines in pharmacies across Egypt and offer them medical consultations, and to help pharmacists find missing medicines, closing the door on the black market. She launched the “Hatlaqi Dawak<\/a>” (You Will Find Your Medicine) application in October 2020, but came up against challenges related to a lack of resources and a large network of beneficiaries of the black market, which has turned into a trade worth millions of pounds controlled by market sharks, according to her information.<\/p>\n<\/blockquote>\n

Hanaa considers that the black market originates in corruption networks that start with employees at pharmaceutical companies and extend to medicine warehouses and distribution companies, reaching pharmacies, which takes medicine out of its natural path and pushes it onto the black market to be traded informally. She says pharmacists, like patients, are harmed by it, and that amid medicine shortages, the pharmacist has no option but to tell the patient the medicine is unavailable or to bring it from the black market and risk his pharmacy facing a legal problem or the customer suspecting him and accusing him of profiteering and greed.<\/p>\n

The young pharmacist says the crisis has extended from medicine items to all their alternatives, and is no longer limited to cancer and chronic disease medicines but includes fever reducers for children and antibiotics. Pharmacies are also losing money because of the gap between the old price at which they sell the medicine and the new price at which they buy it. In addition to black market traders monopolising some medicine items, she attributes part of the medicine shortage crisis to the smuggling of large quantities to neighbouring countries suffering from wars and conflicts.<\/p>\n

“There is no control over medicine prices on the black market. There is an injection to treat cancer that costs EGP 240, and its price has reached EGP 6,000 on the black market, and another injection that costs EGP 21.5 has reached EGP 150. There are people who have built large fortunes from the medicine black market, and the bigger disaster is that some of these medicines are counterfeit and can deceive the pharmacist himself and then cause a disaster for the patient. In my case, someone tried to sell me large quantities of a medicine in short supply, and when I made calls to my contacts, I discovered he owned an unlicensed factory manufacturing counterfeit medicines,” Hanaa says.<\/p>\n

In January 2022, Hanaa launched the Medicine Provision Initiative to provide missing medicines to cancer patients and critical cases free of charge or at reduced prices, in cooperation with pharmacists and donors in various governorates of Egypt, after she personally experienced the suffering of patients and their families during her attempts over a full year to obtain cancer medicines for her sick father before his death.<\/p>\n

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Rising Medicine Exports<\/h3>\n

According to the Egyptian Drug Authority, Egyptian exports of medicines and medical supplies reached<\/a> about USD 1.1 billion in 2023. According to the document<\/a> on the most prominent strategic directions for the Egyptian economy for the period 2024 to 2030, issued by the Egyptian Cabinet in January 2024, Egypt aims to grow its medicine exports to about USD 5 billion by 2030.<\/p>\n

There are 17,000 medicines circulating in the Egyptian medicine market, including 1,000 items that are the most widely traded and well known. The Pharmaceutical Division had announced<\/a> an increase in the prices of medicinal products at the end of last July, with increases ranging between 20 and 25%.<\/p>\n

Egypt has about 176 medicine factories, according to a report<\/a> issued by the Egyptian Drug Authority. The crises in the medicine sector come despite Egypt launching a strategy to localise the pharmaceutical industry, which aims to consolidate local manufacturing of medicines.<\/p>\n

Despite the medicine shortage crisis the country is suffering, medicine sales in Egypt rose to about EGP 130 billion in the first eight months of 2024, an increase of more than 45% compared with the same period last year, when medicine sales were worth about EGP 88.5 billion, according to<\/a> the Pharmaceutical Division of the Federation of Chambers of Commerce.<\/p>\n

Recommended reading:<\/strong> The Shortage of Psychiatric Medicines in Egypt: A Daily Struggle for Survival<\/a><\/p>\n

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Of Doubtful Origin<\/h3>\n

Ahmed Abou Doma<\/strong>, a member of the Pharmacists Syndicate council, explains to Zawia3 that Egyptian law regulates the circulation and sale of medicines and restricts their sale to pharmacies licensed by the Egyptian Drug Authority and the Ministry of Health, to ensure the validity of these medicines and their suitability for safe use, as the pharmacy is their only source, is inspected periodically by inspectors of the Egyptian Drug Authority, and is the only party entitled to deal with legitimate medicine manufacturers and distribution companies.<\/p>\n

Abou Doma considers that advertising medicines, circulating them and buying and selling them through social media pages are acts criminalised by law, and that the matter has developed into brokers who collect these medicines and trade in them. He explains that the danger lies in not knowing their source and in many of them being counterfeit or expired medicines repackaged in new containers, or medicines that entered the country illegally and did not obtain a registration number from the Egyptian Drug Authority or the Egyptian Ministry of Health, making it impossible to know their source and whether they conform to specifications.<\/p>\n

