Regulating and producing antimalarial pharmaceuticals in Ghana and Benin : a state affair? Drug policies, quality standards and markets of medicines ; Réguler et produire les médicaments contre le paludisme au Ghana et au Bénin : une affaire d'Etat ? Politiques pharmaceutiques, normes de qualité et marchés de médicaments

Abstract

Despite the fact that Benin and Ghana are facing the same public health challenges with regards to malaria control, they do not deploy the same kind of drug policies to guarantee access to quality and affordable medicines for the population. Their national drug regulation authorities and local production capacities are different. These differences stem from their colonial heritage and their divergent historical, political and economic paths. Since 2004, Benin and Ghana have adopted Artemisinin-based Combination Therapies (ACTs) to replace the old pharmaceuticals deemed ineffective for the treatment of malaria. The challenge for the two countries is the high cost of these new drugs. The WHO guidelines and international funding for the purchase of ACTs are stimulating pharmaceutical innovation and production in Europe, North America and Asia. In Benin and Ghana, an arena of transnational actors is gradually being set up to supply ACTs. They generate new supply networks that compete with existing ones in the two countries. Financial aid is conditional on the purchase of WHO prequalified ACTs, certification that the Ghanaian pharmaceutical industries do not enjoy, leaving them on the sidelines of this market. Faced with the demands and conditions imposed by transnational actors, countries have little room for maneuver in the conduct of their public policies. Based on archives, interviews and ethnographic surveys carried out with national actors in pharmaceutical regulation, Ghanaian pharmaceutical companies and transnational actors financing ACTs, this work investigates the institutional mechanisms on which the states of Benin and Ghana rely to deploy their national drug policy and build their pharmaceutical sovereignty. ; Le Bénin et le Ghana, bien que confrontés aux mêmes enjeux de santé publique dans la lutte contre le paludisme, ne déploient pas les mêmes politiques pharmaceutiques nationales afin de garantir à la population l'accès à des médicaments de qualité et abordables financièrement. Ils sont équipés ...