1st Edition

Understanding Drugs Markets An Analysis of Medicines, Regulations and Pharmaceutical Systems in the Global South

Edited By Carine Baxerres, Maurice Cassier Copyright 2022
    320 Pages 45 B/W Illustrations
    by Routledge

    320 Pages 45 B/W Illustrations
    by Routledge

    Drawing on anthropology, historical sociology and social-epidemiology, this multidisciplinary book investigates how pharmaceuticals are produced, distributed, prescribed, (and) consumed, and regulated in order to construct a comprehensive understanding of the issues that drive (medicine) pharmaceutical markets in the Global South today.


    Based on primary research conducted in Benin and Ghana, and additional data collected in Cambodia and the Ivory Coast, this volume uses artemisinin-based combination therapies (ACTs) against malaria as a central case study. It highlights the influence of the countries colonial and post-colonial history on their models for state regulation, production, and distribution, explores the determining role transnational actors as well as industries from the North but also and increasingly from the South play in influencing local pharmaceutical markets and looks at the behaviour of health care professionals and individuals. Stepping back, the authors then unpick the pharmaceuticalization process and the multiple regulations at stake by looking at the workings of, and linkages between, (biomedical health) pharmaceutical systems, (representatives of companies) industries, actors in private distribution, and consumer practices.


    Providing a thorough comparative analysis of the advantages and disadvantages of different pharmaceutical systems, it is an important contribution to the literature on pharmaceutalization and the governance of medication. It is of interest to students, researchers and policy-makers interested in medical anthropology, the sociology of health and illness, global health, healthcare management and pharmacy.

    The Open Access version of this book, available at http://www.taylorfrancis.com/books/9780429329517, has been made available under a Creative Commons Attribution-Non Commercial-No Derivatives 4.0 license.


    Introduction- Pharmaceutical markets in the Global South: shaped by history and multiple regulations

    Carine Baxerres and Maurice Cassier

    Part I. Varying choices for State regulation and their consequences

    Chapter 1- Strengthening national pharmaceutical regulation through local production

    Jessica Pourraz, Claudie Haxaire, Daniel Arhinful

    Chapter 2- Strengths and weaknesses of State-controlled wholesale distribution: Benin’s CAME and wholesaler-distributors

    Stéphanie Mahamé, Roch Appolinaire Houngnihin, Adolphe Codjo Kpatchavi

    Chapter 3- Distribution and access to medicines: role of the pharmacist monopoly

    Carine Baxerres, Adolphe Kpatchavi, Daniel Arhinful

    Chapter 4- From depharmaceuticalization to drug abundance: a social history of pharmaceutic regulations in Cambodia

    Eve Bureau-Point

    Part II. Global and local markets of new antimalarials

    Chapter 5- A new geography of pharmaceuticals: trajectories of artemisinin-based medicines

    Maurice Cassier

    Chapter 6- Clashes between subsidized and private ACT markets: when administrative, Global Health, and marketing regulations collide

    Carine Baxerres and Jessica Pourraz

    Chapter 7- When the pharmaceutical system creates persistent attachments or new appropriations of drug molecules: divergent ACT distribution and use in Benin and Ghana

    Carine Baxerres, Kelley Sams, Daniel Kojo Arhinful, Jean-Yves Le Hesran

    Chapter 8- Standardized herbal medicines in Ghana: the construction of a substantial share of the medicine market, especially for malaria

    Maxima Missodey and Daniel Arhinful

    Part III. Pharmaceuticalization: medicines at the heart of health systems and societies

    Chapter 9- Pharmaceutical representative activities in Benin and Ghana: promoting firms while helping construct the pharmaceutical economy of African countries

    Carine Baxerres and Stéphanie Mahamé

    Chapter 10- Self-medication versus consultation: individual autonomy and dependence in health decisions

    Carine Baxerres, Kelley Sams, Roch Appolinaire Houngnihin, Daniel Arhinful, Jean-Yves Le Hesran

    Chapter 11- When subjective quality shapes the whole economy of pharmaceutical distribution and production

    Carine Baxerres, Adolphe Codjo Kpatchavi, Daniel Kojo Arhinful

    Conclusion- Rationalizing drug markets in the Global South: re-making medicines essential

    Maurice Cassier and Carine Baxerres


    Carine Baxerres is researcher in anthropology at the French National Research Institute for Sustainable Development (IRD), in the research unit MERIT (IRD-University of Paris) and LPED (IRD-Aix-Marseille University). Her research interests are global and local pharmaceuticals markets in West Africa and more recently in South-east Asia, and health-seeking behaviors. ORCID No: 0000-0003-3023-3449

    Maurice Cassier is currently a senior researcher at the French National Center for Scientific Research (CNRS, CERMES3, Paris). He has published extensively on the tensions between exclusive intellectual property rights on medicines and the right to health and has developed a research programme on the new geographies of the pharmaceutical industries in the Souths. He is currently working on new models of innovation and local production of health products, based on the categories of public goods and commons. ORCID No: 0000-0003-3908-8073