Illicit trade in goods that displace normally legal goods is an extensive global problem, which carries considerable development risks and losses for developing countries. Focusing on pharmaceuticals, agrochemicals and consumer goods (which in itself consists of a broad range of goods), this case study reviews the example of Ghana to illustrate this problem, although it is a challenge afflicting all West African countries. This paper highlights the magnitude and significance of the problem. It also reveals the actors involved, with a view to identify the drivers and interests behind the trade, and their developmental impacts. Although the case study focuses primarily on three kinds of goods in a single country, the analysis further aims to identify common causal factors that can be extrapolated across the counterfeit, pirated and substandard trade in the wider region with a view to inform the development of prospective policy recommendations.