A treatment crisis persists despite gains in selected countries such as Botswana, Kenya, Uganda and South Africa. Sustainability of pharmaceutical supply remains highly contingent on foreign funding and manufacturing. Africa will remain dependent on imports for at least the medium-term. Ensuring access for a large and predominantly poor patient population is the priority. Local production may be inefficient from cost standpoint, but has two supporting justifications: (a) increases government interest in purchasing and participation, and (b) reduces threat of long-term dependence on foreign contribution, which is subject to political manipulation.
- What regulatory improvement is needed to accelerate registration and enhancing supply chain monitoring?
- What priority should be given to increasing local manufacturing capacity? What types of improvement to the local regulatory structure, including evaluation of safety and efficacy, is needed?
- Technology transfer is essential, whether by voluntary or compulsory licensing. Production-related technical expertise is also required. What policies or incentives are needed to encourage technology transfer?
- The problem of low worldwide R & D commitment for neglected diseases most acutely affects Africa. What policies are needed to encourage research on neglected diseases?