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While the law requires that the water trucks undergo inspections and drivers have medical exams, including to test for HIV, and receive licenses, one expert said he personally knew drivers who said they were able to bribe officials at the Pollution department in the Ministry of Environment in order to obtain a license but avoid having their tanks tested.[288] Another Basra resident said he was personally familiar with this practice and said that as part of the licensing regime, truckers had to pay a one-off fee of IQD 22,000 ($ 18), then another IQD 25,000 ($ 21) for their annual medical examination and finally IQD 72,000 ($ 60) for tank inspections every three month which they told him were prohibitive costs that they preferred to avoid.[289] Great Basra Water Project In 2008, the Japan International Cooperation Agency (JICA) approved a project aimed at improving the quality and quantity of water in Basra

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A 2025 systematic review published in an orthopedic sports medicine journal noted that adverse effects from unregulated manufacturing depict a genuine safety concern independent of the peptide itself