Health-industry linkages for local health: reframing policies for African health system strengthening

Abstract

The benefits of local production of pharmaceuticals in Africa for local access to medicines and to effective treatment remain contested. There is scepticism among health systems experts internationally that production of pharmaceuticals in sub-Saharan Africa (SSA) can provide competitive prices, quality and reliability of supply. Meanwhile low-income African populations continue to suffer poor access to a broad range of medicines, despite major international funding efforts. A current wave of pharmaceutical industry investment in SSA is associated with active African government promotion of pharmaceuticals as a key sector in industrialization strategies. We present evidence from interviews in 2013–15 and 2017 in East Africa that health system actors perceive these investments in local production as an opportunity to improve access to medicines and supplies. We then identify key policies that can ensure that local health systems benefit from the investments. We argue for a ‘local health’ policy perspective, framed by concepts of proximity and positionality, which works with local priorities and distinct policy time scales and identifies scope for incentive alignment to generate mutually beneficial health–industry linkages and strengthening of both sectors. We argue that this local health perspective represents a distinctive shift in policy framing: it is not necessarily in conflict with ‘global health’ frameworks but poses a challenge to some of its underlying assumptions.

Institutional variety and the future of economics

“…Price regulations in the health industry for example can rapidly shape an industry's profile across treatment categories (Sahu 1998;Chaudhuri 2019), and while advancing the development argument for access and affordability, can still blunt the learning opportunities within products and across subsectors (Abrol 2004). Furthermore, within the industry, some nations such as Zimbabwe (Russo and Banda 2015) may use strategic procurement to develop local production responses to essential medicines such as morphine or antiretrovirals (see Mackintosh et al 2016). Such EPE-linked analyses, even when amenable to notions of learning and innovation, need to be compared to build more robust inferences and economic judgment.…”

The potential of digital health technologies in African context, Ethiopia

“…30,33 Africa has the greatest healthcare challenges in the world: life expectancy is 60 years, substantially lower than the global average of 72 years; maternal mortality ratio is 547 per 100,000, but 13 in high-income countries and 216 globally; under 5 mortality is 76 per 1,000, but 5 in high-income countries and 39 globally. 34,35 While there were 1,098 researchers per million inhabitants globally, the corresponding figure for Africa was 87.9 per 1 million. Africa lags in the capacities for health technology innovations, while it bears 23% of the global disease burden and 16% of the world population, with the continent expected to double its population by 2050, from 1 billion to nearly 2.4 billion.…”

The potential use of digital health technologies in the African context: a systematic review of evidence from Ethiopia

“…People living in low-income countries, such as many countries in Africa, are at high risk of many health conditions compared to those living in other regions, while having the most limited access to health innovations 30 , 33 . Africa has the greatest healthcare challenges in the world: life expectancy is 60 years, substantially lower than the global average of 72 years; maternal mortality ratio is 547 per 100,000, but 13 in high-income countries and 216 globally; under 5 mortality is 76 per 1000, but 5 in high-income countries and 39 globally 34 , 35 . While there were 1098 researchers per million inhabitants globally, the corresponding figure for Africa was 87.9 per million 35 .…”