Africa deserves better. African lives demand better. And the solutions exist—if we finally choose to implement them, writes Jovial Rantao.
Every year, Africa spends more than $65 billion importing medical products it could manufacture itself. Let that sink in: a continent of 1.4 billion people, rich in resources and human capital, haemorrhaging billions to foreign pharmaceutical companies for medicines that never needed to cross an ocean.
This isn’t just poor economics. It’s a surrender of sovereignty so complete, so devastating, that it should keep every African leader awake at night.
When Nardos Bekele-Thomas, CEO of the African Union Development Agency, addressed the 7th Biennial Scientific Conference on Medical Products Regulation in Mombasa in November, she delivered a message that transcended diplomatic niceties: Africa’s 70-80% dependency on imported pharmaceuticals is not merely inconvenient—it is dangerous, destabilising, and entirely preventable.
COVID-19 didn’t create Africa’s pharmaceutical crisis. It merely exposed what generations of policy failure had built: a health infrastructure so dependent on the whims of foreign manufacturers that when the world closed its borders and hoarded supplies, African lives became bargaining chips in a global scramble for survival.
While wealthy nations stockpiled vaccines and treatments, Africa waited. When supplies finally trickled in, they often arrived near expiration, as if African lives operated on a different timeline, one measured not in urgency but in charity.
This wasn’t an accident of geography or bad luck. It was the predictable outcome of a system designed—deliberately or through negligence—to keep Africa dependent, perpetually positioned as consumer rather than producer, patient rather than partner.
Fifty-Four Countries, Fifty-Four Walls
Here’s the brutal arithmetic of Africa’s regulatory fragmentation: Fifty-four countries maintain fifty-four separate regulatory systems. For a pharmaceutical company to bring a single product to the African market, it must navigate fifty-four different approval processes, each with its own standards, timelines, and bureaucratic labyrinths.
The result? Local manufacturing becomes economically unviable. Continental markets remain theoretical. Investment flows elsewhere. And Africa continues writing checks to foreign manufacturers while its own pharmaceutical potential withers.
Bekele-Thomas framed it clearly: “This level of dependency exposes our health systems to global market volatility and leaves us vulnerable during crises.” But vulnerability doesn’t capture the full picture. This is systematic exposure, a self-inflicted wound that drains resources, stifles innovation, and costs lives.
To be fair, Africa hasn’t been entirely dormant. In sixteen years, the African Medicines Regulatory Harmonisation Programme has strengthened nine National Regulatory Authorities to WHO Maturity Level 3, established six regional harmonisation initiatives, and created frameworks for joint regulatory activities. Last year, the Continental Pilot for the Listing of Human Medicines approved twelve medicines and four Mpox diagnostics.
These are not trivial achievements. They represent years of technical work, diplomatic negotiations, and genuine commitment from dedicated professionals.
But achievements measured in decades, while billions drain annually and preventable diseases kill daily, is not a pace that matches the urgency of the crisis. Africa doesn’t have another sixteen years to incrementally strengthen regulatory systems while remaining hostage to foreign pharmaceutical supply chains.
The newly operational African Medicines Agency, now headquartered in Kigali, Rwanda, represents what Bekele-Thomas calls “the next chapter of a journey that began with a shared dream”. It’s meant to harmonise regulatory standards, streamline approvals, and create the unified framework that makes continental pharmaceutical production viable.
On paper, AMA is exactly what Africa needs. In practice, the question remains: Will African governments surrender enough sovereignty to make it work? Will they invest the resources needed to build genuine regulatory capacity? Or will AMA become another well-intentioned institution that produces reports while dependency deepens?
The answer depends on whether African leaders recognise a fundamental truth: regulatory nationalism—the instinct to maintain separate systems and independent control—is a luxury the continent cannot afford. Every day African nations cling to fragmented regulations, they choose dependency over sovereignty.
From PMPA to PIFAH: Acronyms Aren’t Action
AUDA-NEPAD has launched an alphabet soup of initiatives: the Pharmaceutical Manufacturing Plan for Africa (PMPA), the Priority 24 Health Products Roadmap, the Programme for Investment and Financing in Africa’s Health Sector (PIFAH), the Demographic Dividend and Sexual and Reproductive Health Programme, and the AU Smart Safety Surveillance Initiative.
Each represents serious planning and genuine effort. But plans without implementation are just expensive paperwork. Roadmaps without political will are tourism brochures for destinations we’ll never reach.
