Improving Access to Medicines in Noncore Markets: (Re)Designing Robust Governance in Healthcare Global Value Chains.

  • Arinze Ekwem

Student thesis: Phd


This PhD addresses the research gap on global value chains in Health. Specifically, it operationalizes the global value chains framework into a Pharmacy to map access to medicines as an outcome of global value chains governance by lead firms and institutional intermediaries. What it contributes are twofold. First is that it operationalizes global value chains into the world of health using a world-system analysis. Second it identifies the performance dimensions of successful interventions to bridge institutional voids in noncore contexts that truncate access to medicines through value chains. In so doing, there are two theoretical - or more modestly - methodological improvements to theory. The first is to reposition an expanded global value chains framework in which the eight possible configurations come alive in health as opposed to the five configurations accepted in the literature. The second is the contribution of an eighth design principle for health communities; common knowledge. This presents an advance on the seven principles of common pool resource governance. The PhD is a work in theory development that employs the case study method to process trace the performance dimensions of global value chains and collective action in health. It is hoped that the PhD offers much for practice to those in the field who work to improve access to medicines. Indeed, there is a case on Nigeria’s notorious open drug market and how design principles can be applied to govern the value chain for generic medicines where the government is unable to do so and lead firms do not find it economical to lead.
Date of Award1 Aug 2022
Original languageEnglish
Awarding Institution
  • The University of Manchester
SupervisorKate Barker (Supervisor) & Philippe Laredo (Supervisor)


  • Globalization
  • Core and Noncore
  • Markets
  • Health Systems
  • Access to Medicines
  • Global Value Chains
  • Institutional Voids

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