
SA faces rising trend of fake drugs as law enforcement battles to curb illicit sales
While such medication poses a risk to consumer health, the report notes that laws in SA cannot deal with the problem effectively.
According to the Tracit, SA ranks 60th out of 158 countries in effectiveness in combating illicit trade, costing the country an estimated 10% of its GDP.
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The sale of counterfeit pharmaceutical products from online platforms and vendors has been growing in popularity as more SA consumers try to source cheaper versions of scheduled medications such as Ozempic, a medication for diabetes that is also widely used for weight loss.
The trend has taken root as regulatory gaps make it difficult for law enforcement to stop illegal sales, according to an independent report from the Transnational Alliance to Combat Illicit Trade (Tracit), which was released this week with Business Unity South Africa (BUSA). Tracit is an independent NPO that aims to combat illicit trade globally.
The report, titled SA's fight against illicit trade: A strategic view, found that SA's current regulations were not equipped to hold third-party platforms accountable. Illicit sales also posed a risk to consumers' health and safety, including strokes and high blood pressure, the report said.
According to the Tracit report, the popularity of counterfeit medication and pharmaceutical products, both online and in the informal economy, were driven by factors including weak trade enforcement at borders, more consumers seeking cheaper alternatives, a lack of public awareness around counterfeit goods, and a lack of capacity for the courts and law enforcement to hold guilty parties and companies accountable.
Although South Africa's pharmaceutical regulatory framework meets international standards, a lack of a strategic framework and clear enforcement responsibilities leaves the system vulnerable to counterfeit infiltration. Efforts to mitigate these risks must focus on strengthening enforcement mechanisms, modernising regulations, and closing gaps in the pharmaceutical value chain to protect public health and safety.
SA's fight against illicit trade: A strategic review
Health bodies such as the South African Health Products Regulatory Authority (SAHPRA) had already raised the alarm over counterfeit Ozempic-like medication or Glucagon-like Peptide-1 (GLP-1) products last year, the report said.
Online platform weaknesses
The report also found that the growth in online platforms had led to more hotspots for the illicit trade of vapes and cigarettes.
Looking at SA's online platforms, Tracit said: 'Key deficiencies [relating to online platforms in SA] include inadequate regulations establishing platform liability for third-party illicit sales, insufficient transparency measures such as seller verification, limited proactive risk management by online marketplaces, and weak consumer recourse mechanisms […]
'Existing frameworks, including the Medicines and Related Substances Act, have not sufficiently evolved to address digital commerce, resulting in critical vulnerabilities.'
Tracit found that SA had been particularly vulnerable to illicit trade, ranking 60th out of 158 countries on its 2025 Illicit Trade Index. Among the top performers on the index, which indicates how capable countries are able to fight illicit trade, are Denmark, followed by the US, Finland, and Germany.
While SA scored above the global average and landed at 52.4 out of 100 in Africa, the index found that supply chain weaknesses, corruption, and the prevalence of illicit trade in cigarettes, alcohol and pharmaceutical products had hampered its ability to achieve a higher score.
The report also found deficiencies in SA's postal and parcel delivery service systems, saying that better regulations were needed to combat smuggling through international and domestic mailing systems.
Speaking at the report's launch, Tracit director Esteban Guidici said that modern illicit trade was often facilitated through small parcels. Guidici said reports from the Consumer Goods Council found that SA lost 10% of its GDP every year due to counterfeit goods and illicit trade.
'[Like all countries], South Africa is grappling with national post [offices] and private couriers. It is flooded with them, and all the illicit goods are inside because of a lack of controls. When it comes to pharmaceutical products, [these are] often sent through small parcels to avoid detection.'
Meanwhile, other recommendations from Tracit included establishing a public-private Interagency Anti-Illicit Trade Coordinator with BUSA and BLSA, to combat illicit trade locally, including a Pharma Crime team.
The coordinator, which will form part of the national government, would aim to raise awareness of illicit trade, provide financial resources to law enforcement, and enforce more aggressive anti-illicit trade regulations.
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