- Maïmouna Diop:Improving Senegal's Public Health Sector through Pharmaceutical Equivalence
pharmaceutical industry, public health, Senegal, Africa, pharmacies
While perusing the booths in the exhibit hall at the 2011 International Pharmaceutical Forum in Dakar, Senegal, I was attracted to the booth of Mayite Equivalence. Mayite Equivalence is a locally produced and distributed pharmaceutical reference manual with more than 2,000 entries on biomedical drugs circulating in the Senegalese marketplace. The accompanying booth was well-staffed and bustling with visitors and great interest. Mayite Equivalence was created by a local pharmacist, Maïmouna Diop, in response to recent changes to the local pharmaceutical marketplace. In the late 20th century, Senegal gradually emerged from France's pharmaceutical manufacturing orbit and began working with new pharmaceutical trading partners. Annually, Senegal manufactures 15-20% of its drugs, with the majority of imported drugs coming from France and Morocco. In the last 20 years, a small but growing percentage of drugs have been imported from the United States. In the last decade, new trading partners from the Eastern European bloc, Asia, Saharan and sub-Saharan Africa have entered into Senegalese markets. The influx of drugs with new names and, in many cases, new languages began to cause some confusion for doctors, pharmacists, and nurses working in public and private spheres. This confusion could have led to improper dosage, unexpected side effects and other medical complications. Maïmouna Diop, observed these growing challenges and began thinking of ways to help streamline Senegal's growing connection to global pharmaceutical networks. For example, Mayite Equivalence includes four pages on the various forms and suppliers of amoxicillin. This frequently prescribed antibiotic is supplied to Senegal by more than a dozen companies from countries such as France, Morocco, Belgium, Côte d'Ivoire, Italy, Austria, and India among others. Morocco, Belgium, and France have long traded with Senegal but the other countries are all new trading partners. Diop sought to decipher this babel of voices and to translate this energy into the creation of Mayite Equivalence.* Diop's dynamism, business acumen, and desire to improve public health in Senegal are palpable. [End Page 11]
Maïmouna Diop's work is indicative of a larger discourse on developing economies, public health, and affordable access to biomedical drugs. When I began my early research on pharmacy practice and pharmaceutical trade networks in Senegal in 2000, there existed a dearth of generic drug production, diversified streams of pharmaceutical importation, and local production of drugs. Only a small percentage of state-sanctioned drugs were distributed as generics. In my initial interviews, I asked pharmacist informants their thoughts about generic drugs, and the majority supported the accessibility of generic drugs, particularly since a large sector of Senegal's population is resource-limited. Others were concerned about how the generic drugs could hurt profit margins.
In recent years, a growing demand for generic drugs has materialized. Rising inflation, stagnating wages, and high employment have contributed to these calls. In addition, the Senegalese public health sector is fairly advanced and access to pharmaceuticals is good, especially in urban areas. Increasingly, customers have experience living abroad, and others have family members who live abroad and educate them on the benefits of generic drugs. Yet, access to generic drugs in Senegal is limited and the country tends to trade most prominently with its Francophone counterparts. The lack of a shared language and cultural familiarity between Senegal and its trading partners has led to rising drugs costs, limited access to new drugs, and little diversification in pharmaceutical trading partners. This is significant in a country with an annual per capita GDP (Gross Domestic Product) of $2,000 and with socially ingrained traditional healing communities. Many Senegalese citizens seek the care of traditional healers before
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or in tandem with biomedical treatment. This behavior is informed by many factors that include local ideas that posit traditional healing approaches as more holistic and powerful than Western medicine. Another reason is that medicine obtained from a pharmacy or other formal biomedical spheres is seen as cost...