Africa’s pharmaceutical sector is facing a pivotal moment as the continent confronts a growing burden of non-communicable diseases (NCDs) while continuing to battle infectious diseases and persistent maternal health challenges.
A new report by the Access to Medicine Foundation examines how eight multinational and regional generic medicine manufacturers are responding to the changing healthcare landscape and identifies opportunities to build more resilient and sustainable medicine supply systems across Africa.
The report analyses Aspen Pharmacare, Cipla Ltd, Emzor Pharmaceutical Industries, EVA Pharma, Hikma Pharmaceuticals, Sothema, Universal Corporation Ltd and Viatris.
It finds that manufacturers are investing in local production, diversifying supply chains, expanding medicine portfolios and developing partnerships aimed at strengthening manufacturing capabilities on the continent.
Yet significant barriers remain, including fragmented procurement systems, unpredictable demand, uneven financing and differing regulatory requirements across countries.
“Africa is at a critical turning point. For decades, the focus across the continent has been on combating infectious diseases like HIV, malaria and tuberculosis. There are dramatic shifts happening. Non-communicable diseases such as diabetes and cardiovascular diseases are surging, and are projected to become the leading cause of death in sub-Saharan Africa by 2030. But at the same time, severe maternal health challenges remain a persistent and urgent priority,” said Jayasree K Iyer, Chief Executive Officer of the Access to Medicine Foundation.
The challenge is compounded by Africa’s heavy dependence on imported pharmaceutical inputs and finished medicines. Iyer said about 95% of active pharmaceutical ingredients used in Africa are imported, while roughly 70% to 80% of medicines consumed on the continent are also imported, mostly from India, China and Europe.
“This means this leaves supply chains vulnerable to global shocks and shortages. This is especially important today as investments and geopolitical climates are shifting all around the world,” she said.
The report argues that stronger local and regional manufacturing could reduce vulnerability to global supply disruptions, particularly for medicines required for long-term treatment.
Claudia Martínez, the foundation’s Director of Research, said Africa’s pharmaceutical challenge is no longer simply about getting medicines into the market, but about developing a supply system capable of serving patients consistently.
“We are very much at a pivot point when it comes to African pharmaceutical manufacturing. The question we’re grappling with is not so much whether medicines can reach African markets. It’s how do we build a supply system that is resilient, that is more affordable, that is actually less dependent on a small pool of manufacturers,” Martínez said.
Manufacturers are increasingly moving into NCD treatment areas, including insulin, cardiovascular medicines and oncology products, while continuing to supply medicines for infectious diseases and maternal healthcare.
Martínez said this expansion is particularly important as more Africans require medicines for chronic conditions that must be taken continuously.
“Local production reduces the risk of stockouts, ensuring patients are able to get the right products at the right time. That is critical if we’re thinking about chronic care, about diabetes, where any interruption in your treatment, or oncology care, can have life-threatening consequences,” she said.
She added that manufacturers are already making progress in some areas, including insulin production.
“We are seeing insulins being produced now in Africa, with the first commercial batches of locally produced insulins, human and analogue, already being distributed and supplied,” Martínez said.
But experts caution that simply increasing manufacturing capacity will not solve the problem without predictable demand.
Dr Mariatou Tala Jallow, Director of the African Pooled Procurement Mechanism at Africa CDC, said many African manufacturers are operating below capacity because markets remain uncertain.
“A lot of investment has been going into the supply side. So many organisations are talking about the millions and billions of dollars invested in African manufacturers. But if there is no market, how do you expect them to be competitive? We have seen what happened after COVID, with PPE, with vaccines. African manufacturers were encouraged to invest, and after the need disappeared, people just ignored them, and some of them obviously folded,” Jallow said.
She said predictable procurement is critical to allowing manufacturers to plan production, invest in capacity and ultimately lower prices.
“When people talk about production capacity, we have talked to manufacturers, and most of them are underutilising their capacity. How can you have competitive pricing if you don’t get the volumes? The predictability of demand is very critical,” she said.
The report also calls for greater regulatory harmonisation and coordinated procurement across countries. Jallow said Africa should stop treating its pharmaceutical market as 55 separate markets.
“I personally don’t like the terminology ‘local manufacturing’. It gives a local flavour. We are talking about a continent of 1.5 billion people. We are too busy looking at it from the perspective of 55 markets that we don’t see the forest for the trees,” she said.
Jallow said regional cooperation could allow countries to pool demand, create larger markets for manufacturers and strengthen the continent’s pharmaceutical security.
“We cannot afford being reactive, thinking that we can do everything in Africa. That is one of the things we saw just after COVID. Manufacturing was reactive. Every country wanted to have a manufacturing facility. Now it’s becoming more strategic: how can we divide up the functions and the roles within the continent? We will never be 100% self-sufficient. It doesn’t make sense. We are in a global world,” she said.
The report identifies eight opportunities for action, including improving demand visibility, coordinating procurement, harmonising regulation, reducing bureaucratic barriers and directing affordable capital towards manufacturers.
For Africa to strengthen medicine security, the report concludes that governments, manufacturers, regulators, development finance institutions and global health organisations must work together to create a more predictable market.
Jallow said strengthening local manufacturing should also be accompanied by stronger confidence in quality-assured African products.
“When you walk into a pharmacy, how often do they give you a product produced in Africa first, compared to giving you all the different brands available? Because they are looking at it from the commercial perspective, and the locally made product comes in last,” she said.
She called for a more deliberate continental approach: “Regulate Africa, procure Africa, manufacture Africa. If we do proper harmonisation and reliance, we can have more quality assurance on the products than we are getting now in some countries.”
The report ultimately argues that Africa’s pharmaceutical future will depend not only on building manufacturing capacity, but on creating the regulatory, financing and procurement systems needed to make that capacity sustainable.
As Jallow put it: “Africa doesn’t lack the capacity. It doesn’t lack the ambition. It’s more of lacking the opportunities, and that is what this report is showcasing.”
