President John Dramani Mahama’s call for stronger African control over health financing and production comes with a challenge that goes beyond building factories: African countries cannot develop a truly integrated health industry if their markets, businesses, researchers, and supply chains remain separated by barriers at their borders.
Launching the High-Level Panel Report of the Accra Reset, A Sovereign Future for Health, on the sidelines of the 81st United Nations General Assembly in New York, President Mahama argued that greater domestic control must accompany the push for health sovereignty.
“Today, through the Accra Reset, we declare unequivocally that there can be NO ownership without control,” he said in a social media post.
But control over production cannot be achieved simply by establishing more pharmaceutical factories in individual African countries. The industry requires a network of suppliers, research institutions, testing laboratories, skilled workers, financing and markets that can operate across national boundaries.
This makes stronger economic links between African countries critical to the ambitions outlined by the Accra Reset.
A pharmaceutical company in Ghana can invest in local production, but scaling that business becomes harder when the inputs it needs come from outside Africa and its potential market remains largely confined to one country. If African markets were more connected, manufacturers could source more inputs within the continent, access a much larger customer base, and spread the cost of research and production across several markets.
A more connected African market could address both constraints.
Countries can develop complementary capabilities, allowing research institutions, manufacturers and suppliers in different markets to participate in the same value chain. One country could supply pharmaceutical inputs, another provide manufacturing capacity, while research institutions elsewhere conduct clinical trials or develop new formulations.
The African Continental Free Trade Area is intended to create a larger market for businesses across the continent, although traders continue to face practical challenges in moving goods between countries, including customs procedures, documentation, and different regulatory requirements. Addressing these challenges could make it easier for pharmaceutical companies to source inputs, distribute finished products and expand into other African markets, supporting greater integration of production and trade across the continent.
Trade links, however, would need to be supported by other policies. Regulatory systems would have to work more closely together so that medicines approved in one market can gain access to others without having to go through lengthy and costly processes in each country. Research institutions and clinical-trial networks would also need stronger links, allowing expertise and findings to be shared across markets.
The financing of pharmaceutical production would present another part of the challenge. Manufacturing facilities and research programmes require substantial capital, while new medicines and technologies can take years to reach the market. Regional development finance, investment funds and other long-term financing mechanisms could help businesses raise the capital needed to build capacity.
The objective, therefore, would not simply be for individual African countries to produce more medicines locally. It would be to build stronger links between the different parts of the continent’s health and industrial systems, allowing countries to contribute different capabilities while accessing a larger shared market.
For Mahama’s Accra Reset agenda, this makes continental integration an important part of the health sovereignty debate. Reducing dependence on external suppliers will require African countries to strengthen their own production capacity, but also to make it easier for businesses, researchers, capital, inputs, and finished products to move between African markets.
