LUSAKA - At a recent public health conference in Lusaka, I shared an uncomfortable truth with African policymakers: if we continue down our current path, Africa will remain a consumer, not a producer, in the global health economy. This is counterintuitive given that Africa has the largest and most disproportionate
disease burden of any continent.
At the moment, an African drug manufacturer can wait six years for market
qualification. Six years, while lives are lost, factories stand idle, and our young
people seek opportunities elsewhere. We can do this in half the time, yet
bureaucracy and outdated procurement rules continue to stifle Africa’s
manufacturing potential.
For too long, it has been fashionable to say African manufacturers are
uncompetitive. This is a myth. At Aspen Pharmacare, we operate in 55 markets
and reach patients in more than 150 countries. We are the world’s leading
supplier of generic anesthetics outside the United States. The barriers we face are not about capability; they are about systems and willpower.
Africa carries the world’s heaviest disease burden yet imports most of its
medicines. Every year, our trade deficit in pharmaceuticals widens. In South
Africa, this deficit stands at over 50%. We import vast quantities of
antiretrovirals, vaccines, tuberculosis medicines, and insulin. These are products
that could, and should, be made here.
This dependence is not only economically unsustainable but strategically
reckless. During the COVID-19 pandemic, Africa found itself at the back of the
global vaccine queue, waiting for others to decide when our turn would come.
Four years later, despite lofty ambitions by the African Union to produce 60% of
our vaccines by 2040, progress has been glacial.
The African Vaccine Manufacturing Accelerator (AVMA), launched with fanfare, is a step forward but a timid one. Its $1.2 billion, spread over a decade, is barely
enough to sustain a handful of “fill-and-finish” facilities, let alone a
continent-wide industry. If we want to build a resilient health system, we must
treat manufacturing as a public good, not a peripheral concern.
We need pooled procurement for vaccines, therapeutics, and diagnostics, just as we did during COVID-19, to achieve scale and sustainability. And we must reform national procurement laws that privilege imports over local value creation.
First, Africa’s regulators, together with the WHO, should adopt priority review
and parallel submissions, allowing drugs to be evaluated simultaneously by local
authorities and the World Health Organisation. This alone could shave years off
the time it takes to bring products to market.
Second, global partners such as Gavi, UNICEF, and the Global Fund must realign
their procurement frameworks to include African producers. Development
partners often speak of “African solutions,” but far too often these do not match
the requirements of Africa.
Third, financial incentives - such as higher Gavi subsidies for locally produced
vaccines must stimulate demand. Without predictable orders, no manufacturer
will invest in building capacity. Fill-and-finish production must come first; once
we have scale, we can expand upstream into active pharmaceutical ingredients.
These steps would not only reduce dependence but unleash the multiplier effect
of local manufacturing: job creation, technology transfer, and economic
resilience.
Africa does not need to reinvent the wheel. The story of China’s rise from
low-cost assembler to manufacturing powerhouse offers a masterclass in
industrial strategy, one rooted in long-term vision, patient investment, and
technology transfer.
South Africa, through its participation in the Belt and Road Initiative (BRI), is
beginning to apply these lessons. As a member of the South African chapter of
the BRICS Business Council, I have witnessed how our cooperation with China is
shifting the paradigm of South–South collaboration from resource extraction to
value-added industrial growth. In parallel to this, we recognize that China is a
much larger economy than ours and one where we will always run a trade deficit.
We therefore need to redouble our efforts and at the BRI partnership, relying less on exports of raw materials to China and more to the conversion of raw materials to manufactured goods.
Under the BRI, 53 African countries are now engaged in infrastructure and
industrial partnerships that attracted over $21 billion in deals last year alone.
These include renewable energy projects like the De Aar wind farms in South
Africa’s Northern Cape, which now generate more than 240 megawatts of clean
power.
Chinese firms are increasingly investing in African manufacturing, from
automotive components to textiles and footwear, helping to reindustrialise
sectors that once employed hundreds of thousands. By producing higher-value
goods locally, we can move from dependency on imported finished products to
self-sufficiency and export competitiveness.
The textile and footwear industries are early examples of what’s possible when
policy aligns with partnership. Industrial parks co-developed by South Africa
and China are reviving local production chains from spinning and weaving to
design and export. Agricultural trade, too, has deepened: China now buys 70% of South Africa’s wool exports, and new agreements are opening markets for our
fruit and avocados.
These are more than trade statistics. They are signs that a new model of
cooperation based on shared value, not extraction, is taking root. This is critical,
as indicated earlier, in a partnership where we look to narrow our trade deficit
with South African-manufactured products.
For Africa to seize its manufacturing moment, we must harmonise our regulatory systems, reform procurement to favour local value creation, and build alliances that prioritise technology transfer. If China could industrialise in a generation, so can Africa—if we commit to doing
so together, as partners.
- Dr Stavros Nicolaou is a member of Aspen Pharmacare Holdings Limited Group Executive Committee and a SA BRICS Business Council Member.