GLP-1 and peptide trials in Barbados: new rules, missing patients

What the Barbados Medical Products Act says about clinical trials

The Barbados Medical Products Act, 2026 (Act 2026-12), which takes effect by Proclamation, brings clinical trials under statute for the first time¹. It defines a clinical trial as "an investigation in respect of a medical product for use in humans that involves human subjects" to discover or verify its effects, identify adverse events, study its pharmacokinetics or ascertain its safety or efficacy (section 2)¹. The key rules¹:

• "No person shall conduct a clinical trial of a medical product on humans without the clearance of the National Ethics Committee appointed pursuant to section 15 and the authorisation of the Authority" (section 55(1)).
• The Board of the Barbados Medical Products Authority must appoint that National Ethics Committee, with membership set by the Board and approved by the Minister (section 15(5)–(6)).
• Trials must follow regulations on Good Clinical Practice and Good Laboratory Practice; the Authority keeps a register of authorised trials; running a trial without approval carries a $5,000 administrative penalty (section 55(3), (5), (6)).
• No one may sell, dispense, supply or manufacture a product "for the purpose of a clinical trial or medical research" without authorisation or a written exemption (section 55(4)).
• The National Pharmacovigilance Programme must cover "identifying and reporting adverse events relating to clinical trials" (section 51(2)(b)), and a National Quality Control Laboratory is created (section 56).

Draft regulations are under way. PAHO reported that a stakeholder consultation in Bridgetown on 20 October 2026 reviewed draft rules on market authorisation, licensing, pharmacovigilance and the conduct of clinical trials¹¹; Barbados aims to reach WHO Global Benchmarking Tool Maturity Level 3 by 2029¹².

How ethics review works in Barbados today

Until the National Ethics Committee exists, a key existing body sits at the University of the West Indies (UWI). Its Cave Hill campus says the Institutional Review Board "is the primary mechanism of ethics review on the Cave Hill Campus" and that it "also serves the Barbados Ministry of Health (MoH)"; membership includes each Cave Hill faculty, senior Ministry staff and at least one community member unaffiliated with either². The Act does not say how the new committee will relate to the existing board¹.

The evidence gap: Black and Caribbean patients in GLP-1 trials

Black patients, who make up most Barbadians with type 2 diabetes¹⁰, are under-represented in the trials behind these drugs. A 2024 systematic review in BMJ Global Health of 27 randomised GLP-1 obesity trials found that participants were 79% white and 9% Black, and that 84.2% of 1,859 trial sites were in high-income countries, "in sharp contrast to the global prevalence of obesity"⁶. In cardiovascular outcome trials of GLP-1 receptor agonists and SGLT2 inhibitors, Black participants made up 2.4% to 8.3% of enrolment⁸. A meta-analysis in the Journal of the Royal Society of Medicine found consistent benefits in white and Asian participants but no observed effects in Black populations, and said it was unclear whether this reflected "under-representation of Black populations and low statistical power" or real differences⁸. A US review concluded that minority enrolment must improve "if clinicians are to have an accurate picture of the benefits and potential pitfalls" of these drugs⁷.

Barbados is a case in point. The national Health of the Nation survey found obesity in 33.8%, hypertension in 40.6% and diabetes in 18.7% of adults aged 25 and over⁹. In a population-based Barbadian sample of people with type 2 diabetes, 90% were Black¹⁰. WHO's own GLP-1 guideline is conditional partly because of "limited data on their long-term efficacy and safety"¹³.

Barbados can run trials

Local capacity exists. UWI researchers ran a feasibility study of a low-calorie liquid diet for type 2 diabetes remission in Barbados: 25 participants lost a mean 10.1 kg at 8 weeks, and the authors reported feasibility "in a predominantly black population in Barbados"⁵; UWI then registered a community implementation study of the same approach (NCT03536377)⁴. On ClinicalTrials.gov, UWI is also the sponsor of HEADWATERS, a phase 2 trial comparing two chemotherapy drugs in metastatic triple-negative breast cancer "in women of African ancestry", with the Queen Elizabeth Hospital listed as a site alongside Ghana and Jamaica, a target of 750 participants and a planned start in June 2027³. When we searched the registry on 7 November 2026, no semaglutide, tirzepatide or other GLP-1 drug trial listed a site in Barbados.

What physicians in Barbados should know

Once the Act is in force, any study that gives a medical product to people in Barbados to test its effects falls under section 55, whether sponsored by industry, a university or a clinic, and supplying a product for "medical research" also needs authorisation¹. For peptide drugs, that means a product cannot be supplied in Barbados simply by calling it research material, and it also gives local investigators a formal path to produce the Caribbean data that today's trials lack¹⁶.