Brazil and Paraguay sign five-year pact targeting counterfeit weight-loss drugs
A new Brazil-Paraguay agreement targets smuggled semaglutide and tirzepatide pens crossing the border, the kind of product that reaches buyers outside any regulated pharmacy chain.
Brazil's National Health Surveillance Agency, Anvisa, and Paraguay's National Directorate of Health Surveillance, Dinavisa, have signed an agreement to fight the smuggling and counterfeiting of medicines, cosmetics, food and medical devices, with weight-loss injectables as the main concern [1]. The agreement runs for five years, was signed on the 20th, and was announced Sept. 1 [1].
The focus is the border region, including the customs checkpoint at the International Friendship Bridge between Foz do Iguaçu and Ciudad del Este. The aim is to curb illegal imports of pens and vials containing weight-loss drugs, anabolic steroids and peptides, which are often moved without health controls [1].
The deal follows an early-August operation in which five people were arrested in Foz do Iguaçu and two in Ciudad del Este, suspected of belonging to a network that counterfeited and sold weight-loss drugs and anabolic steroids. Brazilian authorities also carried out search and seizure warrants and preventive and temporary arrest warrants in Paraná, the Federal District, Goiás, Paraíba, Acre and Minas Gerais, more than 100 court orders in total [1].
Seizures have more than doubled
A Federal Police survey counted 165,589 weight-loss products, including pens, ampoules and vials, seized through June 2026. That is more than double the 60,865 units recorded for all of 2025, an increase of 172% [1]. Separately, Brazilian customs data cited by ColombiaOne reported that the Federal Revenue Service seized more than 76,000 injection pens, vials and other weight-loss products in the first half of 2026, nearly three times the total for all of 2025 [2]. The two counts come from different agencies and are not directly comparable, and the gap between them is not explained in either report.
Most of the injectable pens seized originate in Paraguay and lack registration or oversight by Anvisa, according to BPG [1]. Customs officers have found the products hidden in shoe soles and insoles, in vehicle compartments, in personal-care containers and in jars of doce de leite, a caramelized milk spread. In April, agents searching a tourist bus found hundreds of vials containing tirzepatide, the active ingredient in Mounjaro and Zepbound, inside jars of the spread [2].
Price is part of the draw. Reuters data cited by ColombiaOne puts compounded and smuggled products at about 51% of Brazil's estimated US$7 billion weight-loss drug market. A product marketed in Paraguay as tirzepatide sells for about US$75 for a six-week supply, while a legitimate supply of Mounjaro or Wegovy can cost hundreds of dollars depending on product, dose and pharmacy [2].
Joint operations will not happen automatically. Under the agreement, either agency must notify the other in advance and provide information justifying an action. Cooperation must be agreed by both agencies and formalized in specific work plans, and putting those plans into effect depends on each institution's staffing, materials and funding [1]. The memorandum states that it does not create legally binding rights or obligations, and each agency keeps the right to act on its own under its own laws [1].
Dinavisa's interim national director, Jorge Iliou Silvero, said Brazil and Paraguay "face common challenges in protecting public health" and that "working in partnership enhances regulatory trust, convergence, and the adoption of best practices" [1].
Why it matters for patients
When a medicine enters the supply chain through clandestine channels, there are no guarantees about its origin, composition, concentration, storage, transportation or traceability [1]. Sharing information between the two regulators can help identify where products came from and track their movement, but it does not verify what is inside any particular pen or vial [1].
Brazilian authorities have reported 83 deaths and more than 3,600 health complications associated with weight-loss products since 2018. Those figures cover different products and circumstances and do not mean every case involved a smuggled medicine [2]. Doctors described one patient who needed intensive care after using a product bought in Paraguay and sold as tirzepatide, and another who developed severe gastrointestinal symptoms after increasing the dose of a medicine brought from Paraguay [2]. Approved versions of these drugs carry risks as well; Mounjaro and Wegovy list acute pancreatitis among potential side effects, and incorrect dosing can add complications [2].
The agreement covers traffic between Brazil and Paraguay. It does not change how GLP-1 medicines reach pharmacies in the United States, and no effect on US supply has been reported [1].
A similar pattern has appeared elsewhere in South America with different mechanics. Colombia's regulator, INVIMA, issued alerts over falsified Ozempic containing semaglutide and traced specific counterfeit batches after a global World Health Organization alert. In July 2026, Bogotá health authorities warned about falsified and informally marketed semaglutide and tirzepatide, pointing to self-medication and use without medical supervision, and identified social media, WhatsApp groups and informal online sellers as channels. Colombia has no comparable public record of large-scale border seizures of GLP-1 medicines [2].
What happens next
The agreement is valid for five years [1]. No joint operations or joint work plans have been announced, and neither agency has disclosed a schedule; the text requires advance notice and specific plans, and implementation depends on available resources [1]. Whether the agreement reduces the flow of unregistered injectables has not been reported. BPG notes that rising seizure counts alone do not allow an estimate of the size of the illegal market [1].
On the legal-supply side, Anvisa has approved additional semaglutide medicines, and Brazilian pharmaceutical companies are developing lower-cost alternatives. Reuters reported that Anvisa recently approved Ozivy, a domestic semaglutide product intended to broaden access to treatment [2].
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