IDEAS home Printed from
   My bibliography  Save this article

Markets and Policy Challenges in Access to Essential Medicines for Endemic Disease


  • Maureen Mackintosh
  • Phares G.M. Mujinja


Access to essential medicines is a core element of the effective health systems that are required to deal with endemic disease. Cost-effective access relies in turn on efficient market functioning and on appropriate polices towards the role of markets at national and international levels. This article argues that current international policy frameworks for promoting access to essential medicines lack coherence and display weak empirical foundations for proposed market interventions. A study of medicines markets in Tanzania questions some assumptions about market functioning underlying international policy, and shows how exploratory field studies can reduce the knowledge gap. Medicines policy should aim for rational use of essential medicines and for universal access free at the point of use to medicines essential to treat endemic diseases and other major causes of death. Unregulated retail market competition in essential medicines should be progressively constrained by government and NGO action. Wholesale market competition, in contrast, should be promoted, while the rebuilding of African pharmaceutical manufacturing is important for promoting and sustaining access. At each market level, public and non-governmental non-profit traders and providers can play a regulatory role alongside greater citizen information and civic activism. Copyright 2010 The author 2010. Published by Oxford University Press on behalf of the Centre for the Study of African Economies. All rights reserved. For permissions, please email:, Oxford University Press.

Suggested Citation

  • Maureen Mackintosh & Phares G.M. Mujinja, 2010. "Markets and Policy Challenges in Access to Essential Medicines for Endemic Disease," Journal of African Economies, Centre for the Study of African Economies (CSAE), vol. 19(suppl_3), pages 166-200, November.
  • Handle: RePEc:oup:jafrec:v:19:y:2010:i:suppl_3:p:166-200

    Download full text from publisher

    File URL:
    Download Restriction: Access to full text is restricted to subscribers.

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    1. Martin Ravallion, 2003. "Measuring Aggregate Welfare in Developing Countries: How Well Do National Accounts and Surveys Agree?," The Review of Economics and Statistics, MIT Press, vol. 85(3), pages 645-652, August.
    Full references (including those not matched with items on IDEAS)

    More about this item


    Access and download statistics


    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:oup:jafrec:v:19:y:2010:i:suppl_3:p:166-200. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Oxford University Press) or (Christopher F. Baum). General contact details of provider: .

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    We have no references for this item. You can help adding them by using this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.