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Open Access Highly Accessed Correspondence

An examination of pharmaceutical systems in severely disrupted countries

Jillian Clare Kohler1*, Enrico Pavignani2, Markus Michael3, Natalia Ovtcharenko4, Maurizio Murru5 and Peter S Hill6

Author Affiliations

1 Associate Professor, Leslie Dan Faculty of Pharmacy and Munk School of Global Affairs, University of Toronto, Toronto, Canada

2 Lecturer, School of Population Health, University of Queensland, Brisbane, Australia

3 Consultant for Public Health and Humanitarian Aid, Sao Paulo, Brazil

4 Research Assistant, Initiative for Drug Equity and Access, University of Toronto, Toronto, Canada

5 Public Health Consultant, Modena, Italy

6 Associate Professor, School of Population Health, University of Queensland, Brisbane, Australia

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BMC International Health and Human Rights 2012, 12:34  doi:10.1186/1472-698X-12-34

Published: 6 December 2012

Abstract

This research assesses informal markets that dominate pharmaceutical systems in severely disrupted countries and identifies areas for further investigation. Findings are based on recent academic papers, policy and grey literature, and field studies in Somalia, Afghanistan, the Democratic Republic of Congo and Haiti. The public sector in the studied countries is characterized in part by weak Ministries of Health and low donor coordination. Informal markets, where medicines are regularly sold in market stalls and unregulated pharmacies, often accompanied by unqualified medical advice, have proliferated. Counterfeit and sub-standard medicines trade networks have also developed. To help increase medicine availability for citizens, informal markets should be integrated into existing access to medicines initiatives.