Medicines for Africa I The Emerging Trend of Big Pharma Rethinking its Africa Strategy and Exiting the African Market- Why Now?

The exit of big pharma companies from the African market may create new opportunities for investing in the African market, but overall, this is a set-back for Africa’s broader objective – to develop Africa’s medicines manufacturing sector in order to achieve security of access at all times, during and outside pandemics. The departure of global pharma giants raises critical questions not just about the future of industrial development and security of access to medical products in Africa but also what is driving it and how to prevent further exit of manufacturing corporations from the continent.

What is compelling these companies to re-think their Africa strategy only now? After all, the challenges that are leading them to exit the African market like the poor ease of doing business and limited access to foreign currency are not new. They have always existed. For instance, in the past, whilst Kenya faced similar challenges as it does now, it was nevertheless considered a favorable environment for regional production by some of the leading global multinationals because of a favourable business environment and connectivity. Yet, Kenya’s manufacturing Association has reported that a record 34 manufacturing companies have shut down production plants in Kenya in less than a decade. In spite of challenges that have always existed in the African market, corporations have always managed to win in the African markets.

Until now, pharma companies persevered in the African market though cycles of rising operational expenses, economic downturns, less than optimal policies, weak regulations and more. Granted, outsourcing can help to improve competitiveness by allowing pharma companies to focus on their core business - innovation and manufacturing medicines and delegating logistics and other functions to partners with such functions as their core business overall creating greater efficiencies. Nevertheless, outsourcing is not necessarily the panacea to solving business challenges. It also has some drawbacks. For instance, pharma companies may lose the ability to influence strategy and quality management of its products. In some African markets, it is not uncommon for distributors of multiple companies to selectively push products and withhold others to create scarcity and drive the cost medicines up.

To explain why big pharma now sees exist as the next best option for them to be able to retain and expand their market share, is it inconceivable that counterfeited medicines are the straw that broke the camel’s back? If not the ultimate straw, they are surely a factor? The African market is overwhelmed by the heavy burden of counterfeited medicines. They have been the elephant in the room and many people get upset that medicines for africa (mfa) talks about them despite their insidious and deleterious impact on population health. In Africa, they exert a heavy burden that takes up to a million lives, a likely under-estimation given that few countries gather data systematically and continuously. Almost half of reported counterfeited medicines globally are detected in Africa. Weak enforcement allows counterfeiters to operate with impunity.

Counterfeit medicines create extremely unfair competition for all legitimate businesses in the African market – big and small. Due to a patchwork of regulatory capabilities, they have been largely neglected with sporadic countermeasures that do little to deter counterfeit businesses. Counterfeiters have benefited from the World Health Organization decision that it is no longer in the interest of public health to call counterfeited medicines “counterfeits.” Instead, they are now called substandard falsified medicines which gives counterfeits a big break by allowing them to be considered less damaging than they are. A counterfeit is something that is deliberately and fraudulently mis-labelled with respect to identity, composition or source with intent to deceive. They are inherently unsafe for patients.

Lumping counterfeit medicines with substandard medicines enabled them to become entrenched in the African market compelling legitimate pharmaceutical manufacturing businesses both local and multinational to compete with these illicit zero cost producers. Globally, the counterfeited substandard medicines industry has reached US$200 billion and in the African market US$10 billion by some estimates. Whilst big pharma can chose to exit the African market, domestic companies however do not have this luxury. They have no choice but to operate in a market in which the odds of winning are not in their favour, unless strong action is taken to minimise the impact counterfeit in this market.

The African market is losing multinational corporations that have always managed to win in the African markets in spite of challenges. ?Understanding the reasons why boards of major corporations are sacrificing a market projected to reach 2 billion people by 2050 is critical to mitigating attrition. We can begin by trying to understand what the big pharma exit trend is telling us about the market conditions in which medicines manufacturing companies must do business in Africa.

Counterfeit medicines create extremely unfair competition for all legitimate businesses in the African market – big and small. Dr Lenias Hwenda, CEO medicines for africa (mfa)

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