“I call for a leadership under the responsibility of public operators, in cooperation with private operators”
What are the barriers to access to medicines in African countries?
There are many barriers. What first comes to everyone’s minds is the price of medicines. African countries are all low or middle-income countries. Yet the price of medicines and especially of “innovative” medicines, meaning they don’t have a generic price yet, is more than the countries can afford to pay.
There are other barriers, such as systemic barriers: to be able to use medicines, you need competent health systems. So, there’s often a problem of accessing and using diagnoses to set up “test/treat” approaches like other countries. We also have problems of access to qualified staff, supply chain problems. These are all barriers to access to medicines in African countries.
Contrary to what one might think, certain medicines are more expensive for African countries than for European countries. Indeed, and although there’s a real need, demand is low due to systemic problems. So, there’s no volume effect in the negotiations with the pharmaceutical industry which would make it possible to lower the prices of these medicines.How can public and private operators work better together to meet this need?
There needs to be a complementarity between public and private operators, bearing in mind that the two sectors and types of operator don’t have exactly the same interests. For some private operators, maximising profits is the top priority, which is obviously not the case for public operators and certain private operators working in the field of philanthropy or civil society.
It’s essential to fully understand and align the fields in which these operators have the same interests and work together as much as possible in fields where there’s a coalescence of interests, while being aware that it’s not the case for all the sectors of interest of these various operators.
I’ve personally always advocated for a recognition of the leadership of governments. They are responsible for regulating the activity of both public and private operators. It’s up to governments to raise taxes to pay for investments in health. Cooperation with private operators must be part of a framework set up by governments, in consultation with public operators.
Governments are also responsible for regulating all the standards to ensure the security and efficacity of operations in the field of health, for both healthcare and health products. I would particularly like to emphasise the critical role that governments must play in the regulation of training for health professionals. Far greater numbers of them need to be trained. It’s a need in African countries, but also in France and in rich countries.
What can be done to strengthen the production and distribution chains in Africa? How to make the prices affordable?
It’s important to support the initiatives increasingly emerging in Africa which involve strengthening a continental approach, for example, for regulating medicines with the drugs agency which will soon be set up.
Between 2021 and 2022, we saw the extent to which the fact that there’s no pharmaceutical production in Africa has been an unacceptable barrier to equitable access for the population to vaccines against Covid-19. This fact has raised awareness of the importance of a local production in Africa, which should make the products more accessible and sometimes more suited to African populations. This requires supporting regional approaches. Indeed, we see that each country cannot start producing all the essential medicines or vaccines, but a partnership between groups of countries could lead to the creation of a viable market for local production.
What are the areas of cooperation between the MPP and AFD Group?
For the moment, the MPP is mainly working with AFD on the major project coordinated jointly by the MPP and WHO. It involves setting up a development and technology transfer platform in South Africa for messenger RNA vaccines. France is one of the main funders and one of the first governments to declare its support for this project of which AFD is a partner.
AFD is in discussion with a number of countries taking part in this project and France’s support could help the countries that will benefit from this technology set up this new vaccine production process.
At the MPP, along with myself as Chair of the Board of Directors, we very much appreciate AFD Group’s approach to support countries on a systemic basis and strengthen their institutions.
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(Re)watch the high-level panel Partnering for African Sovereignty on Medical Products Access
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