Africa’s changing disease burden and expanding pharmaceutical markets could give generic drug manufacturers a bigger role in improving access to essential medicines, although financing, procurement and regulatory challenges continue to constrain the sector.
A new report by the Access to Medicine Foundation examines how eight multinational and African regional pharmaceutical manufacturers are responding to the continent’s evolving healthcare needs, while identifying measures that could strengthen pharmaceutical supply chains and make medicine supplies more reliable.
The report comes as African countries face a growing burden of non-communicable diseases such as cardiovascular disease, diabetes and cancer, even as infectious diseases and maternal health problems continue to affect millions of people.
The rising number of patients requiring long-term treatment is also putting additional pressure on health systems and pharmaceutical supply chains that remain fragile in many countries.
Access to essential medicines remains a major concern. The report estimates that only about half of people living with type 1 diabetes in Africa have dependable access to insulin. Fragmented procurement systems have also made it difficult for patients in several countries to consistently obtain medicines for cardiovascular conditions.
The pressure is expected to grow as non-communicable diseases are projected to become the leading cause of death in sub-Saharan Africa within the next five years.
Opportunity for local manufacturing
Despite the challenges, the continent’s pharmaceutical sector is entering a period of opportunity. Efforts to promote local drug manufacturing, harmonise regulations, strengthen regional trade and attract investment could make it easier for manufacturers to produce and supply medicines across borders.
Generic drugmakers are central to this effort. They account for about 80 per cent of medicines by volume globally and remain a major source of affordable treatment for patients in Africa.
The report assessed eight companies: Aspen Pharmacare, Cipla, Emzor Pharmaceutical Industries, EVA Pharma, Hikma Pharmaceuticals, Sothema, Universal Corporation Ltd. and Viatris.
It found that the companies are taking steps to make their supply chains more resilient, expanding into new areas of treatment and forming partnerships aimed at increasing local manufacturing capacity.
“Manufacturers across the ecosystem will play an important role in determining whether medicine supply evolves alongside” Africa’s changing healthcare needs, Claudia Martínez, director of research at the Access to Medicine Foundation, said in the report.
However, the study cautions that manufacturers cannot solve Africa’s medicine-access problems on their own.
Some companies are seeking to reduce supply risks by exploring local production of active pharmaceutical ingredients where feasible, diversifying suppliers and negotiating longer-term agreements for finished medicines.
Others are expanding their product portfolios to include treatments for diabetes and cardiovascular disease, while continuing to supply medicines for infectious diseases and maternal health.
But uncertain demand, fragmented markets and the complexity of pharmaceutical production continue to make investment decisions difficult.
For regional manufacturers, differences in regulatory requirements between countries and poorly coordinated procurement systems can make it difficult to predict demand, plan production or justify investment in new factories and equipment.
Partnerships
The report identifies technology-transfer agreements and World Health Organization prequalification as potential ways of overcoming some of these barriers while creating opportunities for more predictable purchasing commitments.
It also highlights a shift in the nature of partnerships within Africa’s pharmaceutical industry.
While distribution and market-access agreements remain common, an increasing number of partnerships are focusing on building local manufacturing capacity through technology transfer, regulatory support and production arrangements.
Such partnerships could enable African companies to move beyond importing, distributing or marketing medicines and develop stronger technical capabilities to manufacture a wider range of products locally.
The report, however, warns that achieving this will require sustained investment and meaningful transfer of technology and skills.
For partnerships to deliver lasting benefits, local companies need to acquire the technical and strategic capacity required to develop new products, improve production and compete in wider markets.
At the heart of the challenge is the need to create a pharmaceutical market in which manufacturers can plan and invest for the long term with greater certainty.
Beyond drugmakers
The responsibility, the report says, extends beyond pharmaceutical companies to governments, regulators, procurement agencies, development finance institutions and global health organisations.
It identifies several areas where coordinated action could strengthen the sector, including giving manufacturers better information about future demand, making medicine supply more predictable and affordable, coordinating procurement, harmonising regulations, reducing market fragmentation and directing investment towards critical manufacturing capacity.
Reducing regulatory delays and unnecessary bureaucracy will also be important. For Africa’s generic drug industry, therefore, the opportunity is not simply about producing more medicines. A better integrated pharmaceutical market could encourage greater investment in local manufacturing while helping governments secure more reliable supplies of essential medicines.
For patients, the result could be improved access to affordable and consistently available treatment as Africa’s health needs continue to change.