South Africa’s pharmaceutical manufacturers are pressing law enforcement to act against the open sale of unregistered weight-loss medicines, warning that inaction is undermining both patient safety and investor confidence in the country’s regulatory system.
“Slam-dunk cases” sitting unprosecuted
Stavros Nicolaou, chair of the Pharmaceutical Task Group (PTG) and a senior executive at Aspen Pharmacare, says evidence of clear-cut illegal sales has already been handed to the South African Police Service and other authorities, yet prosecutions have been slow to follow. “Where there are slam-dunk cases, and evidence has been sent to the SA Police Service and others, we need to see action,” he said. The PTG is an umbrella body for South Africa’s pharmaceutical manufacturing associations, whose members collectively account for more than 80% of the medicines used in the country.
A “broken window” approach
Nicolaou is calling for authorities to pursue small-scale sellers alongside larger operators, drawing a comparison with the “broken window” policing strategy associated with former New York mayor Rudolph Giuliani, in which minor infractions are prosecuted to deter larger ones. Without visible enforcement, he warned, the public and healthcare providers may start to question the integrity of South Africa’s medicine regulatory system more broadly — a risk that extends well beyond the obesity-drug category.
Retatrutide sold “openly and brazenly”
The flashpoint is retatrutide, Eli Lilly’s experimental triple-hormone obesity drug, which has not been approved by any regulator anywhere in the world but is nonetheless being sold in South Africa by social media influencers, gym instructors and even hairdressers, according to Nicolaou. Retatrutide targets the GLP-1, GIP and glucagon hormone pathways, and a phase 3 trial published in The Lancet in September reported weight loss of up to 18.8% of body weight depending on dose — results strong enough to have fuelled a thriving global black market ahead of any formal approval. Eli Lilly has said it intends to seek US FDA approval for the drug in the first quarter of next year.
Aspen’s stake in a clean market
Aspen Pharmacare has a direct commercial interest in the outcome: it holds the agreement to promote and distribute Eli Lilly’s Mounjaro (tirzepatide) across South Africa and other Sub-Saharan African markets, and is separately pursuing the generic semaglutide opportunity opened up by Novo Nordisk’s patent expiry. A black market in unapproved and unregistered alternatives undercuts both that legitimate distribution business and the price-competition benefits generics are meant to deliver to patients.
What this means for patients
- Retatrutide is not registered or approved for sale anywhere, including South Africa — buying it from an influencer, gym instructor, hairdresser or unlicensed online seller carries real safety risk, since product quality, dosing and sourcing cannot be verified.
- Only SAHPRA-registered GLP-1/GIP medicines (such as approved semaglutide and tirzepatide products) have been through safety and quality review for the South African market.
- Industry is pushing for visible prosecutions, so patients may see more enforcement action and public warnings against unregistered sellers in the coming months.
- Anyone currently using an unregistered weight-loss product is encouraged to discuss safer, regulator-approved alternatives with a doctor or pharmacist.
This article is for general information only and is not medical advice. GLP-1 SA does not endorse or recommend any specific product, including unregistered or unapproved medicines. Always consult a registered healthcare professional before starting, stopping or changing any weight-loss or diabetes treatment.
Sources
- Drugmakers urge crackdown on illegal obesity medicines in South Africa — Business Day, 15 October 2026
- Drugmakers urge crackdown on illegal obesity medicines in South Africa — TimesLIVE / Sunday Times, 15 October 2026