Over-the-Counter Pharmaceuticals: When the Law Says Everything and Its Opposite

Some pharmaceuticals are available over the counter in supermarkets and local shops. This practice raises questions about compliance with the Pharmacy Act, unfair competition, and consumer safety.

The Pharmacy Act is unequivocal: "No person shall sell by retail any medicine or drug in any place other than a pharmacy." Yet, just a few lines later, the same law provides a loophole: "The Minister may, after consultation with the Board, make regulations authorizing the sale by retail in any place other than a pharmacy of such medicines or drugs as may be specified in those regulations." Is this the basis for some pharmaceuticals being found on supermarket shelves without being considered illegal? Pharmacists and consumer associations agree that it is high time to restore order.

For Ashwin Dookun, president of the Pharmaceutical Association of Mauritius (PAM), the issue is not new. "We are tired of telling the Pharmacy Board to take action. There are penalties in the law that can be enforced, but they are not acting." He specifically cites the sale of paracetamol-based medications in local shops—a practice known to everyone, yet no actions have been taken. "I cannot go into a shop and tell the merchant that they cannot sell drugs. It is the Pharmacy Board's responsibility to do so."

This feeling of powerlessness is compounded by the institutional ambiguity surrounding the issue. According to several pharmacists, the Ministry of Health and the Ministry of Commerce keep passing the responsibility for oversight and enforcement back and forth, which explains the lack of action on the ground.

The situation becomes even more complicated with dietary supplements. Ashwin Dookun acknowledges that no law prohibits their sale outside pharmacies. However, he warns that some of these supplements contain controlled substances that should not be sold outside pharmacies. For him, publishing a regulation without ensuring its enforcement is inadequate.

Siddique Khodabocus, president of the Association of Small and Medium Importers of Pharmaceutical Products, shares this view. He clearly distinguishes what is allowed from what is not. "All products authorized by the Pharmacy Board can be sold in supermarkets, including dietary supplements that do not have a 'health claim.'" But for those that could harm health, the stance is firm: "All products such as medications and dietary supplements with claimed therapeutic properties or that can serve a health purpose must be under the supervision of a pharmacist. They should be sold in a pharmacy or parapharmacy where a pharmacist is present."

Pharmacist Arshad Saroar echoes this sentiment while recognizing the limits of the profession. "Dietary supplements can have interactions—pharmacists cannot prohibit their sale in supermarkets." However, this does not prevent them from advocating for more regulation, particularly due to the risks of drug interactions that the average consumer cannot anticipate on their own.

To help consumers navigate this issue, Arshad Saroar suggests a practical guideline: pharmaceutical products with a white label can be sold in supermarkets, whereas those with a blue label are not permitted to be sold outside pharmacies. This distinction is little known among consumers. "It is unacceptable for products with claimed therapeutic properties to be sold freely, where consumers can simply take them off the shelves. Some products can have harmful effects on consumers without them being informed," notes Siddique Khodabocus.

Beyond public safety, the economic aspect is also a concern. Ashwin Dookun denounces unfair competition: supermarkets, by purchasing in large volumes, can negotiate prices significantly lower than those available to pharmacies, creating margins that pharmacies cannot match.

Pharmacists also agree in condemning the sale of pharmaceutical products on social media. "We do not believe they have obtained permission to bring in these products, which are likely not registered," emphasizes Siddique Khodabocus, who advocates for a pharmacist's presence at customs—ports and airports—to oversee the documentation accompanying these goods.

Siddique Khodabocus argues that reform must also involve tightening the conditions of importation and distribution. "They must have track records and be involved in the health sector because it is not a business; it is a service." He believes it is the Ministry of Health, through its pharmaceutical service—the very body that issues permits—that should fully assume this regulatory role. A responsibility that, for now, seems to be awaiting a taker.

We reached out to the relevant ministries, but our requests and calls went unanswered.

For an importer who wishes to remain unnamed, the first distinction to be made is clear. The products found in supermarkets are not strictly pharmaceutical products but rather parapharmaceutical products. "Strictly pharmaceutical products are only available in pharmacies, in accordance with current regulations."

However, he acknowledges that the current legal framework, particularly the Pharmacy Act of 1983, is somewhat outdated and "contains some loopholes that are sometimes exploited." For him, the real issue extends beyond supermarkets and concerns online sales. He observes that some actors are marketing products presented as medicated, making unvalidated therapeutic claims, whereas such claims should normally be backed by clinical trials and publications in recognized medical journals.

The issue of oversight becomes crucial. While advertising for medications is not allowed in Mauritius, misleading communications continue to circulate on social media. "How many cases have actually been sanctioned? Is there a sufficiently structured framework to validate and oversee the medical claims disseminated to the public?" he asks.

Regarding parapharmaceutical products in supermarkets, he specifies that they are supplied by distributors, but that checks and validations by the authorities remain, to his knowledge, "limited." This observation leads him to conclude that the underlying problem lies in a pharmaceutical jurisprudence that struggles to evolve with the pace of digitalization and artificial intelligence.

Jayen Chellum, secretary-general of the Mauritius Consumer Association (Acim), raises questions about traceability and control in the commercialization of pharmaceuticals outside pharmacies. He recalls that these products normally come from accredited and registered importers with the Ministry of Health, and that a control system governs their reception before being put on sale in pharmacies. Since the liberalization of the pharmaceutical trade, he questions the source of these same products when they appear on supermarket shelves.

This ambiguity regarding the origin of products is accompanied, he argues, by an equally concerning ambiguity about who is responsible for their oversight. "The inspectors from the Ministry of Commerce are not trained like those from the Ministry of Health regarding the verification and control of pharmaceutical products." He believes that both ministries—Health and Commerce and Consumer Protection—should jointly supervise this sector. In the absence of a precise legal framework clearly defining the competent enforcement officers, lapses in oversight are inevitable.

Beyond the institutional question, Jayen Chellum highlights the direct risk to consumers: purchasing a pharmaceutical product outside a pharmacy, without prior advice or information, can prove dangerous. He thus calls on the authorities to provide clarity. "The authorities should once and for all determine how they can authorize the sale of what type of products at what type of point of sale." He also finds it necessary to explain why this sale was authorized in supermarkets and what verification mechanisms were put in place in return.