Complex norm localization: from price competitiveness to local production in East African Community pharmaceutical policy

Abstract

This article offers a critical contribution to debates around access to medicines and the global politics of pharmaceutical production in Africa. Specifically, we seek to account for a normative shift within these debates whereby the promotion of local pharmaceutical production in Africa has once again come to be viewed as a central modality for achieving access to health across the continent. While the onset of this normative shift has been highlighted by the global Covid-19 pandemic, in this article we argue that its antecedents can be traced to a more incremental process of global and regional normative change that has been in motion since the late 1990s. To illustrate this, we narrow our empirical focus onto the East African Community (EAC) and the regional initiatives its members have pursued to promote local pharmaceutical production capacities since 2012. We draw and build upon the literature on norm localization to emphasize how the emergence and distinctiveness of this policy reflected the complex way in which policy actors within the EAC sought to localize and combine separate (and somewhat competing) changing global norms around access to health and industrial policy. The article also points to the tensions and unintended consequences which emerged from this complex process of norm localization and the challenges of implementing this strategy within the institutional landscape of the EAC.

African regionalism, economic nationalism and the contested politics of social purpose: the East African Community and the ‘new developmentalism’

“…Significantly, however, neither document clearly articulated a role for the EAC within this ‘new developmentalism’, beyond facilitating expanded regional markets for producers and industrial policy coordination between its members. Although attempts were made during the 2010s to construct bespoke regional strategies for promoting sectors such as textiles and clothing and pharmaceuticals (Murray-Evans & O'Reilly 2022; O'Reilly & Heron 2022), these ultimately fell short of expectations, due to policy coordination issues and unilateralism by EAC members. Instead, EAC members opted for more economically nationalist visions of development which, as outlined earlier in this paper, have increasingly come to conflict with the principles and practices of regional integration.…”

“…The EAC, therefore, lacked the institutional capacities and centralised authority necessary to coordinate a regional industrial strategy. This was particularly evident with the implementation of the EAC's regional pharmaceutical production strategy since 2012, with stakeholders remarking on the limited capacity of the EAC Secretariat and regional institutions to coordinate such an ambitious and complex agenda (Murray-Evans & O'Reilly 2022).…”

“…The consequence of this was that it opened discursive space for the articulation and practice of more developmentalist economic strategies within the region. Although some tentative attempts were made to coordinate such strategies at the regional level (Murray-Evans and O'Reilly 2022; O'Reilly & Heron 2022), it was within national policy spaces where they principally emerged. The reason for this I argue is twofold.…”