Supply Chain Integrity in Africa: Quality Control at All Stages of the Supply Chain for Better Control.
Medicines, and health products more broadly, are undeniably an essential part of patient care. The availability of effective and quality health products is a paramount concern for any health system, whether in developed, low-income, or middle-income countries. This requires a robust supply chain. However, the products involved in this supply chain must be of good quality at the outset and remain so throughout the chain until they reach the final consumer.
The WHO, echoed by several other authors, confirms that medicines can only save lives and prevent acute and chronic conditions if they are safe, effective, of good quality, and used rationally.
Yet, a phenomenon that has been expanding for decades undermines this need for safe medicines: the proliferation of substandard and falsified medicals products, referred to in this document as SF. Globally, the issue of SF is well-documented.
The WHO estimates that 10% of medicines worldwide are falsified or of substandard quality. These products now represent one of the most serious threats to public health on the African continent. A systematic review of articles addressing this issue in Africa reveals that 1639/7508 medicines failed at least one quality test in these studies and are thus declared falsified/substandard. All this data reflects the persistent and pervasive nature of the SF phenomenon.
Long approached from the angle of crime or fraud (Lomé Initiative), the issue of SF must now be understood as the result of systemic vulnerability. SF do not enter markets by chance; rather, this is due to structural weaknesses in supply chains, whether chronic stockouts, unregulated parallel circuits, weak quality control capacities, or insufficient enforcement of existing regulatory frameworks. In this context, the pharmaceutical supply chain can no longer be considered a simple logistical mechanism to ensure product availability.
On the contrary, it constitutes a strategic lever in the fight against SF. A resilient supply chain, integrating quality control mechanisms for prevention, detection, and response, not only reduces the entry of falsified medicines but also quickly identifies non-compliant products before they reach patients.
