Dear Neil and friends of HIFA/CHIFA, I differ with your view of "antibiotics overprescription caused by lack of adequate information". [ https://www.hifa.org/dgroups-rss/exploring-antimicrobial-stewardship-edu... ] I write so because I live in Africa and I see the reality of facts. Sur le terrain.
It is a fact that drugs (antibiotics included of course) are sold in the same clinic where they have been prescribed. Both in public or private settings. In private settings (that are mushrooming all over in towns) major income comes precisely from the selling of 2 items i.e. drugs and lab tests. The clinic literally survives (and prosper $) on these two. No surprise therefore that Widal test is one of the most prescribed: it is quite frequently 'positive' and therefore it requires a treatment. Both - test&drugs - sold with a smile. The same occurs nowadays for the test Elicobacter P. : "positive" and requiring 3 different drugs. Money.
See then the pharmacies around in African towns: thousands-hundred thousands-million of them. Drugs are sold if you have the money to buy them... prescription is never requested or needed. You may educate/inform/advice whoever-wherever but drugs will continue to be swallowed (or injected !!) on the road, where there is a pharmacy or even a simple table with penicillin vials on display...under the sun.
Both - clinics and pharmacies - belong to the same system: privatisation of health care. To regulate or discipline it is impossible, or too late.
HIFA profile: Massimo Serventi is a long-standing Pediatrician working in Africa since 1982. He has worked for several NGOs in 6 African/2 Asian countries. His interests include clinical and community pediatrics, adherence to clinical guidelines and school education as the major determinant of good health. massimoser20 AT gmail.com