Abortion pills a ‘gold mine’ for black market dealers

Despite being kept under “lock and key” at state health facilities and private pharmacies, abortion medication is finding its way onto Namibia’s black market, raising serious questions about internal controls, growing demand and the risks faced by women turning to medically unsupervised procedures.

Police confiscated at least 16 abortion pills in March alone.

Yet behind these figures lies a largely hidden network, one allegedly involving stock diversions from within the health system, informal dealers operating across regions, and medically risky procedures carried out beyond the reach of formal care.

In response to questions from Namibian Sun, the health ministry confirmed that misoprostol, which is frequently used for off-label medical abortions, is registered to be used for specific obstetric and gynaecological conditions.

As a result, it is classified as a strictly controlled medicine, stored under tight security and only used in designated medical settings.

Its presence on the informal market, however, has raised red flags.

“The presence of such medication outside regulated channels is a serious concern,” the ministry said, adding that cases involving suspected diversion or theft have in some instances escalated beyond internal disciplinary processes to the Anti-Corruption Commission (ACC) and the Namibian Police.

Gaps in oversight

Namibian Sun also spoke to a pharmacist working in the private sector this week who, on condition of anonymity, described a troubling pattern of stock going missing even within private pharmaceutical settings.

“These drugs don’t just walk out on their own,” the source said. “In some cases, staff manipulate stock records or delay logging inventory to cover shortages," the individual claimed.

The pharmacist alleged that incidents of missing stock are not uncommon.

“We’ve had situations where pills go missing and only later an internal probe points to someone on the inside," he claimed.

"In one case, a staff member was caught trying to take abortion-related medication and was dismissed.”

According to the source, gaps in oversight can be exploited, allowing medication to quietly enter the illicit market.

The economics of desperation

Once outside formal channels, the pills feed into an underground economy that operates with its own pricing, supply chains and service providers.

Through its investigation, Namibian Sun met with a black market dealer.

Paolo Kanana (not his real name) detailed how the trade functions using abortion pills such as mifepristone and misoprostol. He said prices vary depending on how far a pregnancy has progressed.

“For one to two weeks, you’re looking at between N$500 and N$800,” he said. “Three to four weeks can go from N$1 500 up to N$2 500.” In more advanced cases, prices can reach as high as N$3 500, “labour included”.

“It all depends on demand and availability,” he said. “When pills are scarce, prices skyrocket, especially if the pregnancy is over a month or two. That’s when people are desperate.”

Kanana described a steady flow of business, saying more than 20 pills can be sold within a single month. “In the city, that’s where the gold is,” he added.

The Erongo and northern regions are among the most active markets due to consistent demand, he told Namibian Sun.

Kanana explained that pills typically pass through several hands before reaching the buyer. “Most of us don’t actually perform the procedure,” he said. “We connect clients to someone else.” These third parties, he claimed, are often individuals with some level of medical training. “In many cases, they are nurses, sometimes even students, because they are easier to approach and often need the money.”

For early-stage pregnancies, Kanana said two pills are usually used. “One is placed under the tongue and the other is inserted vaginally. After about two hours, the process starts.” For pregnancies further along, more pills are required. “The bigger it is, the more pills you need," he said, ominously adding, "… and the higher the risk,” he said.

Policy and peril

Health authorities warn that the llegal abortion network can have severe consequences.

While precise figures on unsafe abortions are difficult to isolate, cases are often recorded under a broad category of abortion-related complications, including incomplete and septic abortions.

An enquiry into stillbirths and neonatal deaths covering April 2021 to March 2024 shows abortive outcomes account for about 12% of maternal deaths in Namibia.

Despite the legal restrictions under the Abortion and Sterilisation Act of 1975, which allows termination only under limited circumstances, demand appears to persist, pushing some women toward unsafe alternatives.

Out Right Namibia director Agapitus Hausiku said the issue cannot be reduced to a simple legal debate. He argued that the focus should be on prevention, access to information and ensuring that individuals are not forced into risky decisions.

“For me, it is about making it safe for an individual who finds themselves in that situation to make the correct decision without risking their life,” he said, adding that gaps in education and support continue to leave many, particularly young women, vulnerable.

The health ministry says it has intensified collaboration with law enforcement and regulatory bodies, including the ACC, police and the Namibia Medicines Regulatory Council, to clamp down on the illegal sale of prescription medication, treating it not only as a health issue but also as a growing criminal concern.

At the same time, officials continue to warn that unsafe abortion practices, particularly those involving medication obtained outside the formal system, carry serious risks, including severe bleeding, infection and death.

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