The technical barriers to pharmaceutical independence are surmountable. Africa has the talent, the resources, and increasingly, the technical frameworks. What remains uncertain is whether the continent has the collective political will to prioritise health sovereignty over bureaucratic inertia, national pride over continental necessity, short-term political calculations over long-term survival.
This is the seventh biennial Scientific Conference on Medical Products Regulation. The seventh time, experts, policymakers, and stakeholders have gathered to discuss the same fundamental challenges. The seventh time, development partners have been thanked for their support. The seventh time, someone has praised the platform for creating “a community and a movement.”
At what point does a biennial conference become a ritual rather than a catalyst? When does gathering become an excuse for inaction rather than a spark for change?
Bekele-Thomas insists SCoMRA is “not just a conference; it is a catalyst for collective action”. But catalysts produce reactions. Movements create change. Seven conferences spanning fourteen years, while dependency remains at 70-80% suggest we’re better at convening than converting talk to transformation.
This isn’t merely about economics, though the numbers are staggering. Pharmaceutical manufacturing represents billions in potential revenue, millions in job creation, and a pathway to broader industrialisation. It’s a cornerstone of the African Continental Free Trade Area, which cannot function when health products—essential goods in any economy—remain overwhelmingly imported.
But more fundamentally, this is about dignity and self-determination. It’s about whether African nations can protect their own populations without depending on the goodwill of foreign manufacturers who may or may not prioritise African lives when the next crisis arrives.
Because there will be a next crisis. Another pandemic, another global disruption, another moment when supply chains break and borders close. When that happens, will Africa have built the pharmaceutical capacity to protect its own people? Or will we once again be left waiting, watching, and counting preventable deaths while medicines sit in warehouses an ocean away?
The Path Forward Is Clear—If We Take It
Health sovereignty isn’t a slogan. It’s an imperative. Achieving it requires three things, none of them mysterious:
First, genuine regulatory harmonisation. Not coordination. Not cooperation. Harmonisation—unified standards, mutual recognition, and continental approval processes that make African markets attractive to manufacturers and viable for local production.
Second, sustained investment in manufacturing capacity. Not pilot programs or demonstration projects, but major, sustained commitments to building pharmaceutical production across the continent, with the infrastructure, workforce development, and quality assurance systems that genuine manufacturing requires.
Third, political courage. The willingness to surrender degrees of national regulatory control for continental benefit. The discipline to maintain quality and safety standards while accelerating approvals. The commitment to prioritise health sovereignty even when foreign manufacturers offer seemingly cheaper short-term alternatives.
A Simple Question
Bekele-Thomas concluded her remarks by declaring, “Together, we are proving that Africa is not waiting for the future—Africa is building it.”
With respect to the CEO and the dedicated professionals working on these initiatives: Are we building, or are we planning to build? Are we transforming, or are we conferencing about transformation?
The distinction matters. Because while Africa convenes, discusses, harmonises incrementally, and celebrates small victories, $65 billion continues flowing out annually. Supply chains remain vulnerable. Dependencies deepen. And when the next crisis comes, and it will come, we risk facing it exactly as we faced COVID-19: dependent, vulnerable, and ultimately, at the mercy of others.
The conference in Mombasa this week represents another opportunity. But opportunities without action are just missed chances wrapped in diplomatic language.
Sixteen years of progress deserve acknowledgement. But it doesn’t deserve satisfaction. Not when 70-80% dependency remains the norm. Not when $65 billion still flows outward. Not when Africa’s pharmaceutical potential remains theoretical rather than actual.
The technical path to health sovereignty is clear. The economic case is overwhelming. The moral imperative is undeniable.
The only remaining question is whether African leaders will finally match the urgency of their rhetoric with the boldness of their actions.
Because talk, no matter how well-intentioned or technically sophisticated, has never saved a single life. Medicines do. And until Africa can reliably produce them, we remain not masters of our health destiny, but supplicants hoping for generosity in a world that has repeatedly shown it has none to spare.
The time for the eighth biennial conference should not come before the fundamental transformation does. Make the next gathering a celebration of achieved sovereignty, not another symposium on aspirational goals.
Africa deserves better. African lives demand better. And the solutions exist—if we finally choose to implement them.
Jovial Rantao is a writer for The African Mirror.
This article originally appeared on
The African Mirror website and is published with permission.