Improving pharmaceutical innovation in Africa

African countries with their partners in research and the African pharmaceutical sector are taking steps to reshape the future of pharmaceutical research, medicines access and production for the continent. This is a response to the rapid evolution of the pharmaceutical innovation landscape seen in new trade rules, inter-governmental agreements and the promise of investment for country-driven research and innovation – some bringing benefits to countries, others bringing potential constraints.

An African consultation on pharmaceutical innovation
At the center of this movement is the first-ever comprehensive study on African pharmaceutical research and development capacity: “Strengthening Pharmaceutical Innovation in Africa”. This new evidence will be debated at a special meeting of African leaders in policy, research and pharmaceutical innovation in Pretoria, South Africa on 18-20 February. 

It presents the first picture of the landscape – revealing who is doing what in African pharmaceutical innovation; and provides tools that countries can use to develop national innovation strategies. The tools – a new Framework and Grid – help decision makers decide where on the spectrum of pharmaceutical innovation where they want to go, and what they need to do to get there. 

Today, Africa has a number of inter-governmental agreements and policies on pharmaceutical innovation and access to medicines. Putting these policies into action is a complex effort, where few countries have progressed. In this respect, the Pretoria consultation is unique. At the meeting Africa’s policy, research and industry partners will design an action plan to guide countries in developing their national medicines innovation, access or production strategies – crafted in Africa, by Africans. They will also fine-tune the innovation planning tool (framework/grid), to obtain political support for its use across Africa. 

Tools, and an pharmaceutical innovation process for countries
“This meeting reflects the growing political will for our countries to take matters of medicines development, access and local production into our own hands,” says Dr. Ibrahim Assane Mayaki, the Chief Executive Officer of The New Partnership for Africa’s Development (NEPAD). “But there is a gap today between this desire and achieving the reality of African country-driven pharmaceutical innovation. Countries need to better understand their situations, and what is possible to achieve. And start with a realistic assessment of their capacity to deliver on this promise.” 

The first step toward this goal – taken at the Pretoria meeting – is a reflection on what a ‘national pharmaceutical innovation strategy’ can look like. And how a country can develop the skills it needs to get started – in areas such as priority setting, trade and finance, intellectual property; or medicines development or the manufacturing pipeline. 

“While end-to-end medicines development, production and delivery may be some way off for many countries, a regional approach – where countries define areas of expertise they will develop, and pool resources with neighbours – holds real promise for a first wave of innovation activities,” says Prof. Carel IJsselmuiden, Director of COHRED, the Council on Health Research for Development, an international non-governmental organisation that provides support to countries to develop health and research systems. 

What does a national innovation strategy look like?
For countries, the first step in defining a national or regional innovation strategy is to clarify the reasons for doing this, says Prof. IJsselmuiden. “Policy makers need to consider whether their priority is access or commerce. Do you want to provide maximum access of essential medicines to the population? Or create a pharmaceutical technology sector to drive economic development? Both paths can benefit the country but the skills and investment needed for each are quite different.” 

He comments that providing access does not necessarily require an investment in local production. If the priority is to provide equitable medicines access to all of the population, a regional procurement plan may be the most effective way to serve people’s needs. A careful assessment of national needs and priorities will clarify this and guide policy makers in crafting a strategy and action plan that works for the country. 

A multitude of research and access programmes.
The study estimates there are more than 120 separate initiatives, programmes and organisations in Africa engaged in research and development and delivering medicines for diseases that affect the continent’s population. 

This diverse field of players is generally shaped by the thinking of international programmes and funders and often does not engage with countries’ specific public health needs. This results in the peculiar situation where the pharmaceutical innovation policy for Africa today is largely directed by those outside the continent – a practice that would be unthinkable in any other region of the world. 

African pharmaceutical supply relies largely on foreign funding and manufacturing. Local production has increased in some countries. For example, Egypt and Tunisia produce 60-95% of their national essential medicines requirement. But generally, local innovation and production levels are dramatically low. Most countries in the region will remain dependent on imports, for at least the medium term. 

The study shows that a number of African countries are working to take medicines research and production into their own hands. Countries such as Nigeria, South Africa, Kenya, Tanzania and others have policies to guide investment in developing, producing and delivering medicines for their populations. But most other countries need help developing policies, priorities and their innovation skill base on every level. 

The most important result of the Pretoria meeting, anticipate Dr Mayaki and Prof IJsselmuiden, is agreement on practical approaches that countries can use to make possible the right of access to essential drugs – an essential area of health and development.

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