In today's global marketplace, no pharmaceutical supply chain is immune to the risk of counterfeit pharmaceuticals. Preventing the infiltration of counterfeit pharmaceuticals into the legitimate pharmaceutical supply chains is an important issue of public health debate. It is an important public health issue because of patient welfare and expanding healthcare costs. As a result, pharmaceutical firms are under intense media and public scrutiny to secure their supply chains. Mitigating risk of counterfeit and compromised pharmaceuticals demands pharmaceutical supply chains that are secured and resilient. Although counterfeit and compromised pharmaceuticals are found in both developing and developed countries, they are more prevalent in Nigeria. To reverse this trend and close the weak links in the supply chains of legitimate pharmaceuticals requires developing effective partnerships and multilayered measures. Indeed, safeguarding the integrity of pharmaceuticals and their distribution is not only a matter of brand equity and corporate reputation protection, but also a matter of life and death.