ABIDJAN (Ivory Coast) • There's nothing covert about Roxy - a huge market in Abidjan selling counterfeit medicines, the scourge of Africa and the cause of around 100,000 deaths annually in the world's poorest continent.
Located in the bustling Adjame quarter of Ivory Coast's main city and commercial hub, the haven for fake medicines has been targeted time and again by the authorities and stockpiles burnt.
But it resurfaces every time. "The police hassle us but they themselves buy these medicines," said Ms Mariam, one of the many mainly illiterate vendors who hawk everything from antibiotics to anti-malaria treatments. "When we are harassed we always come to an arrangement with them to resume our activities," she said.
Ms Fatima, another hawker, said: "Many people come here with their prescriptions, even the owners of private clinics." She said there was a "syndicate" controlling the sector that held regular meetings to fix prices and supply levels.
Fake medicines cause some 100,000 deaths a year in Africa, according to the World Health Organisation (WHO). The illicit sector has a turnover of at least 10 per cent of the global pharmaceutical business, meaning that it earns tens of billions of dollars a year, Switzerland-based World Economic Forum estimates, adding that the figure has nearly tripled in five years.
"To sell fake medicines, you need a clientele. The ailing poor are more numerous in Africa than anywhere in the world," said Mr Marc Gentilini, an expert on infectious and tropical diseases and a former head of the French Red Cross.
WHO estimates that one out of 10 medicines in the world is fake but the figure can be as high as seven out of 10 in certain countries, especially in Africa.
The American Society of Tropical Medicine and Hygiene estimated in 2015 that 122,000 children under five died due to taking poor-quality anti-malarials in sub-Saharan Africa, which, along with antibiotics are the medicines most likely to be out-of-date or bad copies.
Interpol in August announced the seizure of 420 tonnes of counterfeit medicines in West Africa in a massive operation that involved about 1,000 officials in seven countries: Benin, Burkina Faso, Ivory Coast, Mali, Niger, Nigeria and Togo.
Ivorian authorities in May burnt 40 tonnes of fake medicines in Adjame, the biggest street market of counterfeit drugs in West Africa which accounts for 30 per cent of medicine sales in Ivory Coast.
Offenders remain largely unpunished worldwide and are mainly targeted for breaching intellectual property rights instead of being held responsible for hundreds of thousands of deaths, Paris-based International Institute of Research Against Counterfeit Medicine says.