Falsified medicines in Belize: fake Tylenol, Sudagrip and semaglutide

A falsified medicine is not a cheap copy. It is a product that "deliberately misrepresent[s] [its] identity, composition or source," in the words of the World Health Organization⁸. Belize has found several in ordinary shops. The Ministry of Health and Wellness (MoHW) and its Drug Inspectorate Unit have issued public warnings about falsified Tylenol, counterfeit Sudagrip and fake Cialis, and in 2026 the country took two steps to catch the next one sooner³¹⁵⁶⁷.

Falsified Tylenol in Belize supermarkets

On 16 October 2023 the Ministry announced that "falsified Tylenol has been discovered at various supermarkets across the country" and that "The falsified product identified bears batch number GS13790 with an expiration date of 03/24"³. It removed the product countrywide and asked merchants and wholesalers to call for removal of their stock³. Chief Drug Inspector Dr. Crystal Samouge told 7 News: "We have not seen this batch in our importation database, so it likely means then that it came in illegally"⁴. The Ministry had not determined who brought it in or how; the product was most widely distributed in the Orange Walk, Cayo and Belize districts, and no adverse effects had been reported⁴.

Counterfeit Sudagrip and fake Cialis

Four months earlier, on 14 June 2023, the Ministry said counterfeit Sudagrip "was encountered at a retail outlet in the Stann Creek District" during routine surveillance; it was seized and an investigation and countrywide removal followed¹. Amandala noted that genuine Sudagrip capsules have the name embossed on them and that the product is widely used in Belize². In September 2019, the Ministry seized another stash of counterfeit Cialis, a prescription drug for erectile dysfunction; fake erectile-dysfunction tablets of unknown origin had been found on the market for up to $170.00 a tablet⁵. Each warning asked the public to buy only from distributors and health facilities holding a valid Ministry licence¹³.

WHO drug monitoring and Belize's post-market surveillance system

Belize joined the WHO Programme for International Drug Monitoring as an associate member in 2020 and became a full member in 2026 with support from PAHO/WHO⁶. It now reports directly to VigiFlow/VigiBase, the WHO global database of individual case safety reports managed by the Uppsala Monitoring Centre, and to the Global Surveillance and Monitoring System for substandard and falsified products⁶. In August 2026 the Ministry held a three-day PAHO-supported workshop to set up a National Post-Market Surveillance System that combines medicine and vaccine safety monitoring with the handling of quality problems, suspected substandard and falsified products and unregistered products⁷. In practical terms: a physician's adverse-event report from Belize can now be matched against reports from the rest of the world⁶⁷.

Falsified semaglutide: the global pattern

The product doctors worry about most today is falsified semaglutide. WHO issued Medical Product Alert N°2/2024 on three falsified Ozempic batches detected in Brazil and the United Kingdom in October 2023 and in the United States in December 2023¹⁰. WHO's monitoring system has recorded "increased reports on falsified semaglutide products in all geographical regions"; some may lack the necessary components, and others may contain an undeclared active ingredient such as insulin¹¹. A case report described a 31-year-old woman admitted in hypoglycaemic coma after a falsified product turned out to contain insulin instead of semaglutide¹⁴. An analysis of 234 European reports linked to counterfeit semaglutide found 89.3 % of suspected reactions were serious, with hypoglycaemia reported disproportionately often¹². In test purchases from online sellers without a prescription, measured semaglutide purity was 7.7 % to 14.37 % against the 99 % claimed¹³. In March 2026 PAHO warned that growing demand may encourage the sale of GLP-1 drugs through unofficial channels and asked countries to strengthen pharmacovigilance and limit use to indications approved by the national regulator¹⁵. Across low- and middle-income countries, a meta-analysis of 67,839 samples found 13.6 % of essential medicines to be poor quality⁹.