The Invisible Witness: How forensic pharmacy holds the key to justice in Ghana

In a crowded courtroom in Accra, a prosecutor holds up a small plastic sachet containing a brownish powder. The police officer who conducted the arrest testifies that the substance tested positive for heroin using a field kit. The accused, a young woman, insists it is nothing more than crushed paracetamol tablets she planned to sell at her chemical seller's shop.

The judge faces a troubling question: Who is telling the truth? Without a credible scientific answer, the case risks collapsing, the suspect may walk free, and public confidence in the justice system suffers another blow.

This scenario plays out with alarming frequency in Ghanaian courtrooms, yet few citizens understand that the solution lies not in better witness testimony but in the specialized work of a largely invisible profession: the forensic pharmacist. As Ghana grapples with the dual scourges of illicit drug trafficking and the proliferation of falsified medicines, forensic pharmacy has emerged as an indispensable pillar of both public health and criminal justice.

However, as experts have documented in both scholarly research and policy analyses, the field remains critically underdeveloped, under-resourced, and misunderstood by the very institutions that depend on its evidence.

Beyond the Autopsy: Defining Forensic Pharmacy

To the ordinary Ghanaian, forensic science is often associated exclusively with autopsies and the examination of dead bodies. As a comprehensive analysis published in the Encyclopedia of Forensic and Legal Medicine observes, this narrow perception overlooks the broader role of forensic medicine in examining living victims, assessing injuries, interpreting medical evidence, investigating malpractice, and supporting the justice system.

Forensic pharmacy, a specialized sub-discipline within this broader framework, focuses specifically on the chemical analysis of pharmaceutical substances, poisons, and narcotics to answer legal questions.

Forensic pharmacy operates at the intersection of pharmaceutical chemistry, toxicology, and the law. Its practitioners are trained pharmacists who apply their knowledge of drug composition, stability, metabolism, and pharmacology to legal contexts. Their work falls into several critical categories.

First, they conduct chemical analysis of suspected narcotics seized by law enforcement agencies, determining not merely whether a substance is present but precisely which compound, in what concentration, and whether it falls under controlled substance legislation.

Second, they analyse biological specimens such as blood, urine, and stomach contents to detect poisons, drugs, or alcohol in cases of suspected poisoning, drug-facilitated crimes, or driving under the influence. Third, they perform quality assessment of medicines seized from the supply chain to determine whether products are genuine, substandard, or falsified, a function with profound public health implications for a country where counterfeit medications remain a persistent threat.

The Hidden Epidemic: Substandard and Falsified Medicines

Perhaps the most urgent public health dimension of forensic pharmacy in Ghana concerns the quality of medicines available to ordinary citizens. The influx of substandard and falsified medicines represents a global public health challenge that bears heavily on developing countries. Research has estimated that approximately ten per cent of medical products in low- and middle-income countries are either substandard or falsified, with antimalarials and antibiotics being the most frequently reported categories.

A landmark study conducted by researchers affiliated with the University of Ghana and the Food and Drugs Authority examined the quality of artemether/lumefantrine tablets, a critical antimalarial medication, obtained from pharmacies and licensed chemical seller shops within the Accra metropolis. The findings were deeply concerning. Of the twenty-five batches analyzed, six failed confirmatory testing using high-performance liquid chromatography, the gold standard method for pharmaceutical quality assessment.

Among these failures, one contained more than one hundred ten per cent of the labelled active ingredient, two contained less than ninety per cent, and three contained no active ingredient whatsoever. In other words, patients taking these medications may have received doses that were dangerously excessive, therapeutically inadequate, or completely inert, contributing to treatment failure, the development of antimicrobial resistance, and loss of confidence in healthcare systems.

The study also revealed that combined screening methods using Minilab technology, colorimetry, and counterfeit drug indicators provided equivalent quality assessment profiles for ninety-two per cent of samples, suggesting that even without access to sophisticated confirmatory equipment, Ghana could significantly enhance its surveillance of medicine quality.

However, the fact that three of the failing samples contained no active ingredient whatsoever underscores the urgent need for robust forensic pharmaceutical analysis. Patients who believe they are receiving life-saving treatment may instead be swallowing chalk, starch, or other inert fillers while their condition deteriorates.

The Legal Framework: What Exists and What Is Missing

Forensic pharmacy in Ghana operates within an incomplete legal architecture. The Coroners Act of 1960 governs investigations into unexplained deaths, and the Criminal Procedure Code and Evidence Act recognize medical experts as essential witnesses whose professional opinions assist courts in determining guilt or innocence. However, these provisions were drafted long before modern forensic pharmaceutical techniques became central to criminal investigations, and they do not adequately address the specific requirements of drug analysis, chain of custody, or expert testimony in pharmaceutical matters.

