Corporate Responsibility: A Rural Pharmacy

In this revamped 40-foot container with a floor space of 30 square meters, you can find everything that’s needed to provide a secure supply of medicines to rural regions in Africa. Ronke Ampiah, who heads the "Rural Pharmacy" project at Merck KGaA, Darmstadt, Germany, takes us on a tour of the pharmacy made from a container.

In addition to the dispensary, the pharmacy has a multi-functional room, which can be used for administering vaccinations or medical counseling, as well as refrigerated storage facilities, and a toilet that is flushed with used water from the sink. The container pharmacy can be transported to rural regions on a truck and set up on site with a minimum of effort.

The ready-to-use rural pharmacy made from a shipping container operates almost autonomously. That’s because in the rural regions of Africa a reliable energy supply and clean drinking water are exceptions. The solar panels on the roof of the container sparkle in the sun, drinking water is produced inside the container, and used water is processed for the toilet. “The clean drinking water that is needed to administer medicines comes from the humidity in the air,” says Ampiah. 

The atmospheric water generator is standing in the corner. It looks just as inconspicuous as a normal water cooler, but it contains a high-tech condenser, a compressor, and several filters, and is operated with solar power. Even in the driest desert regions the air still contains some humidity, so the water generator is able to provide the pharmacy with an adequate supply of clean drinking water.

Both drinking water and pharmacies are urgently needed. According to the World Health Organization (WHO), at least a third of the world’s population has no regular access to medical care or medicines. Karim Bendhaou, who heads EMD North and West Africa, therefore worked together with representatives of the National Health Insurance organization in Ghana to develop the idea of a rural pharmacy for Africa.

“Our work focuses on enabling people to access basic medical care,” he says. A relatively good infrastructure and the great interest of the National Health Insurance authorities in Ghana are good preconditions for the launch of the pilot project in that country. After a planning and construction stage lasting one year, the prototype of the pharmacy in a container was ready for initial implementation.

From the very start, the idea was to choose a simple and robust construction that could be easily set up anywhere. “If everything goes well, a container can be restructured as a pharmacy, equipped, and delivered in six weeks,” reports Ronke Ampiah. “In the future we will also involve local companies in our work.”

Merck KGaA, Darmstadt, Germany is making sure that the project has broad local support. “Things go more easily when you have the government on your side,” says Ampiah. “We are therefore conducting talks with the government of Ghana and also looking for support from NGOs working in the areas of healthcare and development assistance.” This completely new concept for the supply of medicines can be successfully implemented only if the organizers are very familiar with the local conditions in each country. 

This requirement is a very urgent one, because the counterfeiting of medicines is a huge problem in many African countries. In many regions, insufficient supervision of the trade in medicines and unreliable supply chains make it easy for drug counterfeiters to operate. Consequently, Ampiah says, the challenge is to find trustworthy partners who will safeguard the supply chains.

Well-trained pharmacists are another key factor in ensuring the safe provision of medicines. Unfortunately, they too are in short supply, often in the places where they are most urgently needed: in the rural regions. For example, more than eighty percent of the pharmacists in Ghana work in the catchment area of the country’s capital, Accra, and in the central Ashanti region, which is the most densely populated part of the country.

That’s why it’s also necessary to create incentives for young pharmacists to work for one year in a rural region after they have received their university degrees. Micro-loans and the provision of starting capital could make it easier to set up a rural pharmacy. Project leader Ronke Ampiah also says that there are plans to provide additional training for young pharmacists. “Merck KGaA, Darmstadt, Germany in would like to offer its expertise in support of professional training,” she says.

In this project, Merck KGaA, Darmstadt, Germany is offering both “hardware” (the pharmacy made from a container) and “software” (advanced training and support for pharmacists). With this complete package, the company is addressing the complex challenges of health care in rural Africa. As soon as the prototype has passed its test run in Ghana, the path will be open for Merck KGaA, Darmstadt, Germany to bring its little yellow pharmacy to other African countries as well.