LOCAL drug manufacturers are grappling with acute funding challenges which have triggered a failure to expand the medicines basket which now poses a serious threat to the country’s public health system.
Drugs being produced in the country fall short of the 438 medicines listed on Zimbabwe’s Essential Medicines List (EML).
Essential medicines are defined by the World Health Organisation (WHO) as: “Medicines that satisfy the priority healthcare needs of the population.”
These medicines must be accessible to the public at all times, in sufficient amounts, and at affordable levels.
According to the Zimbabwe Pharmaceutical Country Profile, domestic manufacturers are capable of manufacturing 46,9% of essential medicines that are on the current guidelines, if capacity utilisation and support from government is improved.
Experts say the local pharmaceutical manufacturing industry is struggling to expand the therapeutic basket of medicines and equipment required in a fully-functional public health system.
“The current basket of medicinal products manufactured in the country is restricted to tablets, capsules, liquids, creams and ointments.
It is devoid of a wide array of other vital medicines and equipment like small and large injectables, vials, large volume parenteral, and inhalers among others,” said a Ministry of Health and Child Care official who spoke on condition of anonymity.
The source added that the pharmaceutical sector needs central government and stakeholder support to improve medicines production so as to avoid being exposed in times of public health emergencies.
“Reliance on imports is very dangerous. During the peak Covid-19 period, India, the biggest producer, and exporter of paracetamol employed protectionist policies wherein they stopped exporting the drug which was believed to be essential in containing Covid-19.
“When you are dependent on them as a nation, you are easily exposed and resultantly put public health in jeopardy,” said the source.
Research has shown that local pharmaceutical manufacturers are failing to meet demand due to failure to adequately invest in Research and Development (R&D).
Countries like the United States invest heavily in research. In 2019, the US pharmaceutical industry spent US$83 billion dollars on research and development.
Between 2010 and 2019, the number of new drugs approved for sale in the US increased 60% compared with the previous decade, with a peak of 59 new drugs approved in 2018.
Community Pharmacists Association of Zimbabwe secretary Luckmore Bhunu noted that treatment and management patterns are changing with the need for new molecules to be used.
“Resultantly, retailers and wholesalers have no option but to import the newer molecules resulting in diminished business for local producers.
Locally produced medicines have high production costs resulting in high prices as compared to imports
“Government should introduce subsidies in utilities and taxes such that local products become competitive as the cost of production becomes reduced,” Bhunu said.
Besides R&D constraints, it has also been noted that the country’s drug manufacturers are lagging behind in embracing pharmaceutical manufacturing technologies essential in drug production.
Academic Sarah Arden in her research titled Industry 4.0 for pharmaceutical manufacturing: Preparing for the smart factories of the future argues that pharmaceutical manufacturing technologies continue to evolve as the internet of things.
She added that artificial intelligence, robotics and advanced computing begin to challenge the traditional approaches, practices and business models for the manufacture of pharmaceuticals.
“The application of these technologies has the potential to dramatically increase the agility, efficiency, flexibility and quality of the industrial production of medicines.
How these technologies are deployed on the journey from data collection to the hallmark digital maturity of Industry 4.0 will define the next generation of pharmaceutical manufacturing,” Arden said.
According to the National Development Strategy (NDS1), the government seeks to deal with challenges affecting the expansion of the drug manufacturing sector through strengthening procurement and regulation of medicines and commodities, capacitating Natpharm, reviewing policies that improve drug availability and adoption of innovative medicines stock control measures.
Pharmaceutical Manufacturers Association of Zimbabwe chairperson Emmanuel Mujuru was not picking calls when this publication tried to reach him for a comment.
However a well-placed source in the association said the government needs to adopt policies that support new entrants into the sector.
“Setting up a drug manufacturing plant is capital intensive and access to credit locally is limited. There is a need for the government to adopt incentives being offered by other countries to support local and international investors, for instance offering free land, tax free periods and infant protection policies,” the source said.
The source added that these initiatives need to be implemented for the country to have more manufacturing players to meet public demand.
Several retail and wholesale pharmaceutical companies have mushroomed throughout the country yet there are only about 15 licensed drug manufacturing organisations.
In June 2021, the Zimbabwean government launched the 2021-2025 Pharmaceutical Manufacturing Strategy, with the aim to improve the local production of drugs, thereby increasing the availability of the country’s essential medicines and exporting excess drugs.
During the same year, Zimbabwe became the 19th African Union (AU) member state to sign the treaty for the establishment of the African Medicines Agency (AMA).
This enables a favourable regulatory environment for pharmaceutical research and development, local production and trade across countries on the African continent.