Illegal health products, many of which are now advertised and sold through online platforms, pose a serious threat to public safety. It is the mission of governments around the world to curb their sale and purchase. In line with global trends, the Health Sciences Authority (HSA) of Singapore has worked with local and overseas agencies to seize 970,707 units of illegal health products and to remove 7,351 listings from local e-commerce and social media platforms. These are the figures for the year 2024, as released today.
These product confiscations and listing removals have been made possible by co-ordinated efforts involving targeted operations, intelligence sharing, and joint enforcement.
As per the HSA press release: “Codeine cough syrup made up the majority (54 per cent) of illegal products seized, followed by sexual enhancement medicines (19 per cent), sedatives (18 per cent), and other prescription medicines (9 per cent). Sixty-four persons were investigated for illegal supply of health products. These cases are undergoing investigation.”
Codeine cough syrup, though sold for medicinal purposes, can also cause addiction — it falls under the “opioid” category of medicines, according to the American Addiction Centers website.
The website said: “Along with therapeutic uses, codeine can be misused for its rewarding opioid effects such as relaxation and euphoria.” This is why several countries, including India and Singapore, have put codeine on the prohibited or restricted list.
165 litres of cough syrups seized in May 2024
HSA said in its press release today: “One of the notable seizures took place in May 2024, when HSA and the Singapore Police Force (SPF) mounted an operation against the illegal manufacture and supply of cough syrups in a condominium unit in Geylang.
“The cough syrups were manufactured in unsanitary conditions in different parts of the unit, including the bathroom and kitchen sink. Approximately, 165 litres of cough syrups and more than 57,000 units of assorted medicines with a street value of SGD 130,000 were seized. All seized products were meant for illegal supply in Geylang.”
7,351 product listings removed from digital platforms
Across the past year, HSA worked with the administrators of local e-commerce and social media platforms to take down 7,351 listings of illegal health products.
Almost half of the number of listings taken down in 2024 were a result of HSA’s first large-scale collaboration with local online platform administrators in September and October 2024, targeting illegal online sales and sellers.
This operation built on the close collaboration that HSA has established with Amazon Singapore, Carousell, eBay Singapore, Facebook, Lazada, Qoo10, Shopee and TikTok. HSA also issued warnings to 2,868 online sellers in 2024.
The majority of listings removed (37 per cent) were products marketing aesthetic enhancement of skin and hair including dermal fillers, Botulinum toxin, skin whitening, acne treatment and hair loss treatment products.
About 24 per cent were for contact lenses; 7 per cent were for the management of chronic conditions such as cholesterol, hypertension, allergies and pain relief; 5 per cent were contraceptives; 4 per cent were sexual enhancement or male vitality products; 3 per cent were weight loss products; and 3 per cent were antibiotics.
Other listings detected in small numbers included eye drops, nasal sprays, antihistamines, test kits and other prescription medicines. The listings were posted mainly on Shopee (52 per cent) and Lazada (36 per cent). Other affected listings were detected on Carousell (4 per cent) and Qoo10 (4 per cent).
HSA and platform administrators have continued to work together to strengthen the surveillance systems to stop potentially offending product listings from being posted.
Prosecution actions against sale and supply of illegal health products
In 2024, HSA prosecuted 30 persons for the sale and supply of illegal health products. Some notable cases were as follows:
● In January 2024, Rasel Md, 33, was caught for the illegal possession of cough syrups, sedatives and opioids, with the intention to sell them in Geylang. Investigations revealed that he was recruited by a syndicate to peddle the illegal products for a daily pay of SGD 100. During the course of investigations, he re-offended twice. He was prosecuted and sentenced to 31 weeks’ imprisonment.
● In September 2024, Peh Zhisheng Gabriel, 33, was fined SGD 266,500 for importing counterfeit cosmetics and selling them on local e-commerce platforms. The case was uncovered in July 2023, when the Intellectual Property Rights Branch of the Singapore Police Force raided an apartment unit and seized 126 types of branded cosmetic products, later confirmed to be counterfeit.
HSA’s investigations revealed that Peh had sourced the counterfeit cosmetics from China-based suppliers and imported them to Singapore without verifying their authenticity or safety. He listed the counterfeit products through multiple accounts on Lazada and Shopee. Even after receiving several warnings from the platform administrators about the suspected counterfeit products and having his accounts banned, he persisted in selling the products by using his family members’ particulars to create new accounts and earned about SGD 10,000 monthly.
HSA will take stern enforcement actions against anyone who sells or supplies illegal health products. Sellers and suppliers who are selling such products are liable to be prosecuted and if convicted, may be imprisoned for up to 3 years and/or fined up to SGD 100,000.
Illegal health products found to contain potent ingredients and/or banned substances
In 2024, HSA issued public alerts on 14 illegal health products (see list), which included a counterfeit probiotic health supplement. These cases were detected through adverse event reporting from healthcare professionals, regular surveillance, and feedback from consumers. Thirteen persons reported adverse effects experienced by themselves and/or their family members.
Thirteen of these products were found to contain potent ingredients and/or banned substances, while the counterfeit probiotic health supplement did not contain the purported probiotic strain.
The most common adulterants detected were sibutramine (a banned substance since 2010) and potent steroids such as dexamethasone and betamethasone valerate.
Sibutramine was detected in five products marketed for weight loss, while potent steroids were found in seven products marketed for pain relief, eczema relief, skin whitening and general wellbeing.
Consumers hospitalised after using illegal products
● A man in his 50s had been taking “Sausando Cellulite Pills” for five months and was hospitalised after he experienced seizures (fits), hyponatraemia (low level of sodium in blood) and vomiting. The product was marketed as a “natural health food” weight-loss product with exaggerated claims such as “lose weight fast in 7 days” but was found to contain the banned substance sibutramine, a laxative and a diuretic.
● A woman in her 30s was hospitalised after using “88 Total White Underarm Cream”, which was touted to whiten and smoothen the skin. After a month of use, she developed a severe rash over her body and liver impairment with raised liver enzymes and jaundice. Due to the exposure to a high level of mercury, she was diagnosed with allergic contact dermatitis and drug reaction with eosinophilia and systemic symptoms (also known as DRESS syndrome), a severe hypersensitivity reaction characterised by skin rash, blood abnormalities and injury to the liver and/or kidney, which can be life-threatening.
● After taking “ayukalp Mahayograj Guggulu” for about one-and-a-half months for back pain, a woman in her 30s started experiencing fatigue, chest discomfort, and shortness of breath during physical activity. The product was tested by HSA to contain lead at a level exceeding 6,000 times the permissible limit for traditional medicines. Exposure to high levels of lead may cause abdominal pain, nausea, vomiting, anaemia, liver inflammation and brain injury. Over the long term, it may also cause toxic effects to the kidneys, digestive and nervous systems.
Adjunct Assistant Professor Pankaj Handa, Senior Consultant from the Department of General Medicine from Tan Tock Seng Hospital, who treated the woman, advised, “Traditional health products may contain unintended substances in the amounts that can cause toxicity and damage to health. Patients are strongly advised to seek help from a healthcare professional, a pharmacist or physician, before consuming any such preparation.”
