Tramadol is a synthetic opioid that has been on the market since 1977. The independent intergovernmental control organ for the implementation of the United Nations drug conventions, the International Narcotics Control Board (INCB), has not seen it fit to regulate Tramadol. This is because the Expert Committee on Drug Dependence of the WHO still insists Tramadol is of low abuse potential. However, the drug is the cause of rampant addiction across my home country Ghana and other countries in Africa and Asia. In 2015 alone, Egypt reported 100,000 cases. Without the oversight of the INCB, there’s no cap on production and no limit or tracking for exports. That is why manufacturers of generic drugs in places like India and China have been able to flood the market in Africa and Asia with the drug. The argument that, adding Tramadol to the list of controlled substances would make it more expensive for patients in the Third World is now invalid. The cost of obtaining it for cancer and post-surgical patients will be a much lesser evil than the scourge of rampant Tramadol addiction. The INCB needs to regulate Tramadol immediately before a bad problem gets much worse.