A summary of “SA’s regulators are struggling to keep up with black-market weight-loss jabs” by Linda Nordling (Daily Maverick and Bhekisisa, 23 October 2026), with the legal background. Information, not medical or legal advice.
What the article reports
- A court order. In June 2026 the Gauteng High Court ordered iDexis, a compounding pharmacy in Tshwane, to stop making medicine containing semaglutide, the active ingredient of Ozempic. Large quantities of compounded jabs had been confiscated from its premises.
- A generic. The first generic semaglutide reached South African pharmacies in August 2026.
- An unlicensed drug sold openly. Retatrutide is still in clinical trials and is not licensed anywhere, yet it is sold “openly and brazenly”, according to Stavros Nicolaou of the Pharmaceutical Task Group.
- Informal channels. SAHPRA has received about 600 complaints this financial year about medicines sold through online portals, gyms and hairdressers. Some active ingredients have reportedly arrived in travellers’ luggage.
- A doctor as seller. A Johannesburg woman’s doctor sold her retatrutide, said he “had it tested”, and had her sign a waiver.
- Slow rules. Revised compounding guidelines, led by SAHPRA, are not expected before February or March 2027. Australia has already banned pharmacy compounding of weight-loss jabs.
The legal background
- Compounding is not a route to new drugs. Section 14(4) of the Medicines Act lets a pharmacist compound a medicine without registering it, but the active ingredient must appear in a medicine that has been registered. A drug still in trials, such as retatrutide, or one never registered, such as BPC-157, cannot be compounded lawfully.
- Compounding is for individual patients. SAHPRA and the Pharmacy Council said in May 2026 that compounding is strictly limited to medicines prepared for individual patients on a valid prescription. Large-scale production is manufacturing and needs a manufacturing licence.
- Compounded GLP-1s may be banned outright. In March 2025 SAHPRA announced its intention to declare compounded GLP-1 and GLP-1/GIP medicines (semaglutide, tirzepatide) undesirable under section 23 of the Act. Once declared, no one may sell them. As of the latest report we found (May 2026), the declaration had not yet been made.
- Making these medicines at scale needs a manufacturing licence for that kind of product. SAHPRA licenses manufacturers for specific products and dosage forms under good manufacturing practice (GMP). An injection must be made sterile, which needs clean rooms, validated sterile filling and endotoxin control, and a licence that covers sterile products. A site licensed to make a non-sterile product, such as an oral oil, cannot simply switch to injections. A licence also does not permit the sale of an unregistered product: what a licensed manufacturer sells must be registered, or supplied for a named patient under Section 21.
- The lawful route to an unregistered medicine is Section 21: a doctor applies to SAHPRA for one named patient, naming the product and an authorised supplier, and reports the outcome within six months.
Comment
- The regulator’s advice is the right question. SAHPRA’s Daphne Fafudi: “If you cannot trust the source, do not trust the medicine.” The question is how a buyer can trust a source.
- Packaging checks are necessary, not sufficient. SAHPRA’s warning signs (blank or unusual packaging, no expiry date, no package insert, damaged packaging) catch careless fakes. A careful counterfeiter prints a proper box.
- A seller’s test is the seller’s word. “I had it tested” means nothing unless the certificate names the batch in your hand and can be checked at the issuing lab. The worldwide test data we summarise every day shows that about one vial in three fails its label (Peptide Testing).
- Cheap legal supply is the strongest answer. With generic semaglutide now on the shelf, a prescription from a registered doctor is the safest route for anyone who needs this medicine.
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