Abstract
Healthcare coverage is one of the 17 Sustainable Development Goals (SDGs) of the Agenda 2030 of the United Nations. The situation in SSA is bleak: There is a lack of coverage and quality of service and finance. A key part of a functioning (basic) healthcare provision is the availability of medicines. Local production and distribution are the main challenges in the pharmaceutical industry making medicine availability difficult. The majority of drug consumption via out-of-pocket spending is found in the BoP population, especially in the rural areas. This chapter will examine the situation in terms of healthcare coverage, the role of out-of-pocket-spending, the situation of the local pharmaceutical industry and the role of BoP spending. It finds that gaps are pertinent in the existing systems and provisions. This has impact on the business model approach.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Notes
- 1.
The Afrobarometer surveys eight SSA countries on a regular basis. They are: Benin, Côte d’Ivoire, Kenya, Malawi, Mali, Uganda, Zambia, Zimbabwe. In each country more than 1000 citizens are interviewed.
- 2.
This decline in out-of-pocket spending mainly occurred in smaller countries and was, on a regional level, overcompensated by high out-of-pocket spending increases in large countries such as Nigeria.
- 3.
This includes private insurance, enterprise and NGO-based insurance schemes, and voluntary insurance models.
- 4.
M-Tiba is the first of a series of similar schemes in Sub-Saharan African countries offering similar healthcare schemes all based on the Pharma Access Foundation concept (https://www.pharmaccess.org/) run by CarePay, a legal entity founded in Kenya.
- 5.
To avoid confusion, the market size in Table 5.3 refers to only countries in Sub-Saharan Africa. North Africa makes up a large proportion of any industry market in Africa.
- 6.
They calculate the factor according to following formula: factor = local price/international reference price.
- 7.
Note that this refers to ‘household spending’ which corresponds only to the out-of-pocket healthcare spending and does not reflect total healthcare spending in the country.
- 8.
More current data is not available.
References
Adegoke Y (2019) Ghanaian startup mPharma is buying Kenya’s second largest pharmacy chain. Quartz Africa, March 28, 2019. https://qz.com/africa/1582487/ghanas-mpharma-buys-kenya-pharmacy-haltons/. Accessed 3 Feb 2020
AfDB, OECD, UNDP (2017) African Economic Outlook 2017. OECD, Paris
African Union (2012) Pharmaceutical manufacturing plan for Africa – business plan. Addis Abeba
African Union (2015) Update on implementation of the pharmaceutical manufacturing plan for Africa (PMPA). First Meeting of the Specialised Technical Committee on Health, Population and Drug Control 13-15.4.2015. Addis Abeba. http://carmma.org/resource/report-first-meeting-specialised-technical-committee-health-population-and-drug-control. Accessed 17 Feb 2019
African Union (2016) Africa Health Strategy 2016-2030. https://au.int/en/documents/30357/africa-health-strategy-2016-2030. Accessed 23 Nov 2019
Afrobarometer (n.d.) The online data analysis tool (R7 2016/2018). http://afrobarometer.org/online-data-analysis/analyse-online. Accessed 24 Jan 2018
Armah-Attoh D, Selormey E, Houessou R (2016) Despite gains, barriers keep health care high on Africa’s priority list. Afrobarometer Policy Paper 31. https://afrobarometer.org/sites/default/files/publications/Policy%20papers/ab_r6_policypaperno31_health_a_priority_in_africa1.pdf. Accessed 18 Sept 2019
Camelot Management Consultants (2017) Navigating the labyrinth of pharma distribution in Africa. A blueprint to network optimization. https://www.camelot-mc.com/de/study/navigating-the-labyrinth-of-pharma-distribution-in-africa/. Accessed 9 Jul 2020
Cameron E, Nuzzo J, Bell J (2019) Global Health Security Index 2019: Report and model. https://www.ghsindex.org/report-model/. Accessed 15 Apr 2020
Conway M, Holt T, Sabow A, Sun I (2019) Should sub-Saharan Africa make its own drugs? Public Sector Practice, McKinsey & Company. https://www.mckinsey.com/industries/public-sector/our-insights/should-sub-saharan-africa-make-its-own-drugs. Accessed 20 Apr 2020
Dong J, Mirza Z (2016) Supporting the production of pharmaceuticals in Africa. Bull World Health Organ 94:71–72
EY (2018) Global analysis of health insurance in Sub-Saharan Africa. https://www.ey.com/Publication/vwLUAssets/EY-global-analysis-of-health-insurance-in-sub-saharan-africa/%24File/ey-global-analysis-of-health-insurance-in-sub-saharan-africa.pdf. Accessed 12 Feb 2020
Gebre-Mariam T, Tahir K, Gebre-Amanuel S (2016) Bringing industrial and health policies closer: reviving pharmaceutical production in Ethiopia. In: Mackintosh M, Banda G, Tibandebage P, Wamae W (eds) Making medicines in Africa: the political economy of industrializing for local health. Palgrave Macmillan UK, London, pp 65–84
