Can Systemic Corruption be Prevented by Legal Means? The Market for Pharmaceuticals in Southern Ethiopia

Bibliographic Data

ID6112487
AuthorsAkalework Mengesha (Wolaitta Sodo University (WSU), corresponding author), Hilde Bastiaens (0000-0002-5509-3406, University of Antwerp), Raffaella Ravinetto (0000-0001-7765-2443, Institute of Tropical Medicine), Linda Gibson (0000-0002-1220-8680, Institute for Health and Allied Professions Nottingham Trent University (NTU)), Robert Dingwall (0000-0002-1588-3796, Institute for Health and Allied Professions Nottingham Trent University (NTU))
Year2025
Pages1-18
Publication date2025-07-31
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenuePublic Integrity (JOURNAL)
Journal identifiersISSN: 1558-0989 • E-ISSN: 1099-9922
PublisherInforma UK Limited (PUBLISHER • GB)
DOI10.1080/10999922.2025.2539025
OpenAlexW4412817217
LanguageEN
References cited31

Some international and national regulatory and policy actors assume thatstrengthening domestic laws and tightening enforcement measures will besufficient to reduce the extra-legal supply of medicines, whether legal, sub-standard, or falsified, to patients in low- and middle-income countries. Thispaper uses a qualitative study of the pharmaceutical market in SouthernEthiopia to argue that this assumption is unjustified, given the commonlack of institutional capacity and the complexity of supply chains by whichmedicines reach local markets. Data are drawn from interviews with phar-macists, wholesalers, pharmacy owners, regulators, law enforcementagents, and health professionals, supplemented by participant observationand review of relevant policy and legal documents. These data were ana-lyzed through the frame of Actor-Network Theory, to trace the journey ofmedicines from producer to consumer. Officially endorsed regulatory andenforcement mechanisms are entangled in an intricate web of practicesinvolving different actors responding to local demands. The extra-legalsupply of medicine, particularly if substandard or falsified, is an importantglobal public health concern, but it will only be reduced by measures thatplace law and regulation within the context of the social, economic, andcultural factors that shape local markets and undermine the integrity oflegal supply chains

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