Making Medicines in Africa: The Political Economy of Industrializing for Local Health

353 Pages·2016·1.508 MB·English

by  Maureen Mackintosh, Geoffrey Banda, Paula Tibandebage, Watu Wamae (eds.)

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Making Medicines in Africa
The Political Economy of Industrializing
for Local Health
Edited by
Maureen Mackintosh
Professor of Economics, The Open University, United Kingdom
Geoffrey Banda
Research Fellow in Regenerative Medicine, University of Edinburgh, United Kingdom
Paula Tibandebage
Senior Research Associate, REPOA, Tanzania
Watu Wamae
Visiting Research Fellow, The Open University, United Kingdom
Except where otherwise noted, this work is licensed under a
Creative Commons Attribution 4.0 Unported License. To view
a copy of this license, visit https://creativecommons.org/version4
Editorial matter, selection and introduction © Maureen Mackintosh,
Geoffrey Banda, Paula Tibandebage and Watu Wamae, 2016
Individual chapters © their respective authors, 2016
Softcover reprint of the hardcover 1st edition 2016 978-1-137-54646-3
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DOI: 10.1007/978-1-137-54647-0
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Library of Congress Cataloging-in-Publication Data
Making medicines in Africa: the political economy of industrializing for local
health / [edited by] Maureen Mackintosh, Geoffrey Banda, Paula Tibandebage,
Watu Wamae.
p. ; cm.—(International political economy series)
Includes bibliographical references.
ISBN 978–1–137–57133–5
I. Mackintosh, Maureen, editor. II. Banda, Geoffrey, 1969– , editor. III.
Tibandebage, Paula, editor. IV. Wamae, Watu, editor. V. Series: International
political economy series (Palgrave Macmillan (Firm))
[DNLM: 1. Technology, Pharmaceutical – economics – Africa. 2. Technology,
Pharmaceutical – methods – Africa. 3. Diffusion of Innovation – Africa. 4.
Drug Industry – standards – Africa. 5. Economic Development – Africa. 6.
Pharmaceutical Preparations – supply & distribution – Africa. QV 778]
RA401.A55
338.4976151096—dc23 2015025771
Contents
List of Figures v iii
List of Tables ix
Preface xi
Notes on Contributors xiii
Introduction: African Industrial Development, Values and
Health Care 1
Maureen Mackintosh, Geoffrey Banda, Paula Tibandebage and
Watu Wamae
Part I The Pharmaceutical Industry in Africa 5
1 Making Medicines in Africa: An Historical Political Economy
Overview 7
Geoffrey Banda, Samuel Wangwe and Maureen Mackintosh
2 Pharmaceuticals in Kenya: The Evolution of Technological
Capabilities 25
Roberto Simonetti, Norman Clark and Watu Wamae
3 Pharmaceutical Manufacturing Decline in Tanzania:
How Possible Is a Turnaround to Growth? 45
Paula Tibandebage, Samuel Wangwe, Maureen Mackintosh and
Phares G.M. Mujinja
4 Bringing Industrial and Health Policies Closer: Reviving
Pharmaceutical Production in Ethiopia 65
Tsige Gebre-Mariam, Kedir Tahir and Solomon Gebre-Amanuel
5 South-South Collaboration in Pharmaceuticals: Manufacturing
Anti-retroviral Medicines in Mozambique 85
Giuliano Russo and Lícia de Oliveira
6 Can Foreign Firms Promote Local Production of
Pharmaceuticals in Africa? 103
Sudip Chaudhuri
v
vi Contents
7 Raising the Technological Level: The Scope for API,
Excipients, and Biologicals Manufacture in Africa 122
Joseph Fortunak, Skhumbuzo Ngozwana, Tsige Gebre-Mariam,
Tiffany Ellison, Paul Watts, Martins Emeje and
Frederick E. Nytko III
Part II Industrialization for Health 145
8 Health Systems as Industrial Policy: Building Collaborative
Capabilities in the Tanzanian and Kenyan Health Sectors
