Where do pharmaceuticals on the market originate? An analysis of the informal drug supply in Cotonou, Benin

This anthropological study, conducted in Cotonou, Benin between 2005 and 2007, investigates the informal pharmaceuticals market. It was carried out through a long-term participant observation of informal vendors and semi-directive and unstructured interviews. A classification of products sold in the informal market was developed. The fact that a high percentage of them come from Anglophone countries near Benin (Nigeria and Ghana) led to a comparison of the sources of pharmaceutical supply in these three countries as well as their current legislation regarding pharmaceutical distribution. Our study results highlight a new understanding of the phenomenon of the informal market. Nigeria and Ghana rely on a liberal pharmaceutical distribution system with little intervention from public authorities. Conversely, the government maintains considerable influence over pharmaceutical distribution in Benin. Hence, the differences between these three countries in terms of variety of supply sources and flexibility of access to drugs are understood through an investigation of Benin’s informal market. Therefore, it appears that beyond issues concerning the quality of the pharmaceuticals, this phenomenon illustrates a kind of liberalization of pharmaceutical distribution and the ensuing public health issues.

► Provides an analysis of the informal supply of pharmaceuticals in Benin. ► Describes the various types of drugs distributed in Cotonou's informal market, their origins and supply chains. ► Compares the pharmaceutical distribution systems of a Francophone country (Benin) and two Anglophone countries (Nigeria, Ghana). ► Examines a process of liberalization of pharmaceutical distribution, its advantages in terms of cost/access to drugs, and disadvantages for public health.