Reported by
Aldo Benitez
OCCRP
Allan de Abreu
Revista piauí
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It’s barely 4 a.m. on a June morning, and already the streets of Ciudad del Este in Paraguay are filling up with traders hustling to buy and sell everything from socks to home appliances
The city — which sits at the point where Paraguay, Brazil, and Argentina meet — welcomes more than 100,000 people daily <a href="https://healthylife7.com/vibrio-vulnificus-cases-rise-across-florida/” title=”Vibrio vulnificus Cases Rise Across Florida”>across the Puente de Amistad (Friendship Bridge) from Brazil.
But the frontier is also a hot spot for drug smuggling, human trafficking, and money laundering.
And now, the city’s smugglers have found a new cash cow in tirzepatide — the generic name for the active ingredient in the popular weight loss drug Mounjaro.
In recent months “tirze” — originally developed to treat type 2 diabetes — has become a prized product for criminal groups operating on the border, according to official seizure data, smugglers, pharmaceutical industry officials, and social media records
Seizures of the drug have skyrocketed. So far in 2026, Brazilian customs reported that it has already confiscated more than ten times the amount ofted the black market revenue of the tirze trade to be $485 million.
And now, some members of Paraguayan law enforcement suspect the involvement of Brazilian organized crime groups.
Between March and July this year, Paraguayan police reported three large highway robberies targeting trucks carrying tirzepatide on roads leading to the border with Brazil
Pharmacy owners are now living in fear because of violent assaults fueled by the trade, Gerardo Rivalora, spokesman of the regional association of pharmacies, told OCCRP and Brazilian magazine Revista piauí
“We demand that the Paraguayan authorities do something,” said Rivalora
Two officers from Brazil’s Federal Police interviewed by reporters over the border in the city of Foz do Iguaçu said that they had not found evidence of the involvement of organized crime groups in the trade — despite robberies of injectable tirzepatide slimming pens
Credit: Kiko Sierich/Revista piauí
Bottles of the weight loss drug tirzepatide available for sale in a pharmacy in Ciudad del Este, Paraguay. The generic drug is produced legally in Paraguay, but in neighbouring Brazil, all imports (apart from Mounjaro) are banned
Credit: Kiko Sierich/Revista piauí
Bottles of the weight loss drug tirzepatide available for sale in a pharmacy in Ciudad del Este, Paraguay. The generic drug is produced legally in Paraguay, but in neighbouring Brazil, all imports (apart from Mounjaro) are banned
Law Enforcement Challenges
In Paraguay, tirzepatide is manufactured legally, and a weekly dose costs around $40, according to price lists from online pharmacies. In Brazil, the drug is only licensed by Eli Lilly, which manufactures tirzepatide in the U.S. under the brand name Mounjaro. All other imports of tirzepatide are illegal.
In Brazil, a weekly dose of Mounjaro costs nearly seven times as much as it does in Paraguay, at $278, according to a review of online pharmacies
Also helping to drive demand in black market sales is Brazil’s growing obesity problem. The World Obesity Forum states that one in four Brazilian adults is obese, and this figure is expected to rise by 2030
Tirze is normally smuggled through “ant” networks where wholesalers hire people to cross the border-bridge carryingn inside food or cosmetics — Commissioner of the Tripartite Command, a police alliance between the authorities of the three countries in the area
Once inside Brazil, the product is transported in unrefrigerated trucks (reducing the efficacy of the drug that must be kept between 2 and 8 degrees Celsius), or through e-commerce platforms where there is little control of the shipments, according to officers from the Brazilian Federal Revenue Service in Foz do Iguaçu
Revenue officers told reporters that because the border is so busy, they are barely able to inspect between 1 to 5 percent of all people and traffic crossing between the two countries.
Dure said his forces see an average of almost one large-scale tirzepatide robbery per week, in addition to minor robberies and thefts in pharmacies.
“It is generating a huge, huge amount of illicit funds for criminal organizations, in addition to what they earn through what we typically refer to as drug or arms trafficking, or whatever else,” said Dure. “This is bringing them a great deal of money.”
