ABSTRACT
The supply of artemisinin-based combination therapies (ACTs) in Benin and Ghana is made up of both subsidized ACTs produced by European multinationals or Asian generics companies and ACTs produced for private markets by Asian or African manufacturers. Global Health programs significantly structure pharmaceutical markets in the Global South, including in countries where distribution is largely liberalized, as in the case of Ghana. Thus, the subsidized drugs they distribute are abundantly found and take precedence over local production, as we will show through the study of a pilot program, the Affordable Medicines Facility-malaria (AMFm), and its effects on the Ghanaian private market. Faced with this, Asian ACT producers, as well as local and European ones, are deploying marketing strategies to conquer unsubsidized private markets and reach consumers as closely and directly as possible. They are supported in this by their representatives as well as by distributors and retailers, in both urban and rural areas, who rely in particular on the socioeconomic positions of consumers. By analyzing these ACT markets, this chapter shows how companies have to maneuver to capture market share between the administrative regulations implemented by national and transnational actors and the marketing regulations developed by the firms themselves.
