Drug pilferage has been considered as one of the contributing factors for shortage of drugs not only in Malawi, but also in other African countries. A report from the United States President’s Malaria Initiative (PMI) highlighted some of the ways through which malaria drugs are trans-continentally diverted in Africa to include illegal diversions that would occur when a genuine pharmaceutical commodity approved and intended to be used in a specific country is illegally intercepted and sold in another country. Drug pilferage can also occur during transportation from the supplier or manufactures to the national warehouse such as the Central Medical Stores. The drugs can either be stolen from the warehouses or during transportation to the health facilities. Drugs can also be pilfered from pharmacies and drug stores within the health facilities. Furthermore, the Minister of Health, Dr Kumpalume, disclosed that Malawi loses about MK5 billion (about USD7 million) of the MK17 billion (about USD24 million) drug budget to theft. This policy brief therefore delves into the issue of drug pilferage and analyses policy options that could curb its continued persistence. It also makes recommendations based on this analysis.