Marketing is key in medicines distribution in Africa

Nomfundo Dlamini, Tank Research founder.

Given the unfavourable economic climate and high cost of medical services across much of the continent, consumers have established a network of information sharing and cheap, accessible medicines.

There are three primary sources of medication for consumers across much of Africa:

1. Chemists or drug stores

2. Pharmacies

3. Doctors or hospitals

These cascade alongside both education and income. The tier of doctors and hospitals offer the pinnacle of healthcare where consumers know they will receive proper care and medication, but given the costs of consultation, medication, transport and long queues that frequently result in people being turned away, people tend to avoid this route unless seriously ill.

Where registered pharmacies are concerned, they offer specialist advice, require prescriptions and do not stock fakes. These outlets are unfortunately primarily found in urban areas only.

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The first tier - and the largest source of medicines - is commonly referred to as a chemist or drug store and here medications are dispensed over the counter, but not by a professional.

These could be operated by a retired nurse with some medical knowledge, but could just as well be someone with no prior experience operating in an open-air market.

A virtual spaza shop for drugs - the danger here is that there is no requirement for prescriptions, they are widely supported and utilised since they are accessible and affordable and carry a wide range of medication, from analgesics to scheduled medications like penicillin.

They fulfil the need for daily ailments, covering everything from gastric upsets, 'flu, headaches, sore throats, toothache, period pain to general, non-specific infections.

Copy-at or counterfeit medication is widely sold in these stores and no side-effects or directions for use - such as needing to be taken before/after a meal or maximum number of pills to be consumed per day - are discussed.

Fake drugs

As a recent study from the World Health Organization pointed out, the so-called "'fake drugs" come in a variety of forms. There are the substandard drugs, which perhaps wouldn't pass quality tests due to a manufacturing error or because they have already passed their expiry date.

The second kind, known as counterfeit drugs, have been deliberately falsified. This means that they could contain entirely different chemicals than the original or might even have no medical properties at all.

According to the WHO, substandard and counterfeit anti-malarial drugs alone contributed to an additional 72,000 to 267,000 deaths in sub-Saharan Africa annually.

Where medications are properly sourced from wholesalers or distributors, packaging may be opened to sell in smaller quantities as needed (for example an immediate fix for a headache requires only two tablets) and no regulations apply to expiry dates or refrigeration.

Marketing messaging

What would assist in these areas is crisp, incisive messaging around both ailments and their associated treatments to promote the correct products.

There is a high level of recognition of active ingredients in medicines among ordinary consumers, which is refreshing and comforting. They know for instance that aspirin can cause ulcers, which means messaging is well-received and would increase general understanding of medical conditions and products.

The media is a key platform for dissemination of information around medications.

There is also a clear season when ailments increase dramatically: the wet season has been linked to many minor ailments and ramping up communications and activations just prior to or during this season would have an immediate effect on sales.

The question remains, however, as to who should be protecting the consumer? Manufacturers sell to distributors and where is Government regulation in the supply chain?

There is a definite need for regulations to be tightened and enforced to protect the end-user. Is there a role manufacturers can play to ensure that their products are used responsibly and safely, or does their obligation not continue down the value chain?