A New Stage for Global Competition: Africa's Pharmaceutical Market

Africa, already at the center of global powers' economic and geopolitical calculations due to its mineral wealth, fertile agricultural land, and the potential of its young population, now stands on the brink of a new competitive arena: the pharmaceutical market.

Despite being the world's second-fastest-growing pharmaceutical market with a population of 1.4 billion, the continent's production capacity still lags far behind its needs. With a rapidly growing population, accelerating urbanization, and skyrocketing health expenditures, Africa is becoming an unmissable opportunity for pharmaceutical giants. The game is no longer just about dominating minerals and land or gaining political-economic influence; it's about constructing a new market order through African public health.

According to 2019 data, while per capita health spending in Africa remains below $35, the global average exceeds $160, and high-income countries spend over $3,000. This stark contrast clearly reveals the immense growth potential of the continent's health sector.

Africa is one of the rare regions where the population continues to grow, contrary to global trends. Yet, this growth isn't translating directly into production: Egypt alone accounts for 30% of the continent's drug manufacturing, while over 20 countries have no local production at all. The African pharmaceutical market, currently valued at over $50 billion, is expected to grow by 6% to 8% annually until 2029.

In most African countries, deficiencies in health infrastructure, such as cold chain storage and logistics, pose a significant problem. For instance, in Sub-Saharan Africa, a single drug might have to pass through four different countries before reaching a rural clinic. This drives up costs and fuels the counterfeit drug market.

Since production costs on the continent are exceptionally high, approximately 80% to 90% of medical products are imported.

The Global Players in the Market

India is by far the largest supplier to the African pharmaceutical market. With its cheap generic drugs, HIV/AIDS treatments, and antibiotics, India effectively serves as the continent's "pharmacist." Indian firms like Cipla, Sun Pharma, Addii Biotech, and Dr. Reddy's are particularly strong in Sub-Saharan Africa.

China, meanwhile, leads in supplying the active ingredients and raw materials needed for drug production. With its low-cost manufacturing capacity, it competes directly with India.

African countries also import medicines of European origin. French companies, for example, remain highly influential in former French colonies.

For cancer drugs, advanced biotech medicines, and other high-cost treatments, the necessary pharmaceuticals are imported from US-based firms.

The Earthquake Caused by USAID Cuts

In an environment where drug supply is heavily dependent on imports, any shift in foreign aid directly impacts Africa's health systems. In this context, the cutting of funds by USAID, the US's global aid arm, is a development that will shake the continent's balances.

The cuts initiated by the Trump administration significantly reduced USAID's contributions to the health sector. This global reduction, estimated at $60 billion, hit Africa the hardest. USAID, through its provision of medicines, medical supplies, and equipment—particularly in areas like HIV/AIDS, malaria, and maternal and child health—had formed the backbone of many African countries' health systems.

For example, in 2023 alone, USAID spent $2.5 billion on HIV/AIDS programs and donated nearly $1.5 million worth of medical equipment to health facilities in Madagascar. Now, with this aid cut off, many countries are facing shortages of vital drugs, test kits, and equipment. This has laid bare the fact that local production in a strategic field like pharmaceuticals is a matter of security for the continent.

Is China Aiming for a Monopoly in the Pharma Sector?

Under the banner of the "Health Silk Road" initiative, Chinese pharmaceutical companies have been intensively investing in Africa for some time to boost local production. Just as Beijing quietly advanced in the continent's mining sector in the 2000s, it is now pursuing a similar strategy in healthcare.

China's traditional medicine philosophy aligns significantly with the nature-based healing practices common in many African communities. With products like natural medicines and creams, China has already established a foothold in the African market. During the COVID-19 pandemic, China, having won the trust of many African nations, further cemented its influence by setting up vaccine production facilities across the continent.

China's goal isn't just drug sales. Through hospital construction, donations of medical equipment, and training programs for health personnel, the Beijing administration seeks to leave a lasting mark on Africa's health infrastructure. Today, Chinese pharma giants like Sansheng Pharmaceutical and Fosun Pharma are manufacturing at a significant scale in some African countries. These initiatives strengthen China's health diplomacy while deepening its political and economic clout on the continent.

However, it's clear this growing cooperation carries serious risks. Many Chinese-origin drugs are generic and low-cost, which could increase import dependency rather than foster the development of local production capacity. Furthermore, occasional quality concerns regarding Chinese products raise questions about the reliability of health systems. For instance, in 2022, a significant portion of Chinese-origin malaria drugs in Kenya were found to be counterfeit.

It's no secret that Beijing's health investments are driven more by geopolitical interests than humanitarian motives. China aims to use the health sector as part of its "soft power" strategy to expand its influence over Africa, raising new concerns about the independence of the continent's health policies.

Claims that millions of DNA samples collected across Africa during COVID-19 under the guise of "screening" and "aid" are now circulating in Western and Chinese laboratories reveal another dimension of the issue. In health projects conducted in Africa, what data is collected from local communities and how it will be used is often not transparently disclosed. Behind these so-called scientific studies, one can still sense the traces of the old colonial mindset that views Black people as "subjects."

Can Local Production Break China's Generic Hegemony?

African leaders and the private sector are making significant efforts to create a perspective that centers the Black metabolism and the treatment of diseases endemic to the continent, rather than surrendering the health and pharmaceutical sector—a basic right of their people—to global powers that have exploited Africa for years and lie in wait to exploit it further.

The fact that modern medicine is largely Western-derived and centered on the white physiology has led to a poor understanding of local diseases and treatment methods in Africa. This is one of the biggest obstacles to developing unique solutions for Africa's health problems. Nonetheless, Africa is taking notable steps in this field, striving to chart its own course in healthcare.

In 2022, the Board of Directors of the African Development Fund approved a $6.63 million grant to the Common Market for Eastern and Southern Africa (COMESA) aimed at developing the pharmaceutical sector.

The African Development Bank has also committed over $3 billion in investment over the next decade to the African Pharmaceutical Technology Foundation, which strives to equip Africa with a robust pharmaceutical infrastructure.

Ethiopia recently inaugurated a biopharmaceutical manufacturing plant in Addis Ababa. Established in partnership with a German company, the facility aims to produce essential biological medicines for treating diseases like cancer and diabetes.

In Uganda's capital, Kampala, a new drug factory has opened, aiming to increase the production capacity of essential medicines.

South Africa has begun construction on a new biopharmaceutical research and development center in Gauteng province.

A vaccine manufacturing facility, developed by BioNTech, is now operational in Rwanda.

The African private sector is also contributing to the continent's pharmaceutical independence. The Dangote Group, owned by renowned Nigerian businessman Aliko Dangote, has announced it will build a pharmaceutical factory in Lagos. Expected to be one of the largest in Africa, this plant will produce a range of generic drugs to meet the needs of local and regional markets.

Against the new colonial strategies of external powers in the health sector, Africa's coordinated turn towards a health and medicine system based on preventive care—drawing from ancient traditions, centering its own people, and relying on local production—will determine the continent's future.

Africa's health sector must be shaped not by the profit calculations of global corporations, but by placing the right to life of the African people at its very core.

 

This article was originally published in Independent Türkçe, on May 22,2025.

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