An article (subscription required) in the latest issue of Nature provides an in-depth look at the prevalence of unregulated health markets in developing countries. Problems within these health markets include unqualified practitioners, inappropriate diagnoses and counterfeit medicines. A graph shows that high percentages of health providers in Asia and Africa - 87 percent in Bangladesh, for example - are poorly trained.
Authors David Peters, MD, DrPH, with the John Hopkins Center for Public Health, and Gerald Bloom, MDCM, with the University of Sussex, write:
The rapid expansion of health markets in Asia and Africa has made medicines, information and primary-care services available in all but the most remote areas. But it also creates problems with drug safety and effectiveness, equity of treatment and the cost of care. Poorly trained practitioners often prescribe unnecessary pills or injections, with patients bearing the expense and the costs to their health. Counterfeit drugs are rife and drug resistance is growing.
Bringing order to unruly health markets is a major challenge. Yet the problem is largely ignored by governments and international agencies. The World Health Organization (WHO) continues to highlight a shortage of primary health workers as the main barrier to accessing health care in low- and middle-income countries. It neglects the growing presence of drug sellers, rural medical practitioners and other informally trained health-care providers.
Peters and Bloom go on to outline how government, firms, and citizens can become more involved in working to solve these problems.