[Illicit sales of drugs in Senegal. Consequences for community health].

The relatively recent development of parallel drug markets in the Third World has not yet been specifically studied. A research on illicit drug sale was carried out in Pikine, a 600,000 people suburb of Dakar: all items provided by all sellers observed on the markets of the town were inventoried; their indications and posologies were given by a sample of 20 among the 100 identified sellers; complementary information was obtained from the official structures of drug distribution. The list of all medications available shows 23 items--12 directed at [symptoms], and 11 at [causes]. The indications and posologies are remarkably similar for the 20 sellers, whose training was done in well-structured channels outside the official network. Evaluation of the potential consequences of these parallel markets for community health shows: 1) a probably beneficial impact of some medications, such as analgesics, antimalarials, antibiotic eye ointment; 2) exposure to individual risks (tetracyclines, sulfamids) and collective risks (antibiotics, not widespread yet, but capable of selecting resistant germs). Moreover, this illicit sale must be understood in its social context where buying drugs on the markets is the least expensive and most accessible solution for underprivileged people, because of scarcity of resources in the dispensaries. Thus, rather than to automatically condemn illicit drug sale, it seems more appropriate and urgent to evaluate the risks of medications available in each of the countries involved, to develop health information in the population, and meanwhile to make access to drugs in primary health care structures easier.