Auteur :
Mackintoshe
Maureen
Année de Publication :
2008
Type : Article
Thème : Santé
The private market for medicines, considered as a supply chain from manufacturers to end users, is notoriously subject to market failure; in rich countries it is therefore subject to stringent regulation. Yet the empirically based policy literature on access to essential medicines remains limited on how these market problems can be overcome in the supply of medicines from developing country manufacturers to the dangerously unregulated retail medicines markets suffered by the very poor across the world. This paper explores the under-studied role of social enterprise as traders and regulatory actors in the international wholesale markets for essential medicines and their impact on accessibility, quality and prices in these perverse markets, drawing on an interview survey of European-based socially oriented wholesalers supplying the medicines market for sub-Saharan Africa. The paper argues that these enterprises play an important role in regulating price and quality and hence in improving access to medicines by the poor. However they face challenging market and political conditions. The paper analyses the motivations and organisational structures that sustain social and ethical commitment in this market, drawing on theories of social enterprise and non-profit business, and surveys the challenges and constraints. It then examines the formal international and national regulatory interventions in the international markets and their effects on social enterprise, in the context of a substantial institutional divide between the medicines-related campaigning of the large international NGOs and the activities of these market-oriented social enterprises.