For African nations, an important takeaway from the COVID-19 pandemic is the need to be self-sufficient in developing, producing, and distributing medicines and vaccines. “The COVID-19 pandemic highlighted the need for a regionally sourced, quality-assured supply of [medicines and vaccines] on the continent,” an October 2023 report from the Medicines for Malaria Venture (MMV), a Swiss nonprofit, said. “Producing quality medicines close to patients who need them most will save lives and accelerate human and economic progress.”
That target was envisioned in the Africa Agenda 2063 document. It is also a “main goal of the Africa Health Strategy 2016-2030 through which essential medicines, commodity security, and supply systems are underscored as a strategic approach,” said an African Union press release in February.
Egypt’s pharmaceutical companies have a real opportunity to cater to such demand, given the country is already 90% self-sufficient and exports excess medicines to 80 nations. To fully capitalize on opportunities in Africa, local producers need to accurately identify the market’s peculiarities and nuances, especially in Sub-Saharan nations.
Time to change
In a February press release, the African Centres for Disease Control and Prevention (Africa CDC), the African Union’s (AU) health agency, estimated the continent’s pharmaceutical market size at nearly $50 billion annually.
A significant portion of those medications are imported from outside Africa. “Less than 1% of vaccines are currently manufactured on the continent,” said the Africa CDC. The MMV report added that Africa imports “61% of packaged medicines and up to 80% of the pharmaceuticals used.”
Meanwhile, the quality of continent-produced medicines is not assured. Stella Chinyelu Okoli, CEO of Nigerian Emzor Pharmaceuticals, told MMV in October 2023 that “of the 375 medicine producers in the region, only six manufacture drugs to WHO pre-qualification standards.”
That could change soon as African governments try to achieve long-term health security. In February, the AU announced its goal of having “60% of vaccines … manufactured in Africa by 2040.” It tasked the Africa CDC with achieving that target, “broadening [its] mandate to include the manufacturing of medicines and diagnosis, in addition to its current remit of vaccines.”
Unique, demanding market
To build their presence across the continent, Egypt-based pharma producers need to identify and develop treatments for prevalent diseases. Malaria tops that list, as 95% of cases and deaths occur in Africa, noted MMV. “The demand for malaria chemoprevention medicines is expected to grow as the WHO increases the range of eligible populations.”
Another example is the new strain of monkeypox that appeared in the Democratic Republic of the Congo in January 2023. In August, the World Health Organization classified it as a “public health emergency of international concern.”
The Africa CDC lists 25 prevalent diseases, including avian Influenza; cholera; COVID-19; hepatitis B (HBV), C, and E; measles; and Middle East respiratory syndrome (MERS).
Neglected tropical diseases (NTDs) also are a concern. “Securing a future for Africa free of NTDs means establishing health resilience on the continent because NTDs account for significant morbidity and mortality,” the Africa CDC said. In February, it partnered with governments in Ghana, Rwanda, and Tanzania to identify and treat them.
Tech imperative
In addition to producing the correct treatments, Egyptian pharma producers need innovative retail solutions to ensure market access. Oluwaseun Afuye of Salient Advisory, a healthcare consultancy, said increasing dependence on online medical services started “in the wake of the pandemic, [when] there was an increase in the adoption of innovations that enable convenient, remote access to health products and services.”
Online pharmacies are “growing rapidly in many low and middle income countries,” Afuye said. They are “a bridge to connect remote and underserved populations to essential medicines … Patients no longer need to wait long hours … to access medicine.” He noted that more than 160 innovators offer online pharmacy solutions in Africa.
That model is a boon for both large and small African nations, as it requires no brick-and-mortar investments for cross-border expansion. Instead, online pharmacy owners just need business ties with locals to ensure supply and transportation. Ghana’s online pharmacy (mPharma), developed in 2013, now serves “over 2 million Africans across Ghana, Nigeria, Kenya, Zambia, and Zimbabwe,” said Afuye.
Additionally, traditional pharmacies are developing their own online versions, such as Nigeria’s HealthPlus, which has 62 branches in the country. The company uses the “digital platform [to] leverage its existing retail operations … telemedicine and diagnostic services to patients,” Afuye said.
However, the online model has risks, including “proliferation of substandard, falsified or unlicensed medicines, prescription misuse, and data protection – in this case, health records,” Afuye said.
He expects regulation soon: “Generally, technological advancements precede regulation. As innovations mature, and potential risks become evident, regulatory frameworks are gradually developed.”
Unorthodox competition
Egypt-produced medicines may find themselves competing with unusual alternatives. On one side of the spectrum, South Africa has been investing in “scaling up nuclear medicine training and research across the African continent,” said Anina Mumm, a researcher for the Council for Scientific and Industrial Research, a South Africa-based institution.
In May, the South African government inaugurated the Nuclear Medicine Research Infrastructure, the first research facility of its kind in Africa. The press release said it is “a ‘one-stop shop’ that will not only advance drug development and clinical research, but provide cutting-edge diagnostics and treatment in relation to cancer, tuberculosis and other major diseases.”
At the other end of the spectrum, Kenya is looking to institutionalize and regulate treatments and medicines based on plants and traditional therapies, given that “about 80% of people in African countries rely on them when they are ill,” the WHO said.
Currently, local centers offering such treatments are unlicensed, while individuals, usually growing medicinal gardens, raise awareness. “One of the things hampering wider adoption of traditional medicine in Kenya is that there is no government policy encouraging its safe use,” one local expert told the BBC in July. “Indigenous knowledge could be the basis for scientific research [like in] China [where] traditional medicine is accepted and exported as ‘alternative medicine.’”
New landscape
Fueling further the continent’s demand for medicines and treatments are more African countries that tout themselves as medical tourism destinations to attract non-African patients and medical facility investments. “It is a phenomenon that has come to stay … within Africa,” Jennifer Orisakwe, a researcher at Omnia Health, a UAE-based business-to-business publication, said in April.
Currently, South Africa, Nigeria, Kenya, Ghana, Tunisia, and Algeria are leading other African nations. “Egypt and Morocco [are] positioned slightly lower, highlighting existing challenges within their healthcare systems,” Orisakwe said.
She expects medical tourism in the continent to grow from “an estimated $115.6 billion in 2022 to $346.1 billion in 2032.” Orisakwe added that cancer treatments should see the highest demand. Overseeing the continent’s transformation into a medical tourism hub is the Africa Medical Tourism Council, formed in December.
Maximizing medical tourism’s potential means “comprehensive [national] strategies [are] essential,” said Oriskawe. That would create opportunities, as “investment in infrastructure and technology is crucial, requiring collaborative efforts between governments and the private sector.”
Legislative changes to tightly regulate individual African markets are also essential. Orishawe noted, “Implementing and enforcing stringent quality standards and certifications, in addition to accreditation processes, [are essential to] foster trust and confidence.”
This article first appeared in October’s print edition of Business Monthly.
