Fake Ozempic in the Caribbean: alerts next door, and Barbados' new rules

Falsified semaglutide: what WHO found

In June 2024 the World Health Organization published Medical Product Alert N°2/2024 on falsified Ozempic (semaglutide). WHO said the product had been detected in Brazil and the United Kingdom in October 2023 and in the United States in December 2023, and that it "was supplied in the regulated supply chain"¹. One batch number, LP6F832, "is not recognized"; for another, "batch number MP5E511 is genuine, but the product is falsified"¹. WHO warned that the fakes "may result in the ineffective treatment of patients due to incorrect dosage" and may pose other serious risks because they are injected under the skin¹.

The Pan American Health Organization (PAHO) returned to the subject in March 2026. Citing "increasing reports of adverse events associated with their misuse", it warned that "the growing demand for these medicines may encourage their commercialization through unofficial channels" and that such products "may contain incorrect doses, different active ingredients, or undeclared substances"⁵. PAHO asked countries to strengthen pharmacovigilance and supply-chain oversight⁵.

Alerts in Guyana, Trinidad and Tobago and Saint Lucia

The warnings have reached Barbados' neighbours. In June 2024 the Caribbean Broadcasting Corporation (CBC) reported that Guyana's Analyst-Food and Drug Department (GA-FDD), using WHO information, said "fake batches of Ozempic may possibly be on the local market"; it added that "Ozempic (semaglutide) is not registered here, and therefore should not be marketed locally"².

In January 2025 the Trinidad and Tobago Guardian reported that police were investigating a Ministry of Health complaint about "the illegal sale of Ozempic" after social-media posts advertised it locally³. The ministry's principal pharmacist, Anisa Doodnath-Siboo, said "the advertising of the Third Schedule is definitely a breach of the Food and Drug Act"³. In June 2026 Saint Lucia's Ministry of Health, Wellness and Nutrition said it was "increasingly concerned by reports of medications, including GLP-1 products and compounded GLP-1 formulations" offered by establishments and providers that are not licensed pharmacies⁴.

Barbados: no public alert, but a new legal toolkit

No Barbadian regulator has issued a public warning about falsified semaglutide that we could find. Local demand was also modest at first: in January 2024, David Lewis, consultant pharmacist at Lewis Drug Mart, told CBC that Ozempic "is not being used on a wide scale here in Barbados"⁷. But the law has changed. The Barbados Medical Products Act, 2026, assented to on 18 June 2026 and in force on a date set by Proclamation, gives the new Barbados Medical Products Authority clear tools⁶:

• Definitions. A "falsified medical product" is one "the identity, composition or source of which is false or has been misrepresented"; a substandard product "fails to meet its quality standards or specifications or both" (section 2)⁶.
• Imports. "No person shall import a drug into Barbados" without a licence from the Authority, from a manufacturer approved by the Authority (section 37)⁶.
• Marketing authorisation. No one may import, advertise, sell or "otherwise place on the market" a medical product unless it is registered and authorised (section 43)⁶.
• Online sales and testing. The Act applies to the "regulation of internet pharmacies" (section 5), allows risk-based sampling to find products "likely to be falsified or substandard" (section 52) and allows batch recalls (section 53)⁶.
• Advertising. Promoting a medical product needs the Authority's approval, and advertising for "off-label or non-evidence-based use" is prohibited, with a $5,000 administrative penalty (sections 48–49)⁶.

During the June 2026 debate, minister Marsha Caddle said some products sold locally "were banned in many other jurisdictions" and that unverified health claims are "a gap in the legislation and the regulatory regime that must be filled"⁸.

What the evidence shows about illegal semaglutide

A study in the Journal of Medical Internet Research analysed 1,080 search results and found 59 illegal online pharmacy websites selling semaglutide without a prescription¹¹. Of six test orders, only three vials arrived; none of the three Ozempic pens ordered was delivered. All three vials were probable substandard or falsified products, purity was 7.7% to 14.37% against the 99% on the label, and endotoxin was found in every sample¹¹. A research letter by the same group in JAMA Network Open also assessed semaglutide bought from illegal online pharmacies without a prescription⁹. In the European database EudraVigilance, 234 reports involved suspected counterfeit semaglutide between 2018 and 2025; 89.3% of suspected reactions were serious, and hypoglycaemia was reported more often than with genuine semaglutide¹². A Belgian case report described euglycaemic ketoacidosis in an 18-year-old who self-injected semaglutide bought online¹³. WHO says at least 1 in 10 medicines in low- and middle-income countries is substandard or falsified, and that such products "are often sold online or in informal markets"¹⁰.

What physicians in Barbados can do now

For prescribers, the practical steps follow from these sources: ask patients where their pen or vial came from, record the batch number, and treat unexplained hypoglycaemia, unusual reactions or lack of effect as possible quality problems. WHO asks health professionals to report any adverse effect, lack of effectiveness or suspected falsification to the national regulator or pharmacovigilance centre¹, and the new Act requires the Authority to set up a National Pharmacovigilance Programme (section 51)⁶.