Since the collapse of Somalia’s central government in 1991, the country’s pharmaceutical sector has operated without meaningful regulation. Nearly all medicines are imported, but weak enforcement allows expired, counterfeit, and unsafe drugs to enter the market. The Ministry of Health lacks the capacity to monitor imports or enforce existing laws, leaving pharmacies and distributors free to sell potentially dangerous products.Prescription drugs, including addictive painkillers like Tramadol, are often sold without prescriptions. Abuse of such drugs is linked to rising crime, while overuse of antibiotics is accelerating the spread of antibiotic‑resistant bacteria. Many medicines arrive with foreign‑language labels that most Somalis cannot read, increasing the risk of misuse or dangerous drug interactions. Male enhancement products, widely available despite health concerns, have been linked to deaths and serious cardiovascular issues. The combination of public demand, lack of regulation, and poor consumer awareness compounds the problem.