摘要
Medicines are a global, strategic and diplomatic issue [1]. The UN General Secretary’s High Level Task Force [2] on Access to Medicines calls for a new approach to reduce the gap between medical innovations and access to medicines. Inequality in access to quality pharmaceutical products in a framework of global health democracy poses a threat to the ethical and equitable management of the provision of quality health care, particularly during global health crises. In French-speaking Africa, the lack of a unified production of pharmaceutical medicines forces wholesalers （public and private） to import almost all of their medicine demands resulting in a risk of dependence and major pharmaceutical quality defects. These central purchasing units are therefore often faced with the major challenge of guaranteeing the performance of their services and the security of their supplies. In order to achieve component 3 （“Access to Health”） of the SDOs （sustainable development goals）, in particular the access to affordable medicines, it is essential for a country to have a strategy of pharmaceutical independence [3] by anticipating the epidemiological transition and the management of health crises. This strategy of pharmaceutical independence is based in the short and medium term on the strengthening of central purchasing units and the establishment of a public-private partnership between central purchasing units and wholesalers, and in the long term on the establishment of competitive production units that comply with international standards. However, recent health crises have shown the fragility of public central purchasing units and make it difficult to anticipate health crises.
