• Edited by Maureen Mackintosh, Geoffrey Banda, Paula Tibandebage and Watu Wamae
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  • This project studies the supply chains of essential medicines and medical equipment and supplies from local industries and imports into the health systems in Tanzania and Kenya. Shortages and unaffordability of essential commodities are known to be persistent causes of poor quality health care and exclusion from care in low-income African countries. Yet too often, policies for health care and policies for industrialisation are made without reference to each other. The central objective of this study, begun in 2012, is to bring industrial and health policies closer together. We aim to identify opportunities for improved local industrial supply of health-related commodities to strengthen Kenyan and Tanzanian health system performance. Kenya is largest industrial producer within East Africa, and a source of supply of industrial commodities for the health systems of the region. Tanzania also has an industry supplying pharmaceuticals and some other essential items. The comparative study in the two countries aims to share experiences and cross-country learning, while bringing health and industrial policy makers together in each country.
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  • This policy-focused project uniquely combines analysis of low-income country health care systems with a corresponding investigation into local manufacturing capacity. There are huge unmet needs for essential medicines and supplies in Tanzania and Kenya, as in many African countries, and domestic health markets offer large unexploited opportunities for locally based manufacturers.A conceptual framework of industrial and institutional capabilities is used to show how industrial suppliers of essential medicines and medical supplies in both countries face sharply rising international competitive pressures. These result from: broader trade liberalisation and specific policies encouraged by donors to remove tariffs and taxes from imported health sector supplies; externally focused international procurement; competitive and regulatory pressures for higher quality standards; and changes in first line treatments for major illnesses requiring investment in technological upgrading.All domestic manufacturers interviewed engaged in continuous upgrading: hugely challenging in their context of poor infrastructure, expensive and limited industrial finance
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  • Prospects for African development in the coming decades will certainly require an expanded and diverse industrial base. Local pharmaceutical industry has great scope for improving health sector performance. However, this is yet to be achieved in most African countries that currently have fledgling pharmaceutical production. Strengthening policy synergies between the health sector and the pharmaceutical industry is an important way of contributing to achieving better health but this will require specific and targeted public policy support.

  • An important issue in drug supply in all countries concerns how to ensure access to essential medicines on the part of low-income consumers. In many African countries, a large proportion of total pharmaceuticals expenditure is funded privately, with “out of pocket” payments at the point of service being predominant. For a variety of reasons essential medicines are not on the whole available at affordable prices: low-income earners, who are the vast majority of the population in Africa are highly dependent on the private health sector for essential medicines.

  • A key issue for many countries is how to develop effective disease forecasting mechanisms to manage disease burdens. Changing regional climate and demographics are occasioning changes in disease and health patterns. Most African countries face numerous challenges in providing essential drugs and other health care products. The challenges in these countries ought to be viewed in the broader sense of the inadequacy of health systems. Information surveillance and research, an important indicator of a good and functional health care system is weak in many African countries. Good information surveillance coupled with proper diagnosis allows for early detection and prevention of disease epidemics such as Ebola. Fundamental research in the drug industry is crucial and is an integral part of a good health care system. Research generates new understanding of diseases, improves techniques for diagnosis, prevention and treatment.

  • Strategic health security is a matter of paramount importance to all countries. It provides a compelling reason for developing a robust local pharmaceutical manufacturing industry.