Black market for medicines thrives as public healthcare deteriorates

President Dr. Mohamed Muizzu came to power promising accessible, high-quality healthcare and reliable access to essential medicines for all Maldivians. These pledges raised public hopes, particularly as he placed strong emphasis on improving the quality of medicine and service delivery upon taking office.

However, under the current administration, healthcare services have rapidly declined to alarming levels. Accessing Aasandha, once a widely available and reliable service, has now become an administrative ordeal. Citizens often find themselves compelled to appeal to government officials simply to access basic entitlements. The process for receiving Aasandha support for overseas treatment has become equally burdensome, adding mental and financial stress to patients already in vulnerable situations.

At the same time, the availability of medicines in local pharmacies has sharply decreased. In the capital Malé City and across outlying islands, essential drugs have remained out of stock for extended periods. As a result, individuals are increasingly forced to import medicines independently. In the islands, private individuals have begun running small-scale medicine import businesses, filling the vacuum left by the State Trading Organization (STO).

The consequences of this failure are now stark. Many do not have the means to source medicines from abroad, and those who can often face delays and complications. In desperate circumstances, patients are left with no option but to turn to the black market, where medicines are now being sold much like foreign currency. This underground trade has grown rapidly, and it would not be an overstatement to say it has become one of the most in-demand and profitable businesses in the country today.

Further complicating the situation, reports indicate that STO has ceased importing medicines through VIRA forms. Patients have reported being informed that medicines must now be brought in through alternative pharmacies, with the National Social Protection Agency (NSPA) offering to cover costs, though this too is subject to approval and delay.

NSPA has acknowledged that, in certain cases, they are allowing payments through alternate channels. However, no detailed explanation has been provided, leaving patients uncertain about the process. Even when submitting VIRA forms, there is now no guarantee of timely access to medication. Patients must endure a lengthy waiting period while NSPA reviews, evaluates, and decides on each case. If approved, individuals are then forced to personally manage the import process and later seek reimbursement, further increasing their burden.

Although the government has repeatedly set deadlines for resolving the medicine crisis, none have materialized into effective solutions. Beyond announcing the creation of a company to import medicines, no meaningful action has been taken to ease the financial and logistical strain placed on citizens.

In the absence of timely intervention, the black market for medicines continues to grow unchecked, becoming a direct result of the administration’s failure to deliver on its core healthcare promises.