Online Reporter
THE sharp decline in foreign health aid for Zimbabwe and the need to ensure that adequate supplies of all essential medicines are available at public hospitals and clinics has been concentrating minds and accelerating the building of the local pharmaceutical industry.
This building up of the local supply chain was already a policy of the Second Republic, as can be seen by the more than doubling of the locally-made percentage of essential medicines from 15 percent to 36 percent over the past five years.
At the same time, the number of companies involved had risen from nine to 14, but even with the extra manufacturing, capacity utilisation had risen from 12 percent in 2020 to 51 percent last year.
So there was steady and significant progress. But with the changes we have been seeing this year that could place a strain on our supply chains, we clearly need to redouble the efforts.
The Government has made it clear that it will ensure medical supplies are procured and that health systems will continue to improve.
It has also been doing some emergency budgeting to make sure this happens. But it will make it simpler and easier and help reduce costs if more can be made in Zimbabwe.
Despite the upgrade in the local manufacturing since 2020, we are still importing US$220 million of medicines each year. While there will always be an imported component in a small country because of the rarer treatments and medicines where it will never be viable to manufacture the drugs locally, the vast majority of medicines required are for common illnesses and chronic conditions.
The essential drugs list gives an indication of just how few drugs are needed for much standard medical care, less than 100.
There are many more needed once you have treated say 80 percent of ailments, but getting those 80 percent of individual complaints treated from local production would be an excellent target.
Of course, locally manufactured medicines must meet the highest standards consistently.
Having “Zimbabwean-made” printed on the packet or box must be a guarantee of quality. That is certainly required for the local patients, and any growth in exports would only be possible if there was that guarantee.
This requires not just proper standards to be set, which the Medicines Control Authority of Zimbabwe already does, licensing every medicine sold on a pharmacy shelf, but also more testing facilities to guarantee that the extra local production of medicines always meets global standards.
Imported medicines from approved suppliers have already been tested by someone reputable and that same care is needed for local manufacture.
This policy to almost double the size of the local pharmaceutical industry will require investment and access to loan finance, and most of that will need to be raised locally. There is little external investment in this industry internationally, and advances in most countries have to be made with mobilising local resources, although licensing of medicines and manufacture is far more common.
As part of efforts to speed up local investment, the Government is setting up a revolving fund partly funded through the sugar tax, now bringing in more than US$30 million a year.
Cheap finance will not just make it easier to expand production, but also mean that the prices of the final products can be kept within affordable limits.
The Second Republic has already found in other areas that it is often a lot cheaper to help producers produce than find the cash for essentials otherwise. We have seen this with the Pfumvudza/Intwasa programme, where giving small-scale farmers inputs to grow their own food slashed the budget required for food aid, as well as improving rural development. The village borehole scheme is another similar programme.
Since we have to spend a lot of money on medicines and for that matter many medical consumables.
It makes a lot of sense to be adding as much value as possible locally to keep the import bill and the final costs under control. Local production will ensure availability should any global shortages suddenly appear.
Having Government involvement as a funder of investment, as well as easily the largest single customer through NatPharm, could help to moderate prices by ensuring competition as well as helping to moderate costs.
Other countries have used their national health service to put out tenders for the national supply of a particular drug at a stated quality.
Some people might query a move from using the sugar tax for cancer machines to using it more for accelerating local production of medicines.
The suddenness of some of the holes that are likely to appear in some supply chains after aid cuts has meant some manoeuvring and reassignment of Government finances, to ensure essential gaps do not appear.
We have done this before, for example when we were coping with Covid-19 and then last year when we had to cope with a severe drought and the need to support millions of vulnerable people with essential food.
We expect Government competence when these changes are needed, and some of what has now been approved is a sign that the medical experts and those looking after the national finances have found solutions to stated needs so that we do not have to worry.
The main point of the latest Government policy is that not only will we cope, since that had already been promised, but that solutions are being found that build up our capacity to cope, by upgrading local industry.
