# They don’t want to close Roxy: a qualitative account on the perceived efforts by Ivory Coast to end the informal market for medicines

## TL;DR

The study explores why Ivory Coast's efforts to end informal medicine markets are failing, highlighting the need for government action.

## Contribution

The study reveals the complexity and employment role of informal medicine markets in Ivory Coast.

## Key findings

- The informal medicine market is seen as integral to the health system and provides employment.
- Ending the informal market requires significant coordination and resources.
- Ambivalence exists in regulating the market due to its complex nature.

## Abstract

•Informal markets for medicines pose a great danger to public health.•Efforts to regulate and stop the informal markets for medicines are falling short.•The government is failing in its role in making medicines accessible and available.•Failure by the state to provide medicines opens an opportunity for informal markets.•The government need to be decisive in its roles of provision and regulation.

Informal markets for medicines pose a great danger to public health.

Efforts to regulate and stop the informal markets for medicines are falling short.

The government is failing in its role in making medicines accessible and available.

Failure by the state to provide medicines opens an opportunity for informal markets.

The government need to be decisive in its roles of provision and regulation.

The informal market for medicines poses great danger to public health as they expose populations to counterfeit and expired medicines, among many vices. Ivory Coast is one of the countries where this market is growing. The country has been trying to end this market unsuccessfully. This study aims to investigate the perceived role of the state in the regulation and efforts to end this market. A qualitative case study design was used, with in-depth interviews (IDIs) and focus group discussions (FGDs) being the methods for data collection. 20 IDIs and 3 FGDs with 13 participants in total were conducted with sellers, buyers, and pharmaceutical experts. We found that: the informal market plays an integral role in the health system and that it provides employment to many. Additionally, this informal market is complex and requires a lot of cooperation and coordination at many levels to successfully end it, which is resource demanding. Based on some of these reasons, there is an ambivalence in the regulation and the quest to end this market. The study concludes that the government of Ivory Coast needs to be decisive in its roles of regulation and that of ensuring that medicines are available and accessible.