But as demand has soared, some pharmacies have turned the niche practice of compounding into a lucrative business. <\/p>\n
In June, the Gauteng High Court ordered iDexis<\/a>, a compounding pharmacy in Tshwane, to stop producing medicine containing semaglutide \u2014 the active ingredient of Ozempic \u2014 after large quantities of compounded weight-loss jabs had been confiscated on its premises. <\/p>\n The court order was an important legal victory for the country\u2019s regulators, including the South African Health Products Regulatory Authority (Sahpra), Stavros Nicolaou, chairperson of the Pharmaceutical Task Group<\/a>, an umbrella organisation for the pharmaceutical industry in South Africa, said during a panel discussion held in Sandton last week. <\/p>\n But he said the momentum built by the court order could be lost if Sahpra and the South African Pharmacy Council (SAPC) don\u2019t follow up on it quickly with clearer guidelines for compounding pharmacies about what they can, and cannot legally do. \u201cYou can go and win these court cases, and have people on the back foot, but all of that can unravel because we\u2019re just not acting swiftly enough as a country,\u201d he said. <\/p>\n Illegal drugs in plain sight<\/p>\n The panel gathered representatives from Sahpra and the SAPC, as well as the police service, border control, revenue service and the pharmaceutical industry, to explain to the public how they are working together to stop the trade in fake drugs. <\/p>\n Sahpra says it has received around 600 complaints so far this financial year relating to illegitimate and fake medicines being sold through informal supply chains, reaching the public via online portals, gyms, or even local hairdressers. <\/p>\n \u201cWe are worried that the scourge is getting out of control,\u201d said Daphne Fafudi, the body\u2019s head of regulatory compliance. And it\u2019s the public that can pay the ultimate price, she added. \u201cPeople do die, and it doesn\u2019t even come to our attention,\u201d she said. <\/p>\n Some fake or illegitimate drugs are sold covertly. Others are traded in plain sight. One of them is retatrutide, a weight-loss injection that is still being tested in studies and therefore hasn\u2019t been licensed for sale by a drug regulatory anywhere in the world. Yet, it is sold \u201copenly and brazenly\u201d around the world, including in South Africa, said Nicolaou.<\/p>\n In the July episode of Bhekisisa\u2019s TV programme<\/a>, Health Beat, we reported how a Johannesburg woman\u2019s doctor sold her retatrutide, telling her it\u2019s safe because he \u201chad it tested\u201d, while making her sign a waiver to release him of any responsibility for what might go wrong<\/a>. <\/p>\n Earlier this year, a man reportedly died in the United States<\/a> after taking injections sold as retatrutide on the black market \u2014 although the British Medical Journal said the evidence for the drug causing the fatality was \u201cless clear cut\u201d than media reporting suggested. <\/p>\n Nicolaou urged the police service and the Hawks to make an example of those who sell retatrutide in South Africa, as a deterrent to others. \u201cThe public needs to know that our enforcement agencies are actually enforcing the law,\u201d he told the meeting last week.<\/p>\n Vincent Tlala, CEO of the SAPC, said revised guidelines for compounding pharmacies were underway, a process Sahpra is leading, with input from the SAPC. However, Tlala said, these were not expected to be ready until February or March next year. <\/p>\n According to Nicolaou, this is too late. \u201cThe regulations are taking too long,\u201d he says. Regulators in other countries have introduced bans and restrictions on compounding pharmacies specifically for weight-loss jabs, to prevent the kind of products that have flooded South Africa. \u201cWhy are we not doing the same thing?\u201d <\/p>\n What SA law says about compounding<\/p>\n Compounding medicines is lawful in South Africa, but only under specific conditions<\/a>. Compounding requires a healthcare professional\u2019s prescription, generally for a formulation that is not available as a registered medicine \u2014 for instance, if a patient requires a medication as an oral liquid that is only normally sold as a pill. <\/p>\n As for compounding in bulk, the law says that a pharmacy may prepare stock in advance if they can show that patients regularly need the medicine<\/a> \u2014 such as repeat prescriptions for the same person.