The member of the Pharmacists Syndicate council reveals that manufacturers or medicine distribution companies whose products are on the shortage list in the Egyptian medicine market say these products are not currently on their lists, while they are available on WhatsApp and Facebook groups. He questions their source, their validity for use, whether they are genuine or counterfeit, and how they are available in such quantities amid the shortages the Egyptian medicine market suffers from, stressing the need to raise citizens’ awareness to obtain their medicine from reliable sources.<\/p>\n

He stresses that a pharmacist resorting to the black market is acting illegally, which may backfire on him and expose him to problems such as defamation, a complaint within the syndicate, prosecution and the loss of his pharmacy licence, since he is not qualified to distinguish counterfeit items from genuine ones, as medicine counterfeiting has turned into a systematic international industry.<\/p>\n

Karim Karam<\/strong>, head of the medicine file at the Egyptian Center for the Right to Medicine, believes that the black market for medicines began spreading two years ago with the emergence of the medicine shortage crisis, which has worsened over the last six months and extended to alternatives, because most medicine factories export the majority of their production abroad to compensate for the shortage of foreign currency needed to import the raw material and the inactive ingredients used in manufacturing medicines.<\/p>\n

“The crisis worsened, so the Drug Authority resorted to a temporary solution of providing pharmaceutical companies’ production at Al-Esaaf pharmacies across the country, but it is natural for any shortage to create a black market, or what they have come to call ‘over price’, and to lead to monopoly. The solution lies in providing dollars, increasing medicine production and distributing it to distribution companies,” Karam says.<\/p>\n

The head of the medicine file stresses that selling medicines on online platforms is criminalised by law and exposes the seller to a fine of up to EGP 10,000, and that these medicines are of unreliable validity, are often counterfeit and cause damage to the kidneys and liver. He points to a trade in recycling expired medicines, which are repackaged and promoted via social media, while imported medicines shipped from abroad must come with their bill of lading and medical prescription. He explains that the Drug Authority recently established a private treatment department, which receives reports of violations involving the sale of unlicensed medicines online.<\/p>\n

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The Absence of Barcodes<\/h3>\n

Islam Anan<\/strong>, professor of health economics and epidemiology, explains that the black market for medicines flourishes when there are many shortages in medicine items, which is what happened in Egypt because of the compulsory pricing<\/a> set by the Drug Authority, with manufacturers forced to submit their papers and wait until the authority approves the new price, while the government often refused or proposed another price. He points out that some medicines were priced at a dollar exchange rate of EGP 30, others at EGP 40, and others at EGP 50, under the quota system applied with pharmaceutical companies, which allows them a certain percentage at the new price, because Egypt relies in medicine pricing on what is known as reference pricing, which requires the price of a medicine in Egypt to be lower than that of the same product the company makes in all other countries. He notes that while Egypt produces about 90% of its medicine, the primary raw materials are imported, so the rise in the dollar exchange rate was reflected in production costs.<\/p>\n

He points out that the absence of a barcode<\/a>, an optical representation of computer-readable data such as numbers and letters, to track production chains and the path of a medicine box from the factory to the pharmacy, and the failure to set a permitted storage period and penalise medicine warehouses that violate it, are among the reasons that have helped the black market for medicines exist, in addition to medicines not authorised by the Egyptian Drug Authority that are smuggled across border crossings, and genuine medicines brought from abroad with incorrect storage methods that may affect their effectiveness and validity. He explains that the Drug Authority focuses its efforts on confronting counterfeit medicines manufactured in unlicensed factories, in which the active ingredient is lower or absent altogether, and which are traded on the black market.<\/p>\n

The professor of health economics expects a breakthrough in the medicine crisis soon, at the beginning of next November and before the end of 2024, due to the entry of primary raw materials into Egypt this September and the approaching resolution of the problem of fair medicine pricing, and says that as soon as medicines are available in pharmacies, the black market will begin to disappear, especially if judicial enforcement powers are activated to confront medicine smugglers, monopolists and counterfeiters.<\/p>\n

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The Egyptian Drug Authority had launched the unified procurement initiative<\/a> for inactive raw materials on 4 September to ensure the stability of medicine supplies and localise 280 inactive materials, announcing the start of localising 30 inactive materials that represent more than 60% of the import bill for inactive raw materials in the pharmaceutical industry, with the aim of reducing the import bill for those materials, which amounted to USD 100 million annually.<\/p>\n<\/blockquote>\n

While some experts in Egypt’s pharmaceutical sector, including Islam Anan, expect a breakthrough in the medicine shortage crisis soon, Amany, Mohamed, Enas and other patients in Egypt will be victims of black market greed and the risks of counterfeit or expired medicines, and will continue to bear additional financial burdens, adding a new chapter to their daily suffering amid the repercussions of the economic crisis.<\/p>\n","protected":false},"excerpt":{"rendered":"

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