and Their Local Suppliers 147
Maureen Mackintosh, Paula Tibandebage, Joan Kariuki Kungu,
Mercy Karimi Njeru and Caroline Israel
9 The Dissemination of Local Health Innovations: Political
Economy Issues in Brazil 166
Erika Aragão, Jane Mary Guimarães and Sebastião Loureiro
10 Healthy Industries and Unhealthy Populations: Lessons
from Indian Problem-Solving 183
Smita Srinivas
Part III Industrial Policies and Health Needs 201
11 Policies to Control Prices of Medicines: Does the South
African Experience Have Lessons for Other African
Countries? 203
Skhumbuzo Ngozwana
12 Pharmaceutical Standards in Africa: The Road to
Improvement and Their Role in Technological
Capability Upgrading 224
Geoffrey Banda, Julius Mugwagwa, Dinar Kale and
Margareth Ndomondo-Sigonda
13 Innovative Procurement for Health and Industrial
Development 243
Joanna Chataway, Geoffrey Banda, Gavin Cochrane and
Catriona Manville
14 Industry Associations and the Changing Politics of Making
Medicines in South Africa 261
Theo Papaioannou, Andrew Watkins, Julius Mugwagwa and
Dinar Kale
Contents vii
15 Finance and Incentives to Support the Development of
National Pharmaceutical Industries 278
Alastair West and Geoffrey Banda
Bibliography 298
Index 323
List of Figures
1.1 A timeline of selected pharmaceutical firm start-ups by
country, 1930–2013 9
2.1 Local production of non-parenteral medicines in Kenya
by type of product, 2007–13 30
3.1 The expanding local supply gap: total imports and
exports of medicines and blood products 48
5.1 Timelines for the implementation of the factory project 87
7.1 Chemical synthesis to produce the anti-malarial APIs
artemether and artesunate 126
7.2 Synthetic route for the manufacture of the API tenofovir
disoproxil fumarate 128
9.1 The Brazilian pharmaceutical market (unit sales),
1997–2013 173
9.2 Percentage of municipalities covered by the PFPB,
2006–15 176
9.3 Pharmaceutical products: Balance of trade, Brazilian
exports and imports 178
10.1 Institutional triad of health care 189
11.1 Medicine contribution to total private health care costs 218
viii
List of Tables
1.1 Pharmaceutical production and exports, Tanzania,
2004–05 23
3.1 Decline in domestic market share of medicines made in
Tanzania, 2006–12 49
3.2 Share of local manufactures among specified tracer
medicines available in sample outlets, 2006–12 49
5.1 Estimated cost of setting up the factory 91
5.2 Public sector drug import value, by source and type of
health programme 94
5.3 Unit price for selected SMM drugs 96
6.1 Anticipated trends in global pharmaceutical markets 107
6.2 Indian share of pharmaceutical formulations imports
into Africa, 2012 110
6.3 India’s pharmaceutical exports 112
6.4 Comparison of retail formulations prices in India
and Ghana 118
7.1 Common excipients used in solid oral dosage formulations,
their standard use and weight % content, and pricing on
a per-kilogram basis 125
7.2 Raw materials that contribute to the structure of the
API tenofovir disoproxil fumarate (TDF) and their
current commercial pricing 129
8.1 Country of origin of tracer essential medicines, by
procurement sector, Tanzania and Kenya, 2012–13 151
11.1 Pharmacy dispensing fee: fee in rands (R) plus permitted
mark-up (%), by band of SEP in rands (R) and date of
publication of schedule 215
11.2 SEP increases since the implementation of the SEP 216
1 2.1 Drug life cycle stages and regulatory requirements 226
13.1 D onor support of local industry through contracting
for local health supplies: Zimbabwe 252
15.1 Finance capabilities at the firm and financial
institution levels 288
ix