<\/p>\n But some pharmacies produce large quantities without that evidence, Sahpra chief executive Boitumelo Semete-Makokotlela told Bhekisisa. This means \u201cyou\u2019re not compounding, you are manufacturing\u201d, which requires a good manufacturing practice licence that compounding pharmacies do not hold.<\/p>\n A good manufacturing practice licence shows<\/a> that a company has met the safety and quality standards required to manufacture medicines.<\/p>\n A second concern is where ingredients come from. Active pharmaceutical ingredients \u2014 the substances in medicines that make them work \u2014 must be registered in South Africa and imported by a licensed entity, says Semete-Makokotlela. A pharmacy\u2019s operational licence does not authorise it to import unregistered ingredients, she says, yet some have arrived in travellers\u2019 luggage.<\/p>\n Another loophole that needs to be closed, Semete-Makokotlela notes, is where people sell experimental drugs (meds still being studied) or medicinal products directly to the public that are authorised for \u201cresearch purposes\u201d only. This includes some peptide products that are neither registered medicines nor experimental drugs in formal trials (like retatrutide), yet are still widely bought and sold as lifestyle or wellness drugs to do things like lower inflammation and boost energy. <\/p>\n Peptides are short chains of amino acids<\/a> \u2014 small building blocks that the body uses to make proteins. Insulin is a peptide, as is semaglutide, the active ingredient in Ozempic. Both are registered medicines in South Africa. <\/p>\n However, there are other peptides, such as BPC-157<\/a>, which are being sold online and in gyms as solutions to specific health problems, such as tissue repair. These peptides aren\u2019t technically medicines, nor are they actively being studied in drug trials. Yet, they are sold as healthcare products, without evidence that they are safe or effective at treating humans. <\/p>\n Then there is the battle for public opinion, which is proving to be another hurdle. Semete-Makokotlela admits regulators are \u201con the back foot\u201d when consumers see people losing weight while official warnings struggle to compete. <\/p>\n The answer, she believes, includes offering people registered alternatives at different prices \u2014 including cheaper generics<\/a> \u2014 and working with healthcare professionals to steer patients towards safe, registered medicines.<\/p>\n South Africa\u2019s first generic weight-loss drug, containing semaglutide, hit the shelves in August<\/a>. <\/p>\n How the public can stay safe<\/p>\n During the panel discussion, South African Revenue Service official Gene Ravele called the lack of coordination between enforcement agencies \u201cthe number one problem that organised crime is taking advantage of\u201d, and that this is also true for counterfeit and illegitimate drugs.<\/p>\n Border Management Authority head Nakampe Masiapato added that police detectives and prosecutors are often generalists, ill-equipped for specialised pharmaceutical cases. \u201cThey have no idea what this is about,\u201d he said. <\/p>\n For consumers, the advice from regulators is to use authorised channels and check that medicines are registered. Common signs that a drug is not legitimate are that it has unusual or blank packaging, no printed expiry date on the box or container, or that it doesn\u2019t have a normal insert detailing how to take it and the common side effects. Broken or dented packaging is another big \u2018tell\u2019, the Sandton meeting heard last week. <\/p>\n The bottom line is that a product\u2019s online availability, or a seller\u2019s claim that it is equivalent to a registered medicine, is not proof that it has been assessed or approved, said Fafudi. \u201cIf you cannot trust the source, do not trust the medicine.\u201d<\/p>\n This story was produced by the Bhekisisa Centre for Health Journalism<\/a>. Sign up for the newsletter<\/a>.<\/p>\n Some of the reporting on this story is from Bhekisisa\u2019s television programme, Health Beat<\/a>.<\/p>\n Newsletter<\/p>\n Weekdays\n <\/p>\n SA Money Daily<\/p>\n The biggest business, economic and market news of the day.<\/p>\n![](\"https:\/\/www.newsbeep.com\/us\/wp-content\/uploads\/2026\/10\/comp1.jpeg\"\/)
<\/p>\n![](\"https:\/\/www.newsbeep.com\/us\/wp-content\/uploads\/2026\/10\/comp2.jpeg\"\/)
<\/p>\n![](\"https:\/\/www.newsbeep.com\/us\/wp-content\/uploads\/2026\/10\/inline.jpg\"\/)
<\/p>\n