PhD defence S.A. (Amalia) Hasnida

Below is a brief summary of the dissertation:

Poor-quality medicines pose serious public health risks by harming patients, wasting resources, and hindering Universal Health Coverage (UHC). Current frameworks focus mainly on technical solutions and place national medicine regulators at the center, often isolating medicine quality from other critical pharmaceutical policy issues, such as medicine availability, affordability, and irrational use. The existing approach also downplays political and socioeconomic factors, limiting the involvement of other (policy) actors and the exploration of alternative solutions.

This thesis introduces a new and broader framing of the problem of poor-quality medicines using a political economy perspective. In addition, this thesis operationalizes the approach and tests its potential to tackle the issue better. It argues that combining this perspective with technical and regulatory approaches offers new opportunities to address the problem. The research was conducted in Indonesia, the world’s fourth most populous country and home to a competitive domestic pharmaceutical industry. Using mixed-methods case studies, the research focuses on amoxicillin, sampling it from diverse access points, including informal markets, and testing its quality in an independent laboratory to understand the usefulness of this broader approach.