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BY BBC
African countries with small and medium economies are paying a lot more for less effective medicines, said a health expert at BBC Newsday.
In countries such as Zambia, Senegal and Tunisia, common medications such as paracetamol can cost up to 30 times more than in the United Kingdom and the United States.
Drug markets in the poorest countries "just do not work," said Kalipso Chalkidou of the Center for Global Development.
She said that "competition is broken" because of a "concentrated supply chain".
Ms. Chalkidou, director of the organization's global health policy, co-authored a report on drug purchases that concluded that medium-to-moderate-economy countries are buying a smaller range of drugs, resulting in a competition, lower regulation and lower quality.
The richest countries, thanks to public money and strong drug buying processes, are able to afford cheaper drugs.
The poorest countries, however, tend to buy the most expensive drugs, rather than cheaper unbranded pharmaceuticals, which account for 85% of the UK and US market.
The poorest countries are not affected when foreign donors purchase medicines on their behalf, which means that their over-the-counter medicines remain at low cost.
"In the middle, it's very problematic," said Ms. Chalkidou.
Low- and middle-income countries "are not able to negotiate low prices and guaranteed quality products" and there are many increases, often due to taxes and corruption.
She said that a less stringent regulation meant that the quality of the drugs was not as high.
"Without regulation, people think that products do not work, so pay more for products that they think will work and will not work either," said Chalkidou.
The report recommends increased global cooperation and policy reform of the World Health Organization as well as targeted countries' policy to improve procurement practices.
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