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[e-med] (10)Burundi : coup d'arrêt au trafic de médicaments illicites

Un article intéressant (en anglais...) sur le problème soulevé par le prof. 

Alain Prat
Unité de soutien à la réglementation pharmacetique
OMS Genève

1.  Health Policy Plan. 2007 Nov;22(6):393-403. Epub 2007 Oct 4.

Drug shop regulation and malaria treatment in Tanzania--why do shops break the 
rules, and does it matter?
Goodman C, Kachur SP, Abdulla S, Bloland P, Mills A.

Health Policy Unit, London School of Hygiene and Tropical Medicine, London, UK. 

Regulatory infringements are extremely common in low-income countries, 
especially with respect to retail pharmaceutical sales. There have been few 
practical suggestions on public policy responses other than stricter regulatory 
enforcement, which governments are often unable, or unwilling, to do. This 
paper explores the challenges of regulating retail drug sellers, and potential 
solutions, through a case study of malaria treatment in rural Tanzania where 
small drug shops are a common source of medicine. Infringement of 
health-related regulation was extremely common. Most stores lacked valid 
permits, and illegal stocking of prescription-only medicines and unpackaged 
tablets was the norm. Most stocked unregistered drugs, and no serving staff met 
the qualification requirements. Infringements are likely to have reflected 
infrequent regulatory inspections, a failure of regulatory authorities to 
implement sanctions, successful concealment of regulatory violations, and the 
tacit permission of local regulatory staff. Eliminating regulatory 
infringements is unlikely to be feasible, and could be undesirable if access to 
essential medicines is reduced. Alternatives include bringing official drug 
regulation closer into line with locally legitimate practices; greater use of 
positive incentives for providers; and consumer involvement. Such a change in 
approach has the potential to provide a firmer platform for public-private 
collaboration to improve shop-based treatment.

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