Caribbean Regulatory System: The Bahamas Has Registered 2 Products

A non-registration market

Most countries decide product by product which medicines may be sold. The Bahamas does not. The Chief Pharmacist at the Ministry of Health and Wellness, Dr Gina Archer, told The Tribune in February 2026: "The Bahamas currently does not have a national drug registration system"¹. A pharmacist writing to the same paper in October 2025 described the result: a "non-registration market" in which licensed importers can sell drugs "without local product registration or batch testing", relying heavily on the regulators of the United States, the United Kingdom and the European Union to ensure quality².

The Pharmacy Act, 2009 regulates people and premises rather than products. Section 27 requires drugs that are made, sold, imported or exported to meet a recognised pharmacopoeia standard, section 28 sends imports to the Customs Management Act, and section 33 bans importing for storage and wholesale distribution unless the warehouse is registered under the Act¹⁰. There is no product-by-product marketing authorisation in the Act¹⁰. According to The Tribune, a Medical Products Bill that would govern the importation and distribution of medicines had not been tabled or circulated as of 2 February 2026¹.

How the Caribbean Regulatory System works

The CRS was designed for exactly this situation: small Caribbean states without the staff to review every medicine dossier. PAHO described it in 2017 as a regional initiative that gives manufacturers a single entry point to Caribbean Community markets, with one set of requirements⁴. Its first recommendations, in May 2017, were four HIV medicines already prequalified by WHO⁴. A 2016 case study in the Pan American Journal of Public Health describes the model as "regionalization": shared governance and infrastructure, reliance on reference regulators and a centralised entry portal to reduce the burden on industry¹¹.

Reliance is the core of the design. A 2021 review of regulatory frameworks in Latin America and the Caribbean found that 13 of 20 regulators, including the CRS acting for 15 Caribbean states, explicitly accept marketing authorisations from the European Medicines Agency, the US Food and Drug Administration and Health Canada¹². An evaluation of CRS assessments for 2017 and 2018 found median total approval times of 57.5 days and 148 days; the slowdown in 2018 was attributed to staff shortages, and the authors recommended that Member States build the legal frameworks needed to turn CRS recommendations quickly into national marketing authorisations¹⁴.

Each recommendation is only advice. CARPHA's own account, reported in June 2025, states that Member States decide whether to register or import a recommended product, that manufacturers must still meet each country's requirements, and that the CRS had also shared 742 product safety reports with Member States³.

Where The Bahamas stands

The numbers show the gap between the regional tool and national uptake. By June 2025, Guyana had registered 164 CRS-recommended products, Haiti 5 and The Bahamas 2³. Dr Archer told CARPHA: "The product recommendations helped us navigate a complex global landscape", and The Bahamas said CARPHA's VigiCarib pharmacovigilance newsletters keep it informed of regional safety developments³. The Bahamas was among the CARICOM states represented at a PAHO and CARPHA workshop in Miami in March 2025 to strengthen national and supranational regulatory systems in the Caribbean; PAHO's report also notes work on the "transformation" of the CRS into a regional regulatory body⁵.

Without a national register there is little for a CRS recommendation to plug into. The Bahamian experience with counterfeits goes back years: in 2009 the Ministry of Health and the Bahamas Pharmacy Council set up a committee, chaired by the then Chief Medical Officer and assisted by PAHO, to investigate claims that at least one local pharmacy was importing and distributing counterfeit drugs⁷. The 2025 letter warned that the same gap still allows "an initial high-quality shipment followed by sub-standard batches thereafter"².

The Barbados model

Barbados chose a national agency. In 2026 its Parliament passed the Barbados Medical Products Authority Bill; PAHO says the authority will regulate pharmaceuticals, vaccines, medical devices and other health products across their life cycle, from authorisation and importation to distribution and use⁶. PAHO will support Barbados on a roadmap to reach "WHO Global Benchmarking Tool (GBT) Maturity Level 3 by 2029"⁶. The WHO Global Benchmarking Tool rates regulators from level 1, the "existence of some elements of regulatory system", to level 4, "operating at advanced level of performance and continuous improvement"⁹.

Why it matters for GLP-1 drugs and peptides

Semaglutide and tirzepatide are high-value, temperature-sensitive products that counterfeiters already target⁸. A WHO medical product alert in 2024 reported falsified Ozempic batches in three countries⁸. In a market without product registration or batch testing, a physician in The Bahamas cannot check a local register to see whether a pen or vial on a pharmacy shelf is an authorised product; the check rests on the importer, the pharmacist and the packaging. The systematic evidence on poor-quality medicines is mostly about antimicrobials and essential medicines, where a meta-analysis found pooled prevalence of 13.6% in low- and middle-income countries¹³, but it shows why regulators test what enters their markets.