The article examines a number of key problems in the fight against illicit medicines trafficking in Russia in the context of the COVID-19 pandemic and the development of a set of organizational and legal measures to increase the effectiveness of such a fight. The author concludes that the scale and severity of the various consequences caused by the COVID-19 pandemic are, to a certain extent, due to imperfect state control over the shadow pharmaceutical sector. In particular, many standard measures of government response to drug trafficking are not effective enough to ensure reliable protection of the population from the negative impact of illegal circulation of counterfeit, substandard, unregistered, counterfeit drugs.The measures proposed by the author are aimed at improving the efficiency of the system for preventing drug trafficking not only in relation to the modern conditions of the COVID-19 pandemic, but also designed to ensure state control over the production and circulation of drugs in any emergency conditions.