Swaziland is one of three remaining countries in the Southern Africa Development Community Region that do not have adequate regulatory and legislative frameworks to control the use, importation, manufacturing, and exportation of medicines. This is in the face of increased incidence of counterfeit medicines in the region; up to 25% of marketed medicines are substandard, and this is up to 64% for antimalarial medicines, according to a study conducted in 2011. Use of counterfeit and substandard medicines increases the burden of disease because of therapeutic failure, exacerbation of disease, and resistance to medicines. Swaziland’s weakness in medicines regulation and limited regulatory enforcement is also exploited by those smuggling prohibited and counterfeit medicines into neighboring countries.