Africa must take charge of its health to generate wealth
Only thirty-seven African countries boast pharmaceutical production on any scale, although only South Africa produces active pharmaceutical ingredients (API), the central ingredient for any medicine. (Image: Pfizer)
A shocking fact: Africa, with over 14% of the world’s population, accounts for less than 1% of global health expenditure and manufactures less than 2% of the medicines that it consumes, according to a report by the United Nations Economic Commission for Africa.
And this situation exists even as Africa has more than its fair share of health issues. The continent encounters more than 70% of the world’s HIV/AIDS cases and loses as many as 90% patients afflicted by an easily curable disease like malaria.
Medicines are a pressing need for Africa as the continent is witness to 50% of the global deaths of children under five years of age, caused by birth defects and genetic diseases, as well as widely prevalent yet eminently preventable diseases such as pneumonia, diarrhoea, measles, HIV, tuberculosis and malaria.
Access to appropriate and affordable medicines can prevent death in such situations, since such diseases are treatable and death is completely avoidable.
Africa lacks investment for pharmaceutical research and development (R&D) and local drug production, accounting for some of the lowest levels of pharmaceutical manufacturing in the world.
To illustrate, out of fifty-five nations, only thirty-seven African countries boast pharmaceutical production on any scale, although only South Africa produces active pharmaceutical ingredients (API).
It may be noted that an API is the central ingredient for any medicine, and API manufacturing capability is critical for cost-effective pharmaceutical manufacturing.
In other African regions where there is local production, they rely on imported active ingredients. Consequently, there is a dependence on foreign funding and imports for the supply of African pharmaceuticals, and the pharmaceutical market in Africa accounts nowadays for 70% imported products.
In 2011, India represented 17.7% of African pharmaceutical imports; also estimates further suggest that more than 80% of antiretroviral drugs (ARVs) across the continent are imported.
As there is insufficiency of essential medicines in both public and private sector, people are often forced to buy uncertified medicines.
Demographic and lifestyle changes have an impact on health in Africa because through non-communicable diseases like heart disease, lung disorders, diabetes and cancer, this is expected to account for half the deaths in Africa, soon to exceed those caused by infectious disease.
The main contributors of health problems are poor quality of drugs and their regulations – as hard as it is to believe, as many as 64% of antimalarial drugs in Nigeria were found to be counterfeit in the recent past!
Scaling up pharmaceutical production is essential for a sustainable health system in Africa because this can increase the share of population with access to essential medicines, including in rural areas, at a far lower cost.
Local manufacturing of medicines would also create modern jobs, stimulate economic activity and increase productivity.
Challenges such as R&D and exploring the full utilization of the Trade Related Aspects of Intellectual Property Rights (TRIPS) flexibilities, tax and tariff policies, drug regulatory and registration systems and building infrastructure, must be dealt with to increase production capability.
Some of the leading global innovators and generic manufacturers such as Starwin in Ghana, Saidal in Algeria, Universal in Kenya, Aspen in South Africa, or Cipla in Nigeria are homegrown manufacturers.
They stand for an Africa that is capable of producing medicines which meet international standards. Fewer structures and harmonisation of policies through regional integration are needed to improve the pharmaceutical industry.
Besides, intra-Africa trade also offers the prospect of strengthening and better exploiting regional supply chains, expanding economies of scale, as well as make larger investments attractive.