A new U.S. government report reveals an overwhelming majority of online pharmacies are violating the law, selling counterfeit and potentially dangerous medications. The U.S. Trade Representative’s annual “Notorious Markets List,” released this week, shines a spotlight on the illegal pharmacy trade, which continues to threaten public health.

According to the 2024 report, 96% of the 35,000 online pharmacies are operating illegally while selling fake drugs to unsuspecting consumers. U.S. officials estimate that 20 new fake pharmacy websites are launched daily, selling medications without proper licenses or prescriptions.

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“Counterfeiting and piracy is a shared global concern, harming people not just in the United States but also other countries,” said U.S. Trade Representative Katherine Tai in a statement.

The Drug Enforcement Administration and the Centers for Disease Control and Prevention have both issued public warnings about these fraudulent websites, which often promote fake pills as legitimate treatments.

As digital shopping grows in popularity, many Americans have turned to the internet to purchase prescriptions. The surge in online pharmacy use accelerated during the COVID-19 pandemic when home delivery of medications became a vital service. This trend follows the closure of 7,000 physical pharmacies nationwide since 2019.

The report also highlights 19 countries identified as key sources of counterfeit products. They include Argentina, Brazil, Cambodia, Canada, China and India. These nations are considered hubs for counterfeit goods through physical markets.

Additionally, the report draws attention to popular e-commerce platforms that sell counterfeit products, including clothing, shoes and beauty items. TikTok’s parent company, ByteDance, operates a Chinese app called Douyin Mall, which the report claims facilitates significant counterfeit sales.

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U.S. officials are calling for stronger enforcement measures from global leaders. They’re urging for enhanced border security and tougher criminal penalties to combat counterfeit drugs.