Re-Thinking Pharmaceutical Production in Africa; Insights from the Analysis of the Local Manufacturing Dynamics in Mozambique and Zimbabwe

Article

Abstract

Until recently, consensus existed in certain circles that the African industry was not suitable for cost-effective production of quality, safe drugs. Yet, public and private pharmaceutical enterprises have cropped up on the continent, with some venturing into production of sophisticated and complex drugs, such as antiretrovirals (ARVs). In our study, we analyse and contrast the dynamics of local pharmaceutical manufacturing in Mozambique and Zimbabwe with the objective of understanding why pharmaceutical production in Africa is picking up momentum and the influence of global funding for ARVs in this process. Our analysis identifies two routes of development for local pharmaceutical manufacturing: a favourable economic outlook and support from the international community created the necessary conditions for the development of the nascent pharmaceutical industry in Mozambique, while in Zimbabwe, the presence of an established local industry was instrumental in bringing in favourable, if not always coherent, government regulation. In both countries, the introduction of AIDS treatment created windows of opportunity for local production of pharmaceuticals by increasing public sector demand, providing fresh funds, and providing a justification for government regulation favouring local production. Despite the long-standing and well-known problems that created persistent shortcomings in human resources and in the economic and industrial environments, we conclude that pre-existing developmental roots, international funds and supportive state industrial policies are encouraging more manufacturers to enter the business of local pharmaceutical production in Africa. However, the opportunities brought in by fresh AIDS funds will need to be sensibly managed at both the local and global levels, as the world’s interest on the disease may not last in the long term.

Keywords

Medicines in Africa Pharmaceutical manufacturing Pharmaceutical markets Mozambique Zimbabwe 

