Paper short abstract:

The increased availability of pharmaceuticals across the African continent has led to an array of therapeutic possibilities. In this joint-paper we point out key-themes around the role of confidence, suspicion and tactics of legitimisation in relation to medicine use.

Paper long abstract:

The increased availability of pharmaceuticals across the African continent, alongside the global spread of medicines and techniques drawn from other healing traditions, has led to a bewildering array of therapeutic possibilities. In these messy markets and power topographies of therapies, drugs and associated practices, we ask how people come to place or withdraw their trust in particular healers, traders and their medicines. In which ways do personal experience, recommendations and advertisements shape the meaning attached to pharmaceuticals, the nature of therapeutic encounters and their health outcomes. How in turn do these aspects allow for practices of distinction and ideas of belonging and identity, through which trust is partially generated? We base our discussion on two ethnographic studies. The first, (Ghana, Malawi, and South Africa) puts children and young people centre stage to explore the role of uncertainty and trust in the ways that they navigate the increasing complexities of therapeutic choice. The second (Mali) focus on street-sold pharmaceuticals in order to study negotiations of their quality, meanings and effectiveness, is framed within the broader context of pharmaceutical marketing in Mali. Both examples raise important themes around the role of confidence, mistrust, suspicion and tactics of legitimisation in relation to medicine use in contemporary Africa.