title: Drug quality in South Africa: perceptions of key players involved in medicines distribution.
abstract: OBJECTIVE
  Substandard medicines contribute to poor public health and affect development, especially in the developing world. However knowledge of how manufacturers, distributors and providers understand the concept of drug quality and what strategies they adopt to ensure drug quality is limited, particularly in the developing world. The purpose of this paper is to explore pharmaceutical manufacturers', distributors' and providers' perceptions of drug quality in South Africa and how they ensure the quality of drugs during the distribution process.
  
  
  METHODS
  The approach taken was qualitative data collection through key informant interviews using a semi-structured interview guide. Transcripts were analysed thematically in Johannesburg, Pretoria and Durban, South Africa. Participants were recruited purposefully from a South African pharmaceutical manufacturer, SA subsidiaries of international manufacturers, national distribution companies, national wholesaler, public and private sector pharmacists, and a dispensing doctor. In total, ten interviews were conducted.
  
  
  RESULTS
  Participants described drug quality in terms of the product and the processes involved in manufacturing and handling the product. Participants identified purchasing registered medicines from licensed suppliers, use of standard operating procedures, and audits between manufacturer and distributor and/or provider as key strategies employed to protect medicine quality. Effective communication amongst all stakeholders, especially in terms of providing feedback regarding complaints about medicine quality, appears as a potential area of concern, which would benefit from further research.
  
  
  CONCLUSIONS
  The paper hightlights that ensuring medicine quality should be a shared responsibility amongst all involved in the distribution process to prevent medicines moving from one distribution system (public) into another (private).
authors.affiliation: Otago University, Dunedin, New Zealand. aarti.patel@stonebow.otago.ac.nz
authors.forename: Aarti
authors.initials: A
authors.lastname: Patel
authors.forename: Pauline
authors.initials: P
authors.lastname: Norris
authors.forename: Robin
authors.initials: R
authors.lastname: Gauld
authors.forename: Thomas
authors.initials: T
authors.lastname: Rades
mesh_terms: D003695:Delivery of Health Care / Q000592:standards* / Q000706:statistics & numerical data; D004345:Drug Industry / Q000592:standards* / Q000706:statistics & numerical data; D064420:Drug-Related Side Effects and Adverse Reactions; D005569:Formularies as Topic / Q000592:standards; D006291:Health Policy; D006297:Health Services Accessibility / Q000592:standards* / Q000706:statistics & numerical data; D006801:Humans; D055553:Prescription Drugs / Q000592:standards / Q000600:supply & distribution*; D036301:Qualitative Research; D011785:Quality Assurance, Health Care; D011787:Quality of Health Care / Q000592:standards* / Q000706:statistics & numerical data; D012938:Social Perception; D013019:South Africa
chemical_list: D055553:Prescription Drugs