# \[e-drug\] Fighting poor-quality medicines in LMICs: the importance of advocacy and pedagogy

**URL:** <https://talk.edrugplus.org/t/e-drug-fighting-poor-quality-medicines-in-lmics-the-importance-of-advocacy-and-pedagogy/43203>\
**Category:** e-drug\
**Created:** [November 11, 2016, 11:41am UTC](https://talk.edrugplus.org/t/e-drug-fighting-poor-quality-medicines-in-lmics-the-importance-of-advocacy-and-pedagogy/43203 "2016-11-11T11:41:40Z")\
**Posts on this page:** 2\
**Page:** 1

<div class="post-metadata">

**Author:** ![R.Ravinetto](https://dub1.discourse-cdn.com/flex013/user_avatar/talk.edrugplus.org/r.ravinetto/32/311_2.png) [@R.Ravinetto](https://talk.edrugplus.org/u/R.Ravinetto)\
**Post date:** [November 11, 2016, 11:41am UTC](https://talk.edrugplus.org/t/e-drug-fighting-poor-quality-medicines-in-lmics-the-importance-of-advocacy-and-pedagogy/43203/1 "2016-11-11T11:41:40Z")

</div>

E-DRUG: Fighting poor-quality medicines in LMICs: the importance of advocacy  
and pedagogy  
---------------------------------  
[submitted by Raffaella Ravinetto \<rravinetto@itg.be\>  
She adds: “We are deeply indebted to Jacques Pinel (1942–2015) who has been a master and a source of inspiration for all the authors of this manuscript”. WB]

Fighting poor-quality medicines in low- and middle-income countries: the  
importance of advocacy and pedagogy

By Raffaella Ravinetto, Daniel Vandenbergh, Cécile Macé, Corinne Pouget,  
Brigitte Renchon, Jean Rigal, Benedetta Schiavetti and Jean-Michel Caudron

Abstract

The globalization of pharmaceutical production has not been accompanied by a  
strengthening and harmonization of the regulatory systems worldwide. Thus,  
the global market is characterized today by a situation of multiple  
standards, and patients in low- and middle-income countries are exposed to  
the risk of receiving poor-quality medicines. Among those who first raised  
the alarm on this problem, there were pioneering humanitarian groups, who  
were in a privileged position to witness the gap in quality of medicines  
between high-income countries and low- and middle-income countries.

Despite an increasing awareness of the problem and the launch of some  
positive initiatives, the divide in pharmaceutical quality between the North  
and the South remains important, and insufficiently addressed. More advocacy  
is needed for universal access to quality-assured medicines. It should  
target all those who are strongly “involved” with medicines: regulators,  
international organizations, journalists, purchasers, prescribers, program  
managers, policy makers, public health actors and the patients. Advocacy  
should be based on evidence from research and monitoring programs, and  
technical concepts should be translated in lay language through  
communication tools that address all the stakeholders. The fight to ensure  
universal access to quality medicines needs the participation of all, and  
can only be successful if grounded in common understanding.

Keywords: Quality of medicines, Low- and middle-income countries,  
Pharmaceutical regulation, Quality assurance, Equity in health

Full text at Ravinetto et al. Journal of Pharmaceutical Policy and Practice

[https://joppp.biomedcentral.com/articles/10.1186/s40545-016-0088-0](https://joppp.biomedcentral.com/articles/10.1186/s40545-016-0088-0)

---

<div class="post-metadata">

**Author:** ![Pascal](https://dub1.discourse-cdn.com/flex013/user_avatar/talk.edrugplus.org/pascal/32/301_2.png) [@Pascal](https://talk.edrugplus.org/u/Pascal)\
**Post date:** [November 11, 2016, 3:46pm UTC](https://talk.edrugplus.org/t/e-drug-fighting-poor-quality-medicines-in-lmics-the-importance-of-advocacy-and-pedagogy/43203/2 "2016-11-11T15:46:45Z")

</div>

E-DRUG: Fighting poor-quality medicines in LMICs: the importance of advocacy and pedagogy (2)  
--------------------------------------------------------------------------------------------------------------------

Good academic work but a full analysis should incorporate other PH perspectives which influence drug use, the paper does not acknowledge that the issue is multi-dimensional and cross sectional. Affordability, diagnostics and equitable access to care are as important for individuals in low middle income countries.

It may not be realistic in a globalizing world to assume a equally global common understanding to ensure universal access. More (complex) research is needed by the established research groups before to infer conclusions or assumptions on a 'common understanding' for the global community.

Pascal Verhoeven  
MPH/pharmacist  
Lao PDR  
verhoeven.pascal@gmail.com