South Africa's health regulators were right to warn doctors and pharmacists that they face disciplinary action if they continue prescribing or dispensing recalled GLP-1 medicines.
But the warning exposes an uncomfortable reality: a thriving market for illegal and unregulated weight-loss medicines is taking root.
The Mail & Guardian's investigation last week uncovered a trade in unregistered weight-loss medicines sold through social media, gyms, wellness businesses and informal networks. It found that products marketed under the name "Retatrutide" were being sold despite the medicine not being approved for use anywhere in the world.
Since publication, healthcare professionals have contacted the Mail & Guardian to describe how easily the products can be obtained. The message is consistent: the market extends well beyond a single product and the risks are far greater than many consumers appreciate.
Demand for GLP-1 medicines has grown rapidly, as has the market exploiting that demand.
Professional packaging, persuasive marketing and confident sales pitches can make unregistered products appear legitimate. Yet consumers often have no way of knowing what they are injecting, where it was manufactured or whether it meets even the most basic safety standards.
This is not an argument against weight-loss medicines. Properly regulated, they have transformed the treatment of obesity and Type 2 diabetes. The danger lies in medicines sold outside the regulatory system, where there is no assurance of quality, sterility or even the contents of a vial or injection pen.
Sahpra's enforcement action and its warning to healthcare professionals are necessary. Regulators have a duty to act against unlawful manufacturers, distributors and anyone who continues to prescribe or dispense recalled medicines. Healthcare professionals have an equally important responsibility to ensure that the medicines they prescribe or dispense comply with the law and meet accepted safety standards.
But enforcement alone will not solve the problem.
As long as demand remains high, illegal suppliers will continue to find buyers. Consumers need to understand that buying medicines through social media, informal sellers or unregulated channels is not simply a cheaper alternative. They are gambling with their health.
The response cannot end with recalls, disciplinary warnings or court orders. South Africa needs sustained enforcement, informed healthcare professionals and consumers who know the difference between a regulated medicine and one sold on trust alone.
Until then, the illegal market will continue to grow.