By Mark Anum NORTEY
Let’s consider these statistics: As of 2023, the global burden of HIV exceeded 39 million, with Africa bearing over two-thirds of this burden (1).
An estimated 10.8 million people fell ill with TB in 2023, and roughly a quarter of all TB deaths worldwide occurred in Africa (2). Additionally, the African region accounted for 94percent of the estimated 263 million malaria cases recorded that year (3).
With such a staggering disease burden, should Africa continue to rely on external aid, or is it time to build a more self-sufficient healthcare system?
The recent decision by the US Department of State to freeze funding to low- and middle-income countries (LMICs) (4) has sent shockwaves throughout the global health community.
This move has raised serious concerns about the sustainability of HIV/AIDS and TB programs, which have long relied on external funding. For decades, Africa has depended on international donors to support its healthcare systems (5), particularly in the fight against malaria, HIV/AIDS, and TB.
The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) has played a critical role in this fight, committing over $80 billion since its launch in 2003. PEPFAR’s efforts have supported programs that have provided antiretroviral therapy (ART) to over 15 million people in Africa (5), saving millions of lives and preventing countless infections.
Other key contributors to Africa’s battle against HIV/AIDS, TB, and malaria include the Global Fund, UNAIDS, the World Health Organization (WHO), the World Bank, the Bill and Melinda Gates Foundation, and the European Union. These organizations have provided essential funding, technical assistance, and advocacy support.
While this external support has been critical, it has also created a culture of dependency. The funding freeze serves as a wake-up call for African nations to reassess their healthcare systems and seek alternative solutions. It is time for Africa to take ownership of its healthcare future by producing its own life-saving medicines.
Investing in homegrown solutions
Africa’s health challenges require homegrown solutions. Governments must lead the charge by investing heavily in research and development (R&D) to address diseases that disproportionately affect African populations. The continent should be at the forefront of efforts to develop vaccines and innovative treatments for malaria, HIV/AIDS, and TB.
To achieve this, African governments must allocate dedicated budgets for R&D with clear deliverables, timelines, and milestones. Funding should support continent-wide partnerships between universities, research institutions, and local pharmaceutical manufacturers(6).
Building collaborations between governments, health organizations, academia, and the private sector (7) will facilitate the exchange of knowledge, expertise, and resources, ultimately leading to the development of medicines tailored to Africa’s unique healthcare landscape.
Strengthening pharmaceutical manufacturing
Investing in local pharmaceutical production presents a significant opportunity for African nations to reduce their reliance on external aid, improve access to essential medicines, and create a sustainable healthcare system (7,8). The benefits extend beyond health—local pharmaceutical manufacturing can create jobs, stimulate economic growth, and enhance national security by ensuring drug availability during global crises.
Several African countries, including South Africa, Egypt, and Morocco, have made remarkable progress in pharmaceutical manufacturing (9). Ghana’s Danadams Pharmaceuticals, for instance, is producing medications for HIV treatment, reducing dependency on external supplies (10,11). These examples prove that, with the right policies and investments, Africa can develop high-quality medicines that meet international standards.
However, challenges remain, including inadequate infrastructure, limited technical expertise, and weak regulatory frameworks. To address these, governments must strengthen pharmaceutical regulations, invest in workforce development, and promote technology transfer to enhance local capacity.
Enhancing supply chain and logistics
For locally produced medicines to reach those in need, Africa must establish a robust logistical and supply chain framework. This requires harmonizing distribution networks, facilitating cross-border trade of medical products, and strengthening transportation systems to ensure timely delivery of essential medicines.
The African Continental Free Trade Area (AfCFTA) presents a significant opportunity to enhance the accessibility and affordability of locally produced pharmaceuticals. Through the creation of a single market for goods and services across 54 African nations (12,13), the AfCFTA can help reduce trade barriers, lower tariffs on pharmaceutical products, and simplify regulatory approvals.
This agreement can also foster collaboration between African pharmaceutical companies, enabling economies of scale in production and ensuring that life-saving medicines are available in even the most remote regions.
Moreover, to ensure the seamless movement of medical products, African governments must invest in modernizing transportation networks, including road, rail, and air infrastructure.
Efficient and well-coordinated logistics will be essential in reducing lead times for medicine distribution and preventing stockouts of critical drugs. Strengthening national medicine regulatory agencies and harmonizing standards across countries will also be vital in ensuring quality and safety in the pharmaceutical supply chain.
A call to action
The time for prolonged deliberations is over—it is time for decisive action. Africa must transition from discussions and policy dialogues to tangible, time-bound implementation plans.
The recent funding freeze should serve as a wake-up call, prompting urgent action towards self-sufficiency in pharmaceutical production. We urge the African Union (AU), Africa Centres for Disease Control and Prevention (Africa CDC), African governments, and all relevant stakeholders to take bold steps towards achieving this goal.
Key actions:
- Increased investment in R&D: African governments must allocate dedicated funds for pharmaceutical research and development, ensuring the creation of locally relevant treatments and vaccines.
- Strengthening local pharmaceutical manufacturing: Governments should provide incentives such as tax breaks, subsidies, and favourable regulatory environments to encourage local drug production.
- Building strategic partnerships: Encouraging collaborations between universities, research institutions, and pharmaceutical companies to drive innovation.
- Developing a resilient supply chain: Investing in infrastructure and logistics to ensure the efficient distribution of locally manufactured medicines across the continent.
- Promoting policy harmonization: The AU and regional economic blocs must work towards policies that facilitate intra-African trade in pharmaceuticals, reducing barriers to cross-border supply.
Conclusion
Africa stands at a crossroads. The reliance on external donors for life-saving medicines is no longer a viable long-term strategy. The recent funding freeze should serve as a catalyst for change. By prioritizing investment in research, strengthening pharmaceutical manufacturing, and enhancing supply chain systems, Africa can take control of its healthcare future. The time for action is now.
>>>the writer is a Pharmacist, Researcher, and Global Health Expert with nearly 15 years of experience across Sub-Saharan Africa in public health, healthcare policy, pharmaceutical innovation, and healthcare systems management. He brings a wealth of expertise in addressing complex health challenges, driving policy development, and fostering pharmaceutical advancements. Academically, he holds a Pharmacy degree and advanced qualifications, including an MBA in Total Quality Management and an MPH, both earned from prestigious universities in Ghana. He can be reached via [email protected]
References
- WHO. HIV/AIDS | WHO | Regional Office for Africa [Internet]. 2024 [cited 2025 Feb 3]. Available from: https://www.afro.who.int/health-topics/hivaids
- WHO. Tuberculosis in the WHO African Region: 2023 progress update. 2024;
- WHO. Malaria [Internet]. 2024 [cited 2025 Feb 3]. Available from: https://www.who.int/news-room/fact-sheets/detail/malaria
- U.S. Department of State. The United States President’s Emergency Plan for AIDS Relief – United States Department of State % [Internet]. 2025 [cited 2025 Feb 2]. Available from: https://www.state.gov/pepfar/
- Gaumer G, Luan Y, Hariharan D, Crown W, Kates J, Jordan M, et al. Assessing the impact of the president’s emergency plan for AIDS relief on all-cause mortality. PLOS Global Public Health [Internet]. 2024 Jan 1 [cited 2025 Feb 2];4(1):e0002467. Available from: https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0002467
- UNIDO. SUPPORTING PHARMACEUTICAL PRODUCTION IN AFRICA Global UNIDO Project: Strengthening the local production of essential medicines in developing countries through advisory and capacity building support THE PROJECT AT A GLANCE. 2016;
- THE LOCALISATION OF MEDICAL MANUFACTURING IN AFRICA The Institute for Economic Justice. [cited 2025 Feb 3]; Available from: https://www.iej.org.za
- Development Re-imagined. African Pharmaceutical Hubs. 2022;
- African Development Bank. A New Frontier for African Pharmaceutical Manufacturing Industry. 2024;
- Ghana Web. Danadams to increase ARV portfolio from monotherapy to combination therapy [Internet]. 2020 [cited 2025 Feb 3]. Available from: https://www.ghanaweb.com/GhanaHomePage/NewsArchive/Danadams-to-increase-ARV-portfolio-from-monotherapy-to-combination-therapy-1028929
- Pourraz J. Making medicines in post-colonial Ghana: State policies, technology transfer and pharmaceuticals market. Soc Sci Med [Internet]. 2022 Oct 1 [cited 2025 Feb 3];311:115360. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC9454157/
- Kamara J, Essien U, Labrique A. A new era for African health systems: Market shaping and the African Continental Free Trade Area (AfCFTA). Public Health Challenges [Internet]. 2024 Jun 1 [cited 2025 Feb 3];3(2):e172. Available from: https://onlinelibrary.wiley.com/doi/full/10.1002/puh2.172
- WHO. Leveraging the AfCFTA to complement localized production and pooled procurement of healthcare products for reducing healthcare costs and poverty eradication. 2024 [cited 2025 Feb 3]; Available from: https://www.who.int/data/gho/data/themes/mortality-and-global-health-estimates/ghe-leading-causes-of
