Can systemic corruption be prevented by legal means? The market for pharmaceuticals in southern Ethiopia

Mengesha, A, Bastiaens, H, Ravinetto, R, Gibson, L ORCID: https://orcid.org/0000-0002-1220-8680 and Dingwall, R, 2025. Can systemic corruption be prevented by legal means? The market for pharmaceuticals in southern Ethiopia. Public Integrity. ISSN 1099-9922

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Abstract

Some international and national regulatory and policy actors assume thatstrengthening domestic laws and tightening enforcement measures will besufficient to reduce the extra-legal supply of medicines, whether legal, sub-standard, or falsified, to patients in low- and middle-income countries. Thispaper uses a qualitative study of the pharmaceutical market in SouthernEthiopia to argue that this assumption is unjustified, given the commonlack of institutional capacity and the complexity of supply chains by whichmedicines reach local markets. Data are drawn from interviews with phar-macists, wholesalers, pharmacy owners, regulators, law enforcementagents, and health professionals, supplemented by participant observationand review of relevant policy and legal documents. These data were ana-lyzed through the frame of Actor-Network Theory, to trace the journey ofmedicines from producer to consumer. Officially endorsed regulatory andenforcement mechanisms are entangled in an intricate web of practicesinvolving different actors responding to local demands. The extra-legalsupply of medicine, particularly if substandard or falsified, is an importantglobal public health concern, but it will only be reduced by measures thatplace law and regulation within the context of the social, economic, andcultural factors that shape local markets and undermine the integrity oflegal supply chains.

Item Type:	Journal article
Publication Title:	Public Integrity
Creators:	Mengesha, A., Bastiaens, H., Ravinetto, R., Gibson, L. and Dingwall, R.
Publisher:	Informa UK Limited
Date:	31 July 2025
ISSN:	1099-9922
Identifiers:	Number Type 10.1080/10999922.2025.2539025 DOI 2494344 Other
Divisions:	Schools > School of Social Sciences
Record created by:	Jeremy Silvester
Date Added:	19 Nov 2025 09:39
Last Modified:	19 Nov 2025 09:39
URI:	https://irep.ntu.ac.uk/id/eprint/54769

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