References

  1. Banda G. Finance as a ‘forgotten technological capability’ for promoting African local pharmaceutical manufacture. Int J Technol Manag Sustain Dev. 2013;12(2):117–35. doi:10.1386/tmsd.12.2.117_1.CrossRefGoogle Scholar
  2. Banda G. Financing ARV drug manufacture in Zimbabwe: implications for technological capability upgrading and innovation for African local pharmaceutical production. PhD Thesis. UK: The Open University 2012Google Scholar
  3. Barker C. The Mozambique pharmaceutical policy. Lancet. 1983;2(8353):780–82.CrossRefGoogle Scholar
  4. Beall R, Kuhn R. Trends in compulsory licensing of pharmaceuticals since the Doha declaration: a database analysis. PLoS Med. 2012;9(1):e1001154. doi:10.1371/journal.pmed.1001154.CrossRefGoogle Scholar
  5. Benatar SR. Health care reform and the crisis of HIV and AIDS in South Africa. N Engl J Med. 2004;351(1):81–92. doi:10.1056/NEJMhpr033471.CrossRefGoogle Scholar
  6. Brett EA. From corporatism to liberalization in Zimbabwe: economic policy regimes and political crisis, 1980–97. Int Polit Sci Rev. 2005;26(1):91–106. doi:10.1177/0192512105047898.CrossRefGoogle Scholar
  7. Cameron A, Ewen M, Rossdegnan D, Ball D, Laing R. Medicine prices, availability, and affordability in 36 developing and middle-income countries: a secondary analysis. Lancet. 2009;373(9659):240–49. doi:10.1016/S0140-6736(08)61762-6.CrossRefGoogle Scholar
  8. Chaudhuri S, Mackintosh M, Mujinja PGM. Indian generics producers, access to essential medicines and local production in Africa: an argument with reference to Tanzania. Eur J Dev Res. 2010;22(4):451–68. doi:10.1057/ejdr.2010.27.CrossRefGoogle Scholar
  9. CMAM. “Proposta de Necessidades E Alocação de Recursos Para Medicamentos”. Ministério da Saúde de Moçambique 2011.Google Scholar
  10. COWI. Finalização do plano de negócios da SMM: situação dos mercados farmacêuticos Em Moçambique E Na Região Da SADC. Maputo: COWI Consulting, Africa; 2012.Google Scholar
  11. De Oliveira L. Inicitativa de instalação Da fábrica de antiretrovirrais E outros medicamentos Em moçambique; avaliação Do projecto”. Fundação Oswaldo Cruz: Farmanguinhos; 2013.Google Scholar
  12. Fairbairn M. Indirect dispossession: domestic power imbalances and foreign access to land in Mozambique. Dev Chang. 2013;44(2):335–56. doi:10.1111/dech.12013.CrossRefGoogle Scholar
  13. Flynn M. Public production of anti-retroviral medicines in Brazil, 1990–2007. Dev Chang. 2008;39(4):513–36. doi:10.1111/j.1467-7660.2008.00494.x.CrossRefGoogle Scholar
  14. Froese EH. Meeting the pharmaceutical needs of a developing country. World Health Forum. 1991;12(1):25–8.Google Scholar
  15. GIZ. Bringing Medicines to Low-Income Markets—A Guide to Creating Inclusive Business Models for Pharmaceutical Companies. German Federal Ministry for Economic Cooperation and Development (BMZ). 2012. http://www2.gtz.de/dokumente/bib-2012/giz2012-0025en-medicines-low-income-markets.pdf.
  16. GoM. Diploma ministerial No52/2010 Sobre Fixação de Preços de Medicamentos. 2010.Google Scholar
  17. Institute for Health Metrics and Evaluation, and Human Development Network the World Bank. The Global Burden of Disease: Generating Evidence, Guiding Policy Sub-Saharan Africa Regional Edition. The University of Washington and the Human Development Network. Washington, DC: World Bank. 2013. http://documents.worldbank.org/curated/en/2013/08/18187588/global-burden-disease-generating-evidence-guiding-policy-sub-saharan-africa-regional-edition.
  18. Kaplan W, Laing R. Local production of pharmaceuticals: industrial policy and access to medicines: an overview of key concepts, issues and opportunities for future research. 32036. HPN Discussion Paper. The World Bank. 2005. http://www.who.int/medicines/technical_briefing/tbs/KaplanLocalProductionFinal5b15d.pdf.
  19. Kuanpoth J. Patents and access to antiretroviral medicines in Vietnam after world trade organization accession. J World Intellect Prop. 2007;10(3–4):201–24. doi:10.1111/j.1747-1796.2007.00321.x.CrossRefGoogle Scholar
  20. MISAU. “Plano Estratégico Da Área Farmacêutica”. Departamento Farmacêutico do Ministério da Saúde da República de Moçambique. 1996.Google Scholar
  21. Mujinja PGM, Mackintosh M, Justin-Temu M, Wuyts M. Local production of pharmaceuticals in Africa and access to essential medicines: ‘urban bias’ in access to imported medicines in Tanzania and its policy implications. Glob Health. 2014;10(1):12. doi:10.1186/1744-8603-10-12.CrossRefGoogle Scholar
  22. Nicol D, Owoeye O. Using TRIPS flexibilities to facilitate access to medicines. Bull World Health Organ. 2013;91(7):533–39. doi:10.2471/BLT.12.115865.CrossRefGoogle Scholar
  23. Orsi F, D’Almeida C, Lia H, Mamadou C, Paulo T, Benjamin C. TRIPS post-2005 and access to new antiretroviral treatments in southern countries: issues and challenges. AIDS. 2007;21(15):1997–2003. doi:10.1097/QAD.0b013e328273bbe4.CrossRefGoogle Scholar
  24. Osewe PL, Nkrumah YK, Sackey EK. Improving access to HIV/AIDS medicines in Africa: Trade-Related Aspects of Intellectual Property Rights (TRIPS) flexibilities utilization. World Bank Publications. 2008.Google Scholar
  25. Owoeye OA. Compulsory patent licensing and local drug manufacturing capacity in Africa. Bull World Health Organ. 2014;92(3):214–19. doi:10.2471/BLT.13.128413.CrossRefGoogle Scholar