The National Police of Paraguay suspect the participation of members of the First Capital Command (PCC) faction, Brazil’s most powerful organized crime group, Dure added.
“The same crews executing bank robberies and financial institution heists are also carrying out these pharmaceutical hijackings, because they utilize the exact same violence and tactical elements, such as heavy-caliber weaponry,” Dure said.
Paraguayan prosecutor Italo Rienzo told reporters that he suspected the involvement of Brazilian criminal group Comando Vermelho in the trade, following a raid near Asunción, the country’s capital, earlier this year.
He said criminal groups on the border were already involved in large-scale thefts of the drug, and that for them, pharmaceuticals are “the new black gold.”
According to Paraguayan police records, armed gangs have staged three major robberies, targeting trucks and pharmacies for large quantities of tirze in Paraguay this year. On the morning of March 23, assailants with machine guns and rifles took 1,100he security guards of the company, according to police records of the incident.
But Emerson Rodrigues, a high-ranking police officer in Foz do Iguaçu, told reporters that the smuggling networks are pre-existing and do not rely on established organized crime groups
“We have identified a decentralized logistics system that has already been in place for decades on the border through cigarette smuggling, without major criminal actors,” he said
Credit: Kiko Sierich/Revista piau
A customs officer in Foz do Iguaçu, Brazil, close to the border with Paraguay, holds a packet of tirzepatide next to a smartphone box to demonstrate the drug’s size
Credit: Kiko Sierich/Revista piau
A customs officer in Foz do Iguaçu, Brazil, close to the border with Paraguay, holds a packet of tirzepatide next to a smartphone box to demonstrate the drug’s size
Counterfeit drugs are also present in the illegal market. In July this year, Paraguayan police seized 4,000ide the bottles, Paraguayan police said they found only saline
Dure said his forces are seeing Chinese imports of the drug that are similar or identical to what Paraguay produces.
Overall pharmaceutical thefts have also increased by 20 percent between this year and last year, according to a study conducted by the Brazilian road logistics software company Nstech.
Speaking in a storeroom containing boxes of seized tirzepatide, revenue service officers in Foz do Iguaçu told reporters that they had rarely seen a product so small with such a high street value.
Rodrigues explained that the penalty for importing medication without a license has recently been reduced from 15 years in prison to between one and three years, and that smugglers often face no charges
A Flourishing Trade
Back in Paraguay’s Ciudad del Este, a proliferation of pharmacies has provided criminals with increased access to the drug. The number of registered pharmacies went from 1,500 in 2024, to 3,000 in 2026, according to the Association of Pharmacy Owners of Alto Paraná, the department where the city is located.
Paraguay’s National Directorate of Health Surveillance told reporters that it has implemented a traceability system to more effectively track tirzepatide.
“Each package is required to have a unique code that allows for identifying the specific unit and linking it to the corresponding manufacturing or import batch. Unit identity constitutes a firm first regulatory step to strengthen safety and counterfeit detection capacity,” the directorate said
The directorate said it is raising awareness about the dangers of counterfeit medicines, and is strengthening its control systems, especially in border areas such as Ciudad del Este where the illicit medicine trade is concentrated
In a pharmacy called Farmacon in downtown Ciudad del Este, reporters were offered the services of a tirzepatide smuggler named Fernando.
A Farmacon spokesperson told reporters that the company “does not encourage or participate in smuggling activities or irregular shipments of medications, including tirzepatide. Sales are conducted only through physical in-store pickup, and any guidance from employees that contradicts that policy goes against company rules.”
However, reporters found that the services of smugglers were widely available in the city’s pharmacies, and Fernando was happy to talk
“We take [tirze] to all of Brazil, wherever you want,” said Fernando, who claimed he has “about a thousand clients,” when reached by reporters on WhatsApp
He told reporters he buys a 15mg box of the drug in Paraguay for about $100, charges clients a $2 “tax” for transportation, and then sells eachcosts around $700 in Brazil
“It is one hundred percent [profit], man,” he wrote, adding “It is better than usury, my friend.”
