Reducing Import Dependency: Why Local Drug Production is Key to East Africa’s Health Future
The search for longevity has been universal throughout history. From China’s ‘elixirs of immortality’ in the 4th century BC to modern anti-ageing medicine, humanity’s wish to extend life is endless. Various studies evidence that pharmaceutical innovation and consumption have substantially contributed to increased lifespan, both in terms of mean age at death and reductions in premature mortality. While this is a global trend, the pharmaceutical sector in East Africa has followed its own path, influenced by indigenous practices, colonial legacies, and post-independence industrialisation.
Pharmaceuticals play a critical role in improving health outcomes worldwide, but East Africa remains heavily dependent on imports, which limits access to essential medicines and undermines health security. Despite efforts by the East African Community (EAC) to boost local production, systemic financial, regulatory, and infrastructural barriers have slowed progress. This article argues that reducing import dependency and strengthening local pharmaceutical manufacturing are essential for regional health resilience and economic growth.
Current Landscape & Local Manufacturing
EAC set targets to reduce imports from ~70% in 2017 to 65% by 2021, 60% by 2025, and 50% 2027. However, local pharmaceutical production remains far from sufficient across East African countries, underscoring the threat to health security and the urgency for investment in local manufacturing. Kenya, the regional leader in pharmaceutical manufacturing, accounts for roughly 30% of its domestic market, yet 70-80% of medicines consumed in the country were still imported in 2020. Similarly, other countries in the EAC have not made significant progress in achieving the goals, such as Rwanda, Uganda, and Tanzania which still import majority of their pharmaceuticals at 95%, 90% and ~69% respectively.
Moreover, an even smaller proportion of locally manufactured medicines qualify as Essential Medicines (EMs), which are critical for meeting the population’s basic healthcare needs. Each country maintains a National Essential Medicines List (NEML) to address prevalent infections and diseases such as malaria. However, local production remains low: Kenya manufactures just 21% of the medicines on its NEML, Uganda only 10% and Tanzania a mere 5% demonstrating a significant gap in local production capacity. This shortfall means the region relies heavily on imports to meet essential health requirements, leaving health systems vulnerable to supply disruptions and price volatility.
Local pharmaceutical manufacturing in the region has struggled to grow precisely because of these systemic constraints. High import costs, regulatory hurdles, negative perceptions of local medicines, and limited production capacity perpetuate a cycle of dependency, undermining the region’s ability to build self-sufficiency in essential medicine supply.
Pharmaceutical manufacturing, is typically divided into two stages: production of active pharmaceutical ingredients (APIs), and the conversion of APIs into complete dosage forms suitable for administration. In East African countries, local manufacturing has been limited to stage two with a heavy reliance on importing raw materials and equipment to substitute stage one. Consequently, acquiring raw materials raises production costs, impacting the affordability of locally made medicines, results in inconsistent product quality, and hinders competitiveness against imported finished drugs. Without greater local capacity across these stages, the region risks remaining locked in a cycle of import dependency, undermining efforts toward self-sufficiency.
API production has been a focal point in expanding local pharmaceutical manufacturing across the African continent. Egypt and South Africa are currently leading such efforts demonstrating the possibility for others to follow, as well as the challenges that would