Johannesburg – South African border control officials have intercepted more than 1.7 million suspicious pharmaceutical-related products.
At the same time, the medicines regulator has received about 600 complaints this financial year involving allegedly illicit medicines and unauthorised sales channels.
According to officials at a pharmaceutical industry roundtable, the reported cases concern a trade operating through websites, WhatsApp groups, social media, gyms and wellness clinics.
The figures were disclosed at a Pharmaceutical Task Group (PTG) media roundtable in Sandton on Wednesday, 14 October, attended by medicines regulators, customs officials, professional councils and pharmaceutical companies.
The discussions focused on counterfeit and falsified medicines, unlawful distribution, medicine compounding and enforcement challenges.
Participants said suspect sellers were increasingly advertising products openly in digital spaces.
Daphney Fafudi, Senior Manager: Market Control at the South African Health Products Regulatory Authority (SAHPRA), said the regulator had received approximately 600 complaints during the current financial year,.
The complaints primarily involve informal, illegitimate, and falsified products sold through unauthorised channels.
“The cases we know about are only those that have been reported,” she cautioned.
“The concern is always the cases that are not reported and the products that continue circulating until harm occurs.”
The products under scrutiny include weight-loss medicines, including Novo’s blockbuster Ozempic, performance-enhancing substances, codeine-containing preparations, skin-lightening products and counterfeit HIV test kits.
Fafudi explained that substandard medicines are authorised products that fail to meet quality standards, while falsified medicines deliberately misrepresent their identity, composition or source.
Unauthorised medicines, meanwhile, have not undergone the required regulatory assessment.
These categories are distinct; suspicion does not prove every intercepted item is counterfeit.
“Patients often focus on whether a medicine works,” Fafudi added.
“But the real question is whether anyone knows what is in that product, whether it was manufactured correctly, whether it contains the correct ingredients, and whether it has been appropriately assessed and authorised.”
She linked those questions to the risks facing patients who obtain products outside authorised supply channels.
Fafudi insisted that an advertised medicine should not automatically be assumed to have been assessed or authorised.
Border Management Authority Commissioner and Chief Executive Officer Dr. Michael Masiapato reported that officials had intercepted more than 1.7 million suspicious pharmaceutical-related products through border operations.
He described medicines hidden in consignments declared as unrelated goods, as well as supplies entering via couriers, postal services, passenger luggage, and informal importation routes.
“We are seeing everything from slimming products and skin-lightening products to fake HIV test kits, unidentified pharmaceutical substances and other healthcare products entering through multiple channels,” Masiapato said.
Gene Ravele, Head of the South African Revenue Service’s Syndicated Tax and Customs Crimes Division, described electronic declarations, risk engines and intelligence-led inspections used to identify suspicious consignments before they reach consumers.
Ravele said high-risk shipments are referred for inspection and verification, allowing customs officials to investigate misdeclared and potentially unlawful goods.
Sara Norcross, Vice President and General Manager of Novo South Africa and a board member of the Innovative Pharmaceutical Association South Africa, said online visibility was encouraging misplaced consumer confidence.
“When medicines are openly advertised on websites, social media platforms and messaging services, people can begin to assume they are legitimate simply because they are visible,” she warned.
“Visibility should never be confused with legitimacy.”
Norcross said Novo South Africa had identified and reported 39 suspected unlawful medicine-related cases in 2026, most of which were linked to websites, social media platforms and WhatsApp channels.
The reports included suspected illicit sales, unauthorised distribution and activities involving compounding, wellness clinics and aesthetic facilities.
They were reports of suspected conduct, not findings of guilt.
“The majority of activity we’re seeing is no longer happening in back rooms,” she said.
“It’s happening online, in plain sight.”
She said the cases had been reported to relevant authorities; her figures were not presented as prosecutions or confirmed convictions.
Participants also singled out compounding amid demand for weight-loss treatments.
This practice permits a pharmacist to prepare a medicine for an individual patient’s needs when a suitable registered formulation is unavailable.
Tlala distinguished that individual service from making medicines in anticipation of wider demand, an activity he opposed when undertaken by pharmacies as small-scale manufacturers.
Vincent Tlala, Registrar and Chief Executive Officer of the South African Pharmacy Council, warned that pharmacies must not exploit compounding rules as a route into commercial manufacturing.
“What we are seeing in the market, and which we are against, is when pharmacies become small-scale manufacturers,” he said.
Fafudi was equally forceful: “There is a scourge of compounded products, especially in the area of weight-loss”.
The pharmacy council and SAHPRA are drafting updated minimum standards and guidance, expected early in 2027. Roundtable participants expressed concern that the standards might not be finalised before the six-month interim interdict in litigation involving iDexis expires. The outcome remains undecided.
Professional misconduct is another concern. Kwena Mabaso, Head of Complaints Handling and Investigation at the Health Professions Council of South Africa, explained that complaints may originate with patients, clinicians, regulators or the public. Serious cases can lead to suspension, disciplinary sanctions or removal from professional registers.
Yet successful action against illegal supply requires more than professional disciplinary proceedings.
Fafudi acknowledged SAHPRA’s limited enforcement powers.
“SAHPRA does not have arresting powers,” Fafudi said.
“We can investigate, seize products, issue recalls and open criminal cases, but successful prosecutions require collaboration with enforcement and prosecutorial authorities.”
The regulator is pursuing formal cooperation arrangements with the health professions and pharmacy councils to improve investigations involving practitioners and pharmacies and prevent referrals from reaching dead ends.
Fafudi said a proposed agreement between SAHPRA and the two councils was intended to strengthen coordination and information sharing.
Norcross rejected the suggestion that consumer education alone would resolve the problem.
“We cannot educate our way out of this challenge alone,” she said.
“Education must be matched by enforcement, accountability and visible action.”
Participants identified fragmented institutional responsibilities, limited specialist capacity and lengthy investigative processes as obstacles to enforcement.
The South African Police Service did not attend the roundtable, although organisers said it had committed to future discussions.
PTG chairperson Stavros Nicolaou warned that illicit medicine sales also damage the formal economy.
“Healthcare crime is both a patient-safety issue and an economic-crime issue,” he said, citing lost trust, weakened legitimate businesses and diverted economic activity.
His sharpest warning targeted institutional fragmentation: “Criminal networks collaborate.
“Those protecting patients must collaborate too.”
Nicolaou urged agencies responsible for medicine regulation, border controls and professional discipline to share information and act together rather than leave suspected offences caught between separate mandates.
The panel urged consumers to use licensed pharmacies and authorised healthcare professionals, avoid unverified social media sellers and report suspicious products to SAHPRA.
But Nicolaou placed the larger responsibility on institutions charged with enforcement.
“Healthcare crime does not stand still while systems deliberate,” he warned.
“The question is not whether South Africa has the right laws and authorities.
“The question is whether we can act quickly enough, consistently enough and visibly enough to prevent unlawful activity from becoming entrenched.”
The roundtable recommended that patients seek guidance from qualified healthcare professionals when uncertain about a medicine and report suspicious products to the regulator.
