5 eqivent of 100 French franca (about USS17); a similar study carried out in Paris found the awvrage prescription price was 112 French francs (Bessard et. aL, IQ( In Frane, however, in addition to income leveb being 15 times **greatew** than in hvry Coast, most (if not all) of this price would be reimbused by Socal Security.

What is a 'private pharnacy' in the African coatext? It may have little in common with a 'pharmau in the Western sens. Pharmacists are so few in number that in most countries it would not be possible to require the presence of a pharmacist in a pharmacy. As a result, there is some indication that unliensed private drug selers are the targets for distributors of counterfeit drup (Atueyl, 1988). In Nigeria, a survey of retail pharmacies in Maiduguri, Borno State, found that there were 90 retail pharmacies in the town. Of these, 10 were 'ethical pharmacies' run by qualified pharmacists, **and the remainder** wer *dry drug peddler shops, by unqualfied oesons. These had Ucense to sell only propriety (non-prescription) medicin but in fact had a wide range of drugs availabk. Many were expired and we adulterations of popular drugs. TMe drug peddlers often had an 'Ijaction room' whe customers judged to be 'safe' were taken. The public appartly did not distinguish between the two types of pharmacy, and used both a cinics where they consulted and were given prescriptions and treatent. Health problek for which they sought treatment were (in order) malaria, cuts, eye pains, general body pains, dysentery/diarrhea, skin Infection, abdominal pain, family planning, cough, chest pain, and venereal dies The most freqaent treatment was antibiotics, especiaUy injections; antibiotica represented 35% of treatments given. The second most frequent treatment was drug for diarrhea (not ORS', followed by treatment for malria. Th reasons most frequently cited for seeking treatment at the pharmacies **wa** that treatment was expeditious, drugs were rarely out of stock, and the drugs given were efficacious and often better than nospital treatment (Igun, 1987). In Africa, drug shops or peddlers are much more common than pharmacies rn by qualified pharmacists. VUlage drug shops are often patronized because they are close, not because they are considered to be suitable. In Saradidi, Kenya, people cited lack ot transport and distance to alternatives, and that they were open in emergencies, as major reasons for patronizing the drug shops. Prior to introduction of a scheme whereby village health workers provided antimalarial treatments, _53%_ of the people obtained their antimalarial treatments from a shop, and the shookeeper provided advice on dosage, etc. But when antimalarial treatment ws available from the village health worker, 85% of the people preferred to get their treatment there. When the scheme was in place, use of the shops declined significantly, with 90% reporting that they no longer used the shops for antimalarial treatments (Mburu et. aL, 1987).

Another type of drug outlet is the ilicit drug seller who does not opcrate from a fixed pharmacy premises. In Pikine, a suburb of Dakar, Senegal, 102 ilLicit drug sellers were identified and a sample of ten were intervwed in depth. They had set up in markets, on street corners, or were itineant. On average they had 14.5 clients per day. Drugs were sold primarily for symptomatic treatment, with pain and fatigue accounting for 77% of visits; aspirin in combination or alone is part of more than half of