London School of Hygiene & Tropical Medicine

This presentation examines the history of Medecins San Frontiers Magani (“Medicine Market”) Programme in Africa. Its target audience are students and staff interested in the histories of humanitarianism, drug access initiatives, and the post-colonial history of public health initiatives in the Global South.  
When considering how to improve access to essential medicines in humanitarian settings, including for diseases often considered on the boundaries of humanitarian medicine like cancer treatment, who is and should be the “beneficiary”? How have humanitarians conceived and expanded boundaries around beneficiaries for drug access initiatives since the 2000s – and why does this matter? This talk explores the boundaries of supply, demand, and a (mythical?) notion of an African middle-class market for essential drugs, through the lens of Medecins Sans Frontieres (MSF)’s Magani ('Medical Marketplace') programme. This programme, conceptualised in 2015, designed during COVID-19, and piloted in 2025, ran across multiple African countries as an online, non-profit drug sales programme. It folded after this short pilot in late 2025 – and has been the subject of intense discussion at MSF over the meanings of “transformation” and medical “innovation" in humanitarian settings, porous borders between global health and humanitarian medicine, and whether start-up ventures with cost recovery mechanisms should have a place in NGO operations.

The paper draws on and critically analyses the methodological approach of 'synchronous history', or performing policy-relevant research in the absence of contemporary archives. It describes how Manchester-based researchers became embedded in the Magani programme as historians in 2023, undertaking oral history interviews with staff over two years and assisting with primary document analysis. It explores how synchronous history is assisting ongoing 'capitalisation' activities at MSF. This includes interrogating themes like the under-recognised complexities of drug access (e.g., access as availability, pricing, quality) and the sociology of risk for drug sales projects.

Speaker

Janelle Winters

Postdoctoral Research Associate, University of Manchester

Janelle Winters is a global health governance researcher, currently working as a postdoctoral researcher on the Wellcome Trust-funded 'Developing Humanitarian Medicine' project at the University of Manchester’s Humanitarian and Conflict Response Institute. Her research uses contemporary historical methods – including oral histories and active archive compilation with NGOs – to critically interrogate issues around neglected tropical disease control, primary health care, and access to medicines since the 1980s.  She is also a research affiliate at the University of Oxford, where she focuses on the political economy of clinical trials and was a historian embedded within the Mahidol-Oxford Tropical Medicine Research Unit’s 'COPCOV' trial. Janelle holds a PhD in population health sciences from the University of Edinburgh (2020), which explored the World Bank’s historical role in infectious disease control programming. She also holds masters degrees in infectious disease epidemiology (Yale University) and the history of medicine (Newcastle University). Janelle formerly worked as a study director on pandemic influenza vaccine global coordination at the U.S. National Academy of Sciences and an international training specialist at the American Society for Microbiology. 

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