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Accessibility and availability of medicines is a major issue in health systems worldwide and particularly in Africa. In sub-Saharan Africa, access to quality essential medicines is a major public health problem. The present work illustrates the situation in one region of Cameroon, one of the most developed, the South. In the content, the national health system, the essential drug supply system, its difficulties and proposed solutions to improve access and availability of the drug at all levels of the health pyramid.