
Artemisinin-based combination therapy: an illustration of
the global pharmaceutical drug market in Asia and Africa
Objective
Funding Scheme
ERC-SG - ERC Starting Grant

Principal Investigator
"Carine, Bernadette, Anne" Baxerres (Dr.)
Host institution
INSTITUT DE RECHERCHE POUR LE DEVELOPPEMENT
Address
Boulevard De Dunkerque 44 Cs 90009
13572 Marseille
France
Activity type
Research Organisations
EU Contribution
€ 927 034
Principal Investigator
"Carine, Bernadette, Anne" Baxerres (Dr.)
Administrative Contact
Jean Jacques Roubion (Mr.)
Beneficiaries (1)
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INSTITUT DE RECHERCHE POUR LE DEVELOPPEMENT
France
EU Contribution
€ 927 034
Project information
GLOBALMED
Grant agreement ID: 337372
Status
Closed project
-
Start date
1 March 2014
-
End date
28 February 2019
Funded under:
FP7-IDEAS-ERC
-
Overall budget:
€ 927 034
-
EU contribution
€ 927 034
Dualities between public health requirements and economic interests in pharma market in the Global South
HEALTH

Research by the EU-funded project GLOBALMED 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, Dr 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,” she 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,” Dr 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,” she 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, Dr Baxerres outlines her upcoming studies: “Future work based on that already achieved by GLOBALMED will follow the emerging transregional approach. Combining the former 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.”
Keywords
GLOBALMED, health, West Africa, pharmaceutical market, Asia, Global South, Benin, Ghana
Project information
GLOBALMED
Grant agreement ID: 337372
Status
Closed project
-
Start date
1 March 2014
-
End date
28 February 2019
Funded under:
FP7-IDEAS-ERC
-
Overall budget:
€ 927 034
-
EU contribution
€ 927 034
Discover other articles in the same domain of application
Final Report Summary - GLOBALMED (Artemisinin-based combination therapy: an illustration ofthe global pharmaceutical drug market in Asia and Africa)
For each of the study countries, the results of the program share a comprehensive understanding of the issues that drive medicine markets in the Global South today. Our detailed analysis primarily focus on comparing the existing pharmaceutical systems in Benin and Ghana. It will first highlight the influence of the countries’ colonial and post-colonial history on their models for State regulation, production, and distribution. The issues of promoting local production and the monopoly of the pharmacist appear to be important levers for States. Beginning with the currently recommended first-line malaria treatments—artemisinin-based combination therapies (ACTs)—the results explore the determining role that transnational actors (bilateral and multilateral aid agencies, United Nations agencies, private foundations, public-private partnerships, etc.) play in influencing local pharmaceutical markets. Facing but as well playing with them, pharmaceutical firms from Europe, Asia and Africa develop strategies to increase their market shares. It is from the hierarchy of this medicines offer that health care professionals and individuals manage this major epidemic. ACTs provide a case study illustrating the pharmaceutical markets’ current trends in the South. Next, taking a broader perspective on the entire pharmaceutical supply in the study countries, the “pharmaceuticalization” of societies are analyzed by looking at the biomedical health system, representatives of pharmaceutical companies, actors in private distribution, and consumer practices. We also highlight the linkages between these various levels of social realities. Finally, our research contextualize the inherent dualities of medicines between public health requirements and economic interests, and between the pipe dream of care and the imaginaries of consumption.
The research programme conclude by appealing to policy makers and public health actors to improve existing pharmaceutical systems and strengthen the sovereignty of the States and regions under consideration. We construct an appeal to return to the idea of “essential”—in the sense of “essential medicines”—when structuring all pharmaceutical systems in the South. The principles of the concept, ones that favor governing medicines through public health and cost-saving criteria and that include pharmacy in a community-based health system at hospitals, are far removed from the vertical global health programs and massive disease-specific pharmaceuticalization. In terms of production, we advocate that regulation and local production be regionalized to scale, especially in West Africa, including the creation of regional standards and alternatives to WHO standards, as seen in Brazil. We also take a position on the issue of the industrialization of “traditional” medicines which currently need to be thought. In terms of prescribing, we highlight the importance of strengthening health systems horizontally and backing them with a universal health coverage system. Lastly, in terms of distribution, we emphasize the importance of thinking about the differentiated application of the pharmaceutical monopoly based on distribution steps: the need to strengthen it during the wholesale distribution step and to make it more flexible for retail distribution. Thus the results of our research opens avenues for reflection, based on a comparative analysis of the advantages and disadvantages of the pharmaceutical systems studied.
Project information
GLOBALMED
Grant agreement ID: 337372
Status
Closed project
-
Start date
1 March 2014
-
End date
28 February 2019
Funded under:
FP7-IDEAS-ERC
-
Overall budget:
€ 927 034
-
EU contribution
€ 927 034
Deliverables
Deliverables not available
Publications
Project information
GLOBALMED
Grant agreement ID: 337372
Status
Closed project
-
Start date
1 March 2014
-
End date
28 February 2019
Funded under:
FP7-IDEAS-ERC
-
Overall budget:
€ 927 034
-
EU contribution
€ 927 034
Project information
GLOBALMED
Grant agreement ID: 337372
Status
Closed project
-
Start date
1 March 2014
-
End date
28 February 2019
Funded under:
FP7-IDEAS-ERC
-
Overall budget:
€ 927 034
-
EU contribution
€ 927 034