Search

This paper questions the current highlighted question of "fake drugs" in the media and through institutional speeches. After a brief reminder of the expressions used previously in France and in the French-speaking countries of West Africa, the realities which recover various phenomena will be discussed as well as the hotchpotch often made between them: the phenomenon of counterfeit drugs, that of substandard medicines and the recently legally defined in Europe phenomenon of falsified drugs. Then, the data of an anthropological study led from 2005 till 2007 about the informal market of pharmaceutical in Benin will allow to underline the differences which exist between this phenomenon and that of counterfeit drugs as well as that of falsified drugs. Finally, the political and economic stakes which recover these questions will be highlighted and will explain why "fantasized" speeches are often given about them. The conclusion will stop on the problem of substandard medicines and some of the ways to solve it will be sketched.

Impregnated bednets can be considered a major tool for reducing Anopheles bites, malaria morbidity and overall mortality. The resistance of Anopheles gambiae to pyrethroids used to impregnate bednets and curtains has already been noted in the urban area of Cotonou in Benin (18, 21). In this study, we wished to find out if the resistance observed in Cotonou is localized only in this town or is already extensive throughout Benin. In this case, such resistance would be a handicap to the promotion of impregnated bednets in Benin. The study was carried out in 15 localities throughout the different ecological zones of Benin. The study has also taken into account environmental factors favouring the emergence of resistance. We did susceptibility tests with WHO test kits for adult mosquitoes using impregnated papers. The papers were impregnated with permethrin 0.25%, deltamethrin 0.025% and lambdacyhalothrin 0.1%. We also tested DDT 4% to find out if there was a cross resistance between DDT and the pyrethroids. Two mosquito species were tested: An. gambiae and An melas. In northern Benin, where farmers use insecticides against cotton pests, vectors are susceptible to deltamethrin and lambdacyhalothrin and resistant to permethrin. In the south, An. gambiae is resistant to deltamethrin and permethrin. This resistance is high in the urban zone of Cotonou, in the coastal and lagoon areas and at Kraké, a frontier viliage with Nigeria. The resistance observed in southern Benin is confirmed by the lengthening of the knock-down time of mosquitoes which were exposed for 1 hour to insecticide in impregnated WHO test tubes, and by a reduction of permethrin and deltamethrin remanence effect.