Supply and use of essential drugs in sub-Saharan Africa: some issues and possible solutions.

The paper describes drug supply systems in Africa, both public and private, and concludes that the 'private sector' may have serious drawbacks. Many opportunities exist for improving efficiency and reducing waste; the paper gives evidence for the savings to be made. Finally, there are several issues of specific importance to Africa, namely, geographic and spatial constraints to improving logistics, which are much more severe than elsewhere in the world; the problem of counterfeit drugs; financing of drug supplies and cost recovery; and the impact of the HIV/AIDS epidemic on supply and use of essential drugs.