Reviews PERSONAL VIEWS

Let the buyer beware

BMJ 2005; 331 doi: https://doi.org/10.1136/bmj.331.7512.358 (Published 04 August 2005) Cite this as: BMJ 2005;331:358
  1. Eboukél Aka, research pharmacist (aka@p.kanazawa-u.ac.jp),
  2. Candice Legris, Lavoisier research fellow in drug management and policy
  1. department of drug management and policy, Graduate School of Natural Science and Technology, Kanazawa University, Japan
  2. department of drug management and policy, Graduate School of Natural Science and Technology, Kanazawa University, Japan

    The Roxy market in the Adjamé district of Abidjan in Côte d'Ivoire is well known among the city's poor people. With hundreds of vendors, it is a vast expanse of shelters and parasols under which all kinds of drugs in all sorts of forms—pills, syrups, powder, suppositories, injectables, ointments—are displayed in a jumble on tables or in baskets. The drugs are constantly exposed to dust, sun, and changes in weather that can affect their quality. It is common to find drugs sold without their original packaging and repackaged in plastic bags with no mention of the drug's name, active ingredients, or expiry date. Nearly all the vendors are women, and more than a third are illiterate. None has knowledge of drugs or any medical training—but this does not mean they aren't ready to quickly diagnose an illness or try to decipher a prescription so they can provide a drug, though their choice is more likely to be determined by what they have in stock than the actual cause of the illness.

    The substandard drugs are often those in high demand for AIDS and malaria

    The drugs in the market can be …

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