Holt T, Lahrichi M, Santos da Silva J (2015) Africa: a continent of opportunity for pharma and patients. https://www.mckinsey.com/industries/pharmaceuticals-and-medical-products/our-insights/africa-a-continent-of-opportunity-for-pharma-and-patients. Accessed 15 Jul 2018
IFPMA (2017) The pharmaceutical industry and global health. Facts and Figures 2017. Geneva. https://www.ifpma.org/resource-centre/ifpma-facts-and-figures-report/. Accessed 18 Nov 2019
Kutzin J, Yip W, Cashin C (2016) Alternative financing strategies for universal health coverage. In: Scheffler R (ed) World Scientific Handbook of Global Health Economics and Public Policy. Imperial College Press, London, pp 267–309
Lartey PA, Graham AE, Lukulay PH, Ndomondo-Sigonda M (2018) Pharmaceutical sector development in Africa: progress to date. Pharm Med 32:1–11
Lee S, Cho Y-M, Kim S-Y (2017) Mapping mHealth (mobile health) and mobile penetrations in sub-Saharan Africa for strategic regional collaboration in mHealth scale-up: an application of exploratory spatial data analysis. Glob Health 13:63ff
Mackintosh M, Mugwagwa J, Banda G, Tibandebage P, Tunguhole J, Wangwe S, Karimi Njeru M (2018) Health-industry linkages for local health: reframing policies for African health system strengthening. Health Policy Plan 33:602–610
Mohandas B (2019) Healthcare in Africa: reflections on a decade of transformation. Private Healthc Emerg Markets 7:3–6
M-TIBA (n.d.) About us. http://pharmaccess.m-tiba.org/about. Accessed 25 June 2018
Musango L, Ota M (2015) The critical role of health financing in progressing universal health coverage. The African Health Monitor. Special Issue: Universal Health Coverage 20:3–10
Pearson B, Milimo E (2017) Africa’s pharmaceutical futures. Afr Rep 91:68–69. https://www.theafricareport.com/802/africas-pharmaceutical-futures/. Accessed 18 Mar 2018
Russo G, Banda G (2015) Re-thinking pharmaceutical production in Africa; Insights from the analysis of the local manufacturing dynamics in Mozambique and Zimbabwe. Stud Comp Int Dev 50:258–281
Strasser R, Kam SM, Regalado SM (2016) Rural health care access and policy in developing countries. Annu Rev Public Health 37:395–412
The Economist (2017a) Access to healthcare in Africa and the Middle East. Economist Intelligence Unit, London
The Economist (2017b) Access to healthcare. Building sustainable health systems. Economist Intelligence Unit, London
UN (2015) Transforming our world: the 2030 agenda for sustainable development. United Nations, New York
UNCTAD (n.d.) Statistical Database. https://unctadstat.unctad.org/EN/. Accessed 23 Feb 2020
UNECA (2019) Economic report on Africa 2019: Fiscal policy for financing sustainable development in Africa. Economic Commission for Africa. Addis Ababa
von Carlowitz P, Röndigs A (2016) Distribution in Afrika. Distributionslogistik in Westafrika als Beispiel. Springer Gabler, Wiesbaden
WHO (2017a) Atlas of the African Health Statistics 2017. WHO Regional Office for Africa. Brazzaville
WHO (2017b) World Health Statistics 2017. Monitoring health for the SDGs. Sustainable development goals. Geneva
WHO (2018) Atlas of African health statistics 2018: Universal health coverage and the sustainable development goals in the WHO African Region. Brazzaville
WHO (n.d.) Global Health Expenditure Database. http://apps.who.int/nha/database. Accessed 16 Apr 2020
Willcox ML, Peersman W, Daou P, Diakité C, Bajunirwe F, Mubangizi V, Mahmoud EH, Moosa S, Phaladze N, Nkomazana O, Khogali M, Diallo D, Maeseneer J de, Mant D (2015) Human resources for primary health care in sub-Saharan Africa: progress or stagnation? Human Resource Health 13:76ff
World Bank (2016) UHC in Africa: a framework for action. Washington, DC. https://openknowledge.worldbank.org/handle/10986/26072. Accessed 18 Jun 2019
World Bank (n.d.-a) Global Consumption Database. http://datatopics.worldbank.org/consumption/home. Accessed 15 Feb 2018
World Bank (n.d.-b) World Development Indicator Database. https://data.worldbank.org/products/wdi. Accessed 4 Aug 2018
Zekeng E (2016) Healthcare systems in Sub-Saharan Africa: focusing on community-based delivery (CBD) of health services and the development of local research institutes. United Nations Peace Progr 3:44–49
Author information
Authors and Affiliations
Rights and permissions
Copyright information
© 2020 The Author(s)
About this chapter
Cite this chapter
von Carlowitz, P. (2020). Healthcare System and Pharmaceutical Market in Sub-Saharan Africa. In: Success in the Bottom of the Pyramid Market in Africa. SpringerBriefs in Business. Springer, Cham. https://doi.org/10.1007/978-3-030-59068-0_5
Download citation
DOI: https://doi.org/10.1007/978-3-030-59068-0_5
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-59067-3
Online ISBN: 978-3-030-59068-0
eBook Packages: Economics and FinanceEconomics and Finance (R0)