The urban pharmaceutical sector benefits from a wide variety of suppliers and distributors in its close proximity, whereas rural areas are having more difficulties accessing quality drugs and often procure what is available. This leaves room for the introduction of both legal and illegal parallel imports entering the Kenyan market.

Kenya receives quite a number and variety of subsidized drugs from multilateral donors. Communicable diseases are mostly addressed through donations, thus it will be seen that drugs catering for HIV, TB, and Malaria are offered to the public for free.  In addition, there are many programs geared towards Family Planning (FP); these drugs or FP methods are also offered free to the public and received through donors.  This creates an uneven playing field in the market, which disables the private sector from selling the same drugs as they are not able to compete with the highly subsidized supplies that the public sector receives.

It is imperative that the supply chain includes more local manufacturers to increase production and distribution of these donor drugs.  There is an urgent need for dialogue between the public and private sector to encourage public sector capacity building but through local production. 

The commercial private sector supply chain ends at the retail sector, where pharmacies are selling the products. These retailers consist of formal and informal outlets. Informal outlets lack any legal requirements or practice as they are a not officially registered, there are accounts that between 9 and 90% of the pharmacy-patient interaction across the country is done via illegal outlets.  This is a worrying number as the retail chemists are often the first and last source of medical supply information/counselling and treatment that a patient receives.

The following Figure shows a detailed picture of the actual supply chain in Kenya.

Figure. Actual Supply Chain^[1]

^[1] Overview of Experiences in the Pharmaceutical Supply Chain: Implications for the Poor in Kenya, Private Sector Innovation Programme for Health.