The proliferation of counterfeit and substandard medicines remains a critical public health challenge in West Africa, driven by fragmented pharmaceutical supply chains, weak traceability mechanisms, and limited real-time oversight, these vulnerabilities undermine drug safety, erode public trust, and impose significant economic and health burdens across the region, this study investigates the potential of integrating blockchain and Internet of Things (IoT) technologies to enhance traceability, data integrity, and security within pharmaceutical logistics, drawing on supply chain management theory and digital trust frameworks, the research proposes a blockchain-loT-enabled framework designed to prevent counterfeit drug infiltration from manufacturing through distribution and retail stages, using a design-oriented methodology supported by stakeholder insights and secondary regulatory data, the study examines how lot sensors can provide real-time of drug movement and storage conditions, while blockchain ensures immutable, transparent, and monitoring auditable records of pharmaceutical transactions, the findings demonstrate that the proposed framework significantly improves end-to-end visibility, strengthens accountability among supply chain actors, and enhances regulatory oversight, even within infrastructural and governance constraints common in West African contexts, the study contributes to the growing body of literature on digital supply chain security by offering a region-specific, policy-aligned framework with practical relevance for regulators, pharmaceutical manufacturers, and logistics providers, it further provides actionable recommendations for phased implementation and cross-border collaboration aimed at improving medicine safety and public health outcomes in West Africa.