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Based on the case of Benin, this paper describes recent changes that have occurred in the field of international pharmaceuticals in West Africa: legal recognition of generic drugs, development of the pharmaceutical industry in “emerging” countries, and competition with Western multinational corporations. The introduction of generic drugs in West African countries occurs in different ways, and there are significant differences in the national pharmaceutical legislations between Francophone and Anglophone countries. Importers, distributors, prescribers, and consumers in Anglophone countries have been more open to generic drugs and supplies from “emerging” countries from the outset. This has had a very positive impact in terms of access to medicines, but raises a number of public health issues. The flexibility of the liberal distribution that accompanies these phenomena creates a loss of control by healthcare professionals. Beyond the legal differences between countries, products circulate, and delivery practices tend to homogenize, illustrating the current globalization of medications.