This article seeks to highlight an aspect of the illegal pharmaceutical trade in the Caribbean. With the advent of COVID-19 there has been a shortage of a number of drugs in the formal sector. This is largely due to restrictions on foreign exchange, importation delays and sensationalized reporting of unrecommended drugs having a curative effect on COVID-19 patients. This article examines the issue of “the informal suitcase trading” of these drugs. It posits a need for a collaborative and multi-sectoral approach to mitigate the negative effects of the practice on health, trade and national security.