African solutions to African health problems

The director general of Nigeria’s National Agency for Food and Drug Administration and Control, Dr Paul Orhii, told journalists: “Before now, 70% of essential drugs in use in Nigeria were imported, while the remaining 30% that were manufactured locally were substandard. It got so terrible that even fellow African countries such as Ghana and South Africa were rejecting made-in-Nigeria drugs. But the situation has changed for the better in the last five years.”

Indeed, says Dr Paul Orhii, “the breakthrough is such that a global organisation like the UNICEF now proposes to buy drugs from Nigeria. And that was what gave us the confidence to ask the Bank of Industry for a N200bn ($.1bn) loan to rejuvenate the nation’s pharmaceutical industry. Obviously, we have covered much ground and we are getting there gradually.”

Sub-Saharan companies that are not subsidiaries of Western or Asian pharmaceutical companies have sometimes struggled to maintain the quality of their products and there have been a number of scandals regarding the efficacy or safety of drugs supplied across the continent over the past 20 years.

In addition, most African producers are much smaller than their competitors based elsewhere in the world and so lack many of their advantages of scale.

If these two problems can be overcome then African manufacturers could gain huge contracts in the supply of the very medications that are required in Africa, such as ARVs. The WHO is already working with Nigerian manufacturers to help them gain WHO approval.

Local production is the aim

As part of the Pharmaceutical Manufacturing Plan for Africa, African governments have agreed to promote local production in order to create employment, encourage security of supply, save foreign exchange, reduce the cost of the raw materials used as non-active ingredients and encourage low production.

The leadership of the African Union is committed to ensuring access to essential medicines for countries in need, irrespective of their level of technological development and manufacturing capacity.

However, this is made more difficult because of the complete absence of any level of pharmaceutical manufacturing in nine African countries and the existence of primary production in only South Africa.

Apart from anything else, the lack of skilled, highly educated workers in the required fields makes production difficult, not to mention research and development. Highly skilled scientists, engineers and technicians are needed even in manufacturing. In the long term, however, the emergence of pharmaceutical industries will provide the kind of technical employment that would greatly benefit any economy.

However, the Plan states: “Modern production is technology driven and may not create many entry level jobs. There are however possibilities of job creation across the value chain if we embark on research through
development, production and distribution. Jobs can be created in public research organisations, small and medium biotech companies, upstream in engineering and downstream in public health services.”

The Plan also calls for reliable, sustainable, reasonably priced electricity and water supplies, and modern IT and telecommunication infrastructure. Governments have some influence here but are largely restricted to providing attractive and efficient regulatory environments. They cannot fund R&D and manufacturing themselves.