NextBillion - An Initiative of the William Davidson Institute at the University of Michigan

Monday, April 8, 2019

By Andrew Jacobs and Matt Richtel

Four days after her toddler’s health took a turn for the worse, his tiny body racked by fever, diarrhea and vomiting, Sharon Mbone decided it was time to try yet another medicine.

With no money to see a doctor, she carried him to the local pharmacy stall, a corrugated shack near her home in Kibera, a sprawling impoverished community here in Nairobi. The shop’s owner, John Otieno, listened as she described her 22-month-old son’s symptoms and rattled off the pharmacological buffet of medicines he had dispensed to her over the previous two weeks. None of them, including four types of antibiotics, were working, she said in despair.

Like most of the small shopkeepers who provide on-the-spot diagnosis and treatment here and across Africa and Asia, Mr. Otieno does not have a pharmacist’s degree or any medical training at all. Still, he confidently reached for two antibiotics that he had yet to sell to Ms. Mbone.

“See if these work,” he said as she handed him 1,500 shillings for both, about $15.

Antibiotics, the miracle drugs credited with saving tens of millions of lives, have never been more accessible to the world’s poor, thanks in large part to the mass production of generics in China and India. Across much of the developing world, it costs just a few dollars to buy drugs like amoxicillin, a first-line antibiotic that can be used against a broad range of infections, from bacterial pneumonia and chlamydia to salmonella, strep throat and Lyme disease.

Kibera residents are prodigious consumers of antibiotics. One study found that 90 percent of households in Kibera had used antibiotics in the previous year, compared with about 17 percent for the typical American family.

Photo courtesy of psyberartist.