Abstract
The development of the drugs Artemisinin and Ivermectin won their creators the 2015 Nobel Prize in Physiology or Medicine. Although it is significant that the Nobel Foundation awarded the prize to contributions in the field of global health, the event strengthened the pervading view of pharmaceuticals as magic bullets. The development of new pharmaceuticals, however, does not lead straightforwardly to the eradication of infectious disease. There are many difficulties in distributing and administering pharmaceuticals “correctly.” This paper elucidates the practicalities of dispensing pharmaceuticals by describing how health workers engage in the mass Ivermectin administration program and the vaccination of infants in southern Ghana.
Previous studies in the anthropology of pharmaceuticals have insisted that the many informal pharmaceutical vendors in sub-Saharan Africa play a crucial role in the distribution of pharmaceuticals. However, informal pharmaceutical distributors are relatively rare in Ghana, while licensed chemical sellers are popular, especially in rural areas. Chemical sellers are unique pharmaceutical distributors, as they are licensed by the government, yet have no formal education in the field of biomedicine. People living in rural areas mainly obtain pharmaceuticals through such private chemical sellers and public health centers. Although chemical sellers contribute to the expanding availability of pharmaceuticals, they cannot substitute for health centers. One reason is that chemical sellers do not provide all the same types of pharmaceuticals as do health centers. In particular, Ivermectin and the vaccines that this article focuses on are only available in health centers. More importantly, there are differences in how chemical sellers and health centers treat pharmaceuticals. It should be emphasized that in health centers, the distribution of pharmaceuticals is recorded precisely, and nurses in health centers pay careful attention to the timing of administration. That record keeping is not only for avoiding human error but also for locating pharmaceuticals in time. According to the pharmaceutical and medical sciences, it is vital to take pharmaceuticals at regular intervals. The timing also depends on the character of the relationships between the drugs’ active ingredients and their target disease agents. This paper proposes that the anthropology of pharmaceuticals in sub-Saharan Africa ought to explore how pharmaceuticals are administered according to an accurate time schedule, using the concept of a chemical milieu, following Foucault’s notions of dispositive and milieu.
This study focuses on town “A” in the western part of Ghana’s Eastern Region, where I stayed intermittently from 2005 to 2016 for a total of three years. Approximately 2,500 people over the age of eighteen live in “A,” the main products of which are cacao, oranges, palm, and timber. Town “A” has five chemical sellers and one health center, but no hospitals or pharmacies.
(View PDF for the rest of the abstract.)
