Un article intéressant (en anglais...) sur le problème soulevé par le prof.
Unité de soutien à la réglementation pharmacetique
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.