title: An examination of pharmaceutical systems in severely disrupted countries.
abstract: This research assesses informal markets that dominate pharmaceutical systems in severely disrupted countries and identifies areas for further investigation. Findings are based on recent academic papers, policy and grey literature, and field studies in Somalia, Afghanistan, the Democratic Republic of Congo and Haiti. The public sector in the studied countries is characterized in part by weak Ministries of Health and low donor coordination. Informal markets, where medicines are regularly sold in market stalls and unregulated pharmacies, often accompanied by unqualified medical advice, have proliferated. Counterfeit and sub-standard medicines trade networks have also developed. To help increase medicine availability for citizens, informal markets should be integrated into existing access to medicines initiatives.
authors.affiliation: Associate Professor, Leslie Dan Faculty of Pharmacy and Munk School of Global Affairs, University of Toronto, Toronto, Canada. jillian.kohler@utoronto.ca.
authors.forename: Jillian Clare
authors.initials: JC
authors.lastname: Kohler
authors.forename: Enrico
authors.initials: E
authors.lastname: Pavignani
authors.forename: Markus
authors.initials: M
authors.lastname: Michael
authors.forename: Natalia
authors.initials: N
authors.lastname: Ovtcharenko
authors.forename: Maurizio
authors.initials: M
authors.lastname: Murru
authors.forename: Peter S
authors.initials: PS
authors.lastname: Hill