Can Uganda break Africa’s dependence on imported medicines?

Families grappling with sickle cell disease often face a stark reality: the necessary medication may exist, but it remains out of reach where it is needed most.

Nearly 80 per cent of the global burden of sickle-cell disease falls on sub-Saharan Africa. The World Health Organization estimates that about 240,000 children are born with the condition in Africa each year, and in some settings as many as eight in every 10 affected children may die before their fifth birthday where diagnosis and appropriate care are unavailable.

Yet WHO Africa has previously reported hydroxyurea availability in only 11 countries in the region. The same gap between medical knowledge and access is visible in maternal health.

In 2023, about 260,000 women worldwide died from pregnancy and childbirth-related causes. Sub-Saharan Africa accounted for roughly 182,000 deaths, about 70 per cent of the global total.

Obstetric haemorrhage remains a major contributor. Behind those figures lies a larger question now confronting Uganda and the continent: can Africa manufacture more of the medicines and health technologies its people need, and can governments create markets large enough to sustain those manufacturers?

That question has gained new relevance after Uganda’s Dei BioPharma Ltd was formally onboarded as a registered supplier under the African Pooled Procurement Mechanism, or APPM, coordinated by the Africa Centres for Disease Control and Prevention.

In an August 28 notification, APPM Director Dr Mariatou Tala Jallow indicated that the company had met the technical requirements to participate as a supplier under the pooled procurement arrangement.

The significance for Uganda lies less in the fortunes of one company than in the market APPM is trying to create. African countries have traditionally bought medicines largely through separate national procurement systems.

For manufacturers, that fragmentation can mean smaller orders and uncertain demand, making it harder to justify expensive investment in factories, regulatory approvals, skilled staff and product development.

APPM attempts to change that equation by combining demand from participating countries. In its first tender for essential reproductive, maternal and newborn health medicines, Africa CDC reported prices between 30 and 90 per cent below participating member states’ benchmarks, while establishing framework arrangements intended to improve supply security.

The eventual test is whether such purchasing power translates into medicines that are consistently available and affordable for patients. The African Union has set a target for at least 60 per cent of Africa’s health product needs to be met through African manufacturing by 2040.

But factories alone will not achieve that. Manufacturers also need viable products, reliable regulation, quality systems, financing, skilled workers and customers able to buy what they produce.

Dei BioPharma’s entry into APPM comes as its own regulatory portfolio expands. The company has submitted 65 product applications to Uganda’s National Drug Authority. Forty have been approved for manufacture and 14 for sale.

Those figures show progress through the regulatory process, although APPM registration does not guarantee that every product will be purchased through the continental mechanism. Individual products must still satisfy applicable regulatory, technical, quality and procurement requirements.

Among the company’s products are HYXUREA, a hydroxyurea 500 mg tablet used to treat sickle-cell disease, and TRENMIC, a tranexamic acid 500 mg tablet used in the broader management of serious bleeding.

Their relevance lies in the health problems they address, not simply the number of medicines a factory can produce. Established in 2014, the company operates a pharmaceutical and biotechnology manufacturing complex in Matugga, Wakiso District.

Its ambitions extend beyond conventional medicines to injectables, oncology products, biological products, biosimilars, diagnostics and vaccines.

“Our ambition is global and deliberately long-term: to develop and make biological drugs available to more than 90% of the populations of the world which currently cannot access them,” founder Dr Matthias Magoola has said.

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