  26. Pavignani E, Durão JR. Managing external resources in Mozambique: building new aid relationships on shifting sands? Health Policy Plan. 1999;14(3):243–53.CrossRefGoogle Scholar
  27. Pfeiffer J, Montoya P, Alberto J, Baptista MK, de Morais M, Pugas MM, et al. Integration of HIV/AIDS services into African primary health care: lessons learned for health system strengthening in Mozambique—a case study. J Int AIDS Soc. 2010;13(1):3. doi:10.1186/1758-2652-13-3.CrossRefGoogle Scholar
  28. Pinheiro E, Vasan A, Kim JY, Lee E, Guimier JM, Perriens J. Examining the production costs of antiretroviral drugs. AIDS (London, England). 2006;20(13):1745–52. doi:10.1097/01.aids.0000242821.67001.65.CrossRefGoogle Scholar
  29. Portal V. Lula Visita 1a Fábrica de Remédios Contra Aids Em Moçambique—Portal Vermelho. 2010. http://www.vermelho.org.br/noticia/141228-9.
  30. Rovira J. Creating and promoting domestic drug manufacturing capacities: a solution for developing countries? In: In Negot heal intellect prop access mediciens. Sterling: International Centre for Trade and Sustainable Development; 2006.Google Scholar
  31. Russo G, McPake B. Medicine prices in urban Mozambique: a public health and economic study of pharmaceutical markets and price determinants in low-income settings. Health Policy Plan. 2010;25(1):70–84. doi:10.1093/heapol/czp042.CrossRefGoogle Scholar
  32. Russo G, Cabral L, Ferrinho P. Brazil-Africa technical cooperation in health: what’s its relevance to the post-Busan debate on ‘aid effectiveness’? Glob Health. 2013;9:2. doi:10.1186/1744-8603-9-2.CrossRefGoogle Scholar
  33. Russo G, de Oliveira L, Shankland A, Sitoe T. On the margins of aid orthodoxy: the Brazil-Mozambique collaboration to produce essential medicines in Africa. Glob Health. 2014;10(1):70. doi:10.1186/s12992-014-0070-z.CrossRefGoogle Scholar
  34. Sacco S. 2004. A comparative study of the implementation in ZIMBABWE and south africa of the international law rules that allow compulsory licensing and parallel importation for HIV/AIDS drugs. University Phd Dissertation. The American University of Cairo. http://repository.up.ac.za/xmlui/bitstream/handle/2263/1100/sacco_sf_1.pdf?sequence=1.
  35. Seiter A. A practical approach to pharmaceutical policy. Vol. 55203. Directions in development. Washington: The World Bank, 2010. https://openknowledge.worldbank.org/bitstream/handle/10986/2468/552030PUB0Phar10Box349442B01PUBLIC1.pdf?sequence=4.
  36. Shadlen KC, Fonseca E. Health policy as industrial policy: Brazil in comparative perspective. Polit Soc. 2013;41(4):561–87.CrossRefGoogle Scholar
  37. SMM, and Farmanguinhos. Plano de negócios Da SMM. Matola: Sociedade Moçambicana de Medicamentos; 2013.Google Scholar
  38. Turshen M. Reprivatizing pharmaceutical supplies in Africa. J Public Health Policy. 2001;22(2):198–225.CrossRefGoogle Scholar
  39. UNCTAD. UNCTADSTAT—Trade Statistical Database. United Nations Conference for Trade and Developtment. 2013. http://unctadstat.unctad.org/ReportFolders/reportFolders.aspx?sCS_referer=&sCS_ChosenLang=en.
  40. UNIDO. Pharmaceutical sector profile: Uganda. Global UNIDO project: strengthening the local production of essential generic drugs in least developed and developing countries. Vienna: United Nations Industrial Development Organization; 2010.Google Scholar
  41. UNIDO. Pharmaceutical sector profile: Zimbabwe. Global UNIDO project: strengthening the local production of essential generic drugs in least developed and developing countries. Vienna: United Nations Industrial Development Organization; 2011.Google Scholar
  42. UNIDO-AUC. Pharmaceutical manufacturing plan for Africa—business plan. Prepared as part of the African union commission-UNIDO partnership. Addis Ababa: United Nations Industrial development Organization; 2012.Google Scholar
  43. Van de Maele N, Evans DB, Tan-Torres T. Development assistance for health in africa: are we telling the right story? Bull World Health Organ. 2013;91(7):483–90. doi:10.2471/BLT.12.115410.CrossRefGoogle Scholar
  44. Waning B, Diedrichsen E, Moon S. A lifeline to treatment: the role of Indian generic manufacturers in supplying antiretroviral medicines to developing countries. J Int AIDS Soc. 2010;13:35. doi:10.1186/1758-2652-13-35.CrossRefGoogle Scholar
  45. WHO. Local production for access to medical products: developing a framework to improve public health. WHO Public Health Innovation and Intellectual Property. ISBN: 978 92 4 150289 4. 2011. http://www.who.int/phi/publications/local_production_policy_framework/en/.
  46. Wilson KR, Kohler JC, Ovtcharenko N. The make or buy debate: considering the limitations of domestic production in Tanzania. Glob Health. 2012;8(June):20. doi:10.1186/1744-8603-8-20.CrossRefGoogle Scholar
  47. World Bank. The World Bank Statistical Database. 2013. http://data.worldbank.org/.

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  1. 1.Global Health and Tropical Medicine, Instituto de Higiene e Medicina TropicalNova University of LisbonLisbonPortugal
  2. 2.Institute of Development Studies, Library RoadUniversity of SussexBrightonUK
  3. 3.The Open UniversityBuckinghamshireUK

Personalised recommendations