The fragmentation of forensic governance in Ghana has been identified as a critical weakness by legal and forensic experts. As detailed in an analysis published in the Ghanaian Times, forensic science disciplines such as DNA profiling, fingerprints, ballistics, toxicology, digital forensics, trace evidence, and document examination are not classified as medical professions and therefore fall outside the mandate of the Medical and Dental Council.

Clinical forensics and pathology, by contrast, are branches of medicine and are already regulated under Ghana's medical regulatory system. This creates a troubling governance gap in which forensic pharmaceutical analysis, which sits squarely between medicine and chemistry, lacks clear regulatory oversight.

The consequences of this fragmented governance are predictable and deeply concerning. Investigations may suffer contamination or inconsistent procedures because different institutions apply different standards. Chain of custody procedures vary across agencies, creating legal vulnerabilities that defense lawyers can exploit to challenge evidence admissibility.

Expert testimony varies in reliability, contributing to the collapse of serious cases on technical rather than factual grounds. Perhaps most troublingly, sensitive biometric and DNA data generated from biological samples in drug cases are managed without a national privacy framework, placing citizens at risk of data misuse.

The Training Gap: A System Without Specialists

One of the most significant barriers to the development of forensic pharmacy in Ghana is the absence of formalized training pathways. As documented in the forensic medicine literature, forensic medicine is not fully taught as a dedicated specialty in Ghanaian medical schools, and most doctors graduate without adequate forensic training. This deficiency is even more pronounced in pharmaceutical sciences, where no university currently offers a dedicated postgraduate programme in forensic pharmacy.

The consequences of this training gap extend far beyond the laboratory. When doctors and pharmacists without specialized, forensic training are called to testify in court, they may not fully understand legal procedures, evidence standards, or the specific requirements for expert testimony.

A poorly documented or incorrectly analyzed pharmaceutical exhibit can lead to wrongful acquittal or, equally concerning, wrongful conviction. The forensic pharmacist must possess not only pharmaceutical knowledge but also legal understanding, proper documentation skills, and courtroom confidence, competencies that cannot be acquired through generalist training alone.

The lack of formal training also perpetuates a vicious cycle.

Without qualified forensic pharmacists, institutions lack the capacity to train the next generation of practitioners. Without a critical mass of specialists, there is insufficient demand to justify the establishment of dedicated training programmes. Breaking this cycle requires deliberate policy intervention, including the establishment of postgraduate programmes in forensic pharmaceutical sciences at Ghanaian universities and the creation of structured internship opportunities within existing forensic institutions.

Institutional Infrastructure: The Current Landscape

Despite these challenges, several institutions in Ghana contribute to forensic medicine and pharmaceutical analysis. These include the Ghana Police Hospital, the Ghana Police Forensic Crime Laboratory, teaching hospitals, the Ghana Prisons Service Hospitals, psychiatric hospitals, and the Ghana Standards Authority. However, these bodies operate under separate mandates without a unified statutory framework that governs the scientific standards they must meet, the accreditation they require, or the ethical safeguards they must uphold.

The Ghana Standards Authority houses the Department for Drugs, Cosmetics, Forensic and Toxicology Labs, which plays a central role in pharmaceutical quality assessment. Similarly, the Food and Drugs Authority operate laboratory services that support medicine regulation.

However, these institutions face persistent challenges related to equipment maintenance, reagent supply, and staff retention. When expensive analytical instruments such as liquid chromatography-tandem mass spectrometry machines break down, acquiring spare parts and service contracts can take months, leading to crippling backlogs of cases. Suspects may remain in pre-trial detention for extended periods simply awaiting laboratory confirmation of whether a seized substance is an illegal narcotic or a legal pharmaceutical.

A Comparative Perspective: Learning from Zambia

Ghana need not invent solutions to these challenges from scratch. Regional neighbors’ have confronted similar fragmentation and developed legislative responses from which Ghana can learn. In 2020, Zambia enacted the National Forensic Act and established a National Forensic Science Regulator under the Ministry responsible for Home Affairs. Zambia had faced similar challenges, with forensic sciences operating without statutory governance while forensic pathology remained governed by medical law.

The Zambian model rests on four practical governance pillars that offer important lessons for Ghana. First, the legislation separates regulation from service delivery, preventing conflicts of interest in which the same institution both produces evidence and certifies its validity. Second, it licenses and accredits forensic providers under national standards, ensuring baseline quality across all forensic service providers.

Third, it defines scientific, ethical, and privacy requirements across all forensic disciplines, including pharmaceutical analysis and toxicology. Fourth, it introduces strong penalties for tampering with evidence or misusing forensic information, creating deterrence against misconduct.

Importantly, Zambia did not disrupt existing institutions. The National Forensic Science and Biometrics Department, the Office of the State Forensic Pathologist, and other specialized bodies continue to perform forensic work. The regulator governs standards, accreditation, ethics, and scientific validity, not daily operations. This approach strengthens credibility, protects scientific integrity, and provides a governance structure suitable for Ghana's administrative and legal environment.

The Human Cost: Why This Matters for Ordinary Ghanaians

Behind the policy discussions and technical debates lie real human consequences that demand urgent attention. Consider the victim of sexual assault who reports to a hospital only to be examined by a doctor lacking forensic training. The resulting medical report may be incomplete or poorly documented, weakening the case in court and sometimes allowing perpetrators to go free. For the ordinary Ghanaian victim, this means justice may be delayed or denied, not because the crime did not occur, but because the medical and pharmaceutical evidence was not properly handled or analyzed.

Consider the patient who purchases antimalarial medication from a licensed chemical seller, trusting that the product will cure their illness. If that medication contains no active ingredient, as documented in the Accra study, the patient's condition worsens. They may develop severe malaria requiring hospitalization, incurring catastrophic health expenditures that push families into poverty. They may develop resistance to artemisinin-based therapies, reducing future treatment options. They may tragically die from a disease that should have been curable.

Consider the accused individual whose freedom hangs on the results of a drug test. If the chain of custody is broken, if the sample is contaminated, or if the analyst lacks proper training, the evidence may be excluded, not because the accused is innocent, but because the system failed to meet basic scientific standards. In such cases, justice is not served, regardless of the actual guilt or innocence of the accused.

The Path Forward: Recommendations for Action

Addressing these challenges requires coordinated action across multiple fronts. First, Ghana must establish a National Forensic Authority or Forensic Science Regulator, as recommended by forensic experts and legal scholars. Such a body would provide unified statutory governance, set national standards for forensic practice, accredit laboratories and practitioners, and ensure ethical safeguards across all forensic disciplines, including pharmaceutical analysis.

This authority should operate under the Ministry of the Interior to align with national security priorities while maintaining technical independence from operational agencies.

Second, Ghanaian universities, particularly the University of Ghana and Kwame Nkrumah University of Science and Technology, should establish postgraduate programmes in forensic pharmaceutical sciences. These programmes should train pharmacists not only in analytical chemistry but also in evidence law, chain of custody procedures, courtroom testimony, and quality management systems. Graduates of such programmes would form the cadre of specialist forensic pharmacists that Ghana urgently needs.

Third, the Food and Drugs Authority and Ghana Standards Authority require increased investment in analytical equipment, maintenance contracts, and reagent supplies to ensure continuous laboratory operations. Backlogs of drug testing cases must be cleared, and turnaround times must be reduced to prevent prolonged pre-trial detention. Regional laboratories should be established to decentralize forensic pharmaceutical services and improve access outside Accra.

Fourth, law enforcement agencies require structured training in evidence handling and chain of custody procedures. Police officers who seize suspected narcotics must understand how to properly package, seal, label, and store pharmaceutical evidence to prevent degradation and contamination. Without this foundational understanding, even the most sophisticated laboratory analysis may be rendered inadmissible due to procedural errors.

Fifth, public awareness of forensic pharmacy must increase. Courts, police, prosecutors, defence lawyers, and judges require education on the capabilities and limitations of forensic pharmaceutical analysis. Citizens must understand their rights regarding forensic evidence and the importance of preserving evidence in cases involving pharmaceutical crimes, poisonings, or drug-facilitated offences.

Conclusion: A National Necessity

Forensic and legal medicine is not merely about examining the dead, it is about protecting the living, defending the innocent, and ensuring justice prevails. In Ghana, although the discipline exists, it remains underdeveloped due to lack of training, limited awareness, and inadequate institutional structures.

For the ordinary Ghanaian, strengthening forensic pharmacy means faster justice, fairer trials, better protection of victims, and greater trust in the justice system.

The research evidence is clear. Substandard and falsified medicines are present on the Ghanaian market, with some products containing no active ingredient whatsoever. Narcotics cases depend on chemical analysis whose integrity can be compromised by procedural failures at any stage from seizure to court presentation. Poisoning victims may receive delayed or incorrect diagnoses because toxicological analysis is unavailable or inaccessible.

A strong forensic medicine system ensures that truth is guided not by suspicion or emotion, but by scientific evidence. As Ghana advances its justice and healthcare systems, forensic pharmacy must be recognized not as a luxury, but as a national necessity, one that safeguards truth, protects human dignity, and upholds justice for all. The question is no longer whether Ghana can afford to invest in forensic pharmacy, but whether Ghana can afford not to.