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Artemisinin-based combination therapy: an illustration of the global pharmaceutical drug market in Asia and Africa

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Dualities between public health requirements and economic interests in pharma market in the Global South

Evolution of pharmaceutical systems in the Global South is subject to many social and economic influences, both current and historic. Analysis of first-line malaria treatments as a case study has revealed the phenomena at play.

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Research by the EU-funded project GLOBALMED (Artemisinin-based combination therapy: an illustration of the global pharmaceutical drug market in Asia and Africa) was geared to understand the social, political, economic and health stakes surrounding the pharmaceutical markets in Benin and Ghana in West Africa as well as Cambodia in South-East Asia. The idea was to improve existing systems and to strengthen the sovereignty of the states and regions discussed based on a comparative analysis of the advantages and disadvantages of the pharmaceutical systems studied.

Imposing influence on pharma systems in West Africa and Asia

Principal investigator, Carine Baxerres describes a very impressive series of dissemination events: “A big international symposium in March 2018 at Ouidah, Benin on ‘Regulations, markets, health: Questioning current stakes of pharmaceuticals in Africa’.” Presentations were made to health authorities in Cambodia (April 2016), in Benin (February 2017) and in Ghana (February 2018). “We presented our research results at scientific symposiums in Europe – Prague, Barcelona, Toulouse, Oxford, Paris, Marseille, Bâle, to name but a few,” Baxerres continues. Routledge Editions will be publishing a collective book on GLOBALMED results.

Upheavals in pharmaceutical systems identified and realities bared

Pharmaceutical markets in the Global South were profoundly disrupted during the post-colonial period by the construction and growth of an industry in emerging countries, by the creation of global donor markets in the early 2000s and by the emergence of local production centres in Africa. “This has created a hierarchy in pharmaceutical markets, that mix colonial and post-colonial legacies, the recent dominance of Asian medicines and the ascendency of global health,” Baxerres comments. Detailed analysis primarily focused on comparing the existing pharmaceutical systems in Benin and Ghana – in particular, artemisinin-based combination therapies (ACTs) for malaria. “We then went on to explore the determining role transnational actors such as United Nations agencies, private foundations and public-private partners play in influencing local pharmaceutical markets and how healthcare professionals and individuals manage this major epidemic,” Baxerres continues. Taking a broader perspective, GLOBALMED analysed the entire pharmaceutical supply. The exercise involved looking at the biomedical health system, representatives of pharmaceutical companies, actors in private distribution and consumer practices.

The future for pharmaceutical markets in the Global South

GLOBALMED strongly recommends a return to the idea of ‘essential medicines’ as developed in the early 1970s when structuring all pharmaceutical systems in the southern continents. Opening avenues for reflection, project conclusions promise to improve existing systems and to strengthen the sovereignty of the states and regions discussed. As well as a future book on Ghanaian formal pharmaceutical entrepreneurs, there are plans to present a proof of concept at the European Research Council for an innovative film production model for a stronger impact of social sciences research on health. This will be tested through the production of a short series from the project. Summing up her plans for the future, Baxerres outlines her upcoming studies: “Future work based on that already achieved by GLOBALMED will follow the emerging transregional approach. Combining the previous social sciences formulation and the new global study of West Africa and South-East Asia, I will be able to uncover the dynamics at play, an exciting challenge for me as a specialist anthropologist of West Africa.”


GLOBALMED, health, West Africa, pharmaceutical market, Asia, Global South, Benin, Ghana

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