Access to safe, effective, quality, and affordable medicines is an essential component of the right to health. It is also one of the targets of Sustainable Development Goal (SDG) 3. To achieve medicine security, communities need medicine accessibility, availability, affordability, and acceptability.
Communities without any one of these four basic components can be medicine-insecure; however, within the African context, these components intersect. For many people living in Africa, accessing quality essential medicines remains a significant challenge, and this undoubtedly contributes to the poor health metrics of most countries in the region and the difficulty in achieving medicine security on the continent.
Given that the African region bears 24% of the global burden of disease, with a significantly rising burden of non-communicable diseases (NCDs), such as diabetes and heart diseases, there is a critical need to intensify efforts towards curbing disease incidence and prevalence. Achieving this, however, requires increasing solutions and efforts aimed at ensuring uninterrupted access to effective, safe, quality, and affordable medicines.
African governments need to take strategic actions towards strengthening access to medicines on the continent. This calls for strong collaboration between government institutions, the private sector, public health institutions, and pharmaceutical companies
Challenges facing access to Medicine in Africa
Several interconnected issues are associated with poor access to medicines in Africa. The African region relies heavily on the importation of medicines to meet its healthcare needs due to its poor local pharmaceutical manufacturing capacity.
A 2019 McKinsey report noted that, for the 1.1 billion people in Africa, there are only roughly 375 pharmaceutical manufacturing companies, with those in sub-Saharan Africa clustered in nine out of 46 countries. The dearth of pharmaceutical manufacturing industries in Africa has meant that for most African countries, pharmaceutical imports comprise as much as 70–90% of drugs consumed.
This overwhelming dependence on importation predisposes vulnerable citizens to shortages. This also means that changes to supply chain logistics or policies affecting the importation of the drugs could cause scarcity and make medicines inaccessible.
Another challenge that also contributes significantly to the poor pharmaceutical manufacturing capacity in Africa is the limited technical know-how. There is a dearth of skilled local talents that have knowledge and expertise in pharmaceutical research and development, modern manufacturing techniques, and the use of sophisticated industrial tools and machines needed to boost pharmaceutical manufacturing.
The lack of an optimal pharmaceutical supply chain is also one of the major causes of poor access to essential medicines. Evidence shows that the supply chain system in Africa is largely weak and unsustainable.
The above factors, combined with a lack of sustainable health financing mechanisms, the circulation of fake and counterfeit medicines, and the prevailing government apathy and lack of political will encapsulated by a poor investment in healthcare, continue to make medicines inaccessible for a vast majority of the population in Africa, stalling the process towards achieving universal health coverage (UHC).
Strategies to improve access to medicines in Africa
African governments need to take strategic actions towards strengthening access to medicines on the continent. This calls for strong collaboration between government institutions, the private sector, public health institutions, pharmaceutical companies, and other relevant stakeholders.
There is no better time than now to promote more local production of medicines by private and government-owned pharma companies as well as industries that manufacture active pharmaceutical ingredients. To address this, Bloom Public Health proposes the establishment of pharmaceutical hubs.
These are compact modern-day pharmaceutical industrial estates that will bring together pharmaceutical companies and service providers to co-locate and share infrastructure, providing regulatory support and access to affordable funding. Bloom Public Health is championing this initiative through the Pharmacity project in Nigeria.
Another strategy is increasing investment towards the attainment of WHO prequalification for local pharmaceutical companies. WHO PQ provides opportunities for increased sales and market access by conferring eligibility for international, donor-sponsored tenders for medicines and increased potential to compete successfully for contract manufacture for local markets, thus increasing the availability of quality, efficient, and safe medicines in Africa.
In Nigeria, Bloom Public Health, in partnership with the National Institute for Pharmaceutical Research and Development (NIPRD), is currently implementing a World Bank-funded program to support selected Nigerian pharmaceutical manufacturers through the WHO PQ process.
To address the challenge of poor pharmaceutical manufacturing talent and know-how in Africa, Bloom Public Health and its technical partner, Biotech Training Facility, Netherlands, are set to launch the African Vaccine Academy (AVA).
The AVA is an African-wide initiative that will provide training on general bio-manufacturing processes with access to self-paced eLearning interactive training materials, webinars, and virtual classrooms, as well as practical hands-on biopharmaceutical training at Biotech Training Facility in Leiden, Netherlands.
Read also: The impact of poor-quality medicines on public health in Africa
The AVA will precede the establishment of the African Pharmaceutical Academy (APA), an on-site pharmaceutical training academy that will deliver training to new graduates in Sub-Saharan Africa and will aim to impact needed skills and expertise relevant to the pharmaceutical industry across the continent.
Other strategies that can be explored to improve access to medicines on the continent include strengthening health insurance systems, increasing investment in herbal medicine research, and strengthening medicine supply chain systems.
In conclusion
Without reliable access to medicines, good health and well-being cannot be guaranteed. It is therefore imperative that African governments implement tailor-made mechanisms and country-compatible strategies to strengthen access to medicines on the continent and progress towards universal health coverage.
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