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Pourraz Jessica

PHD Student in Sociology, EHESS

Doctoral Training "Health, Populations and Social Policies" (SPPS)

Holder of a doctoral contract (2014-2017) within the framework of the research project "Globalmed"

Contact: jessica.pourraz(at)ird.fr


Dissertation title: "Regulating malaria drugs in Benin and Ghana: public policies, quality standards and medicines markets"

Under the supervision of Maurice Cassier (Cermes3) and Carine Baxerres (IRD, Merit)

In the 1980s, resistance arose to many commonly used treatments against malaria (as chloroquine) in Africa. Initially reluctant to recommend Artemisinin Combination Therapy-ACTs in Africa for financial reasons (the new medicines are far more expensive than the old ones), the WHO waited until 2006 to officially change its malaria treatment guidelines, though has recommended the use of ACTs since 2001 due to a treatment failure rate of 15%. ACTs were officially adopted in 2004 by Benin and Ghana. Financing ACTs is a major challenge for African countries in this transition. Therefore, drugs are bought and subsidized by transnational actors. In Benin and Ghana, a global arena of transnational actors composed of the Global Fund, Unicef, bilateral cooperation programs such as USAID-PMI, the World Bank, has gradually developed itself around ACTs and malaria in the public sector and from 2010 in the Ghanaian private sector. The arrival of ACT in Africa is a moment of political reconfiguration in terms of regulation and production of medicines. The new WHO’s recommendations for ACTs and the use of international funds granted for the purchase of these treatments stimulates pharmaceutical innovation and industrial production both in the countries of the global North that in those of the global South. The early 2000s marked a major turning point in malaria control with the arrival of ACTs, which subsequently generated a massive influx of funding to ensure equitable access to the new medicines. Global Health initiatives generate new supply networks of ACTs who come to be juxtaposed against existing networks, mingle, and even compete with them. Financial assistance is conditional upon the purchase of WHO prequalified ACTs leaving Ghanaian pharmaceutical companies which are not WHO prequalified outside this subsidised market. Facing stringent WHO standards, local pharmaceutical firms, National Regulatory Authorities and regional actors, are trying to shape and appropriate their own system of norms around medicines in order to be able to supply medicines to their own countries, access their own domestic markets and not rely on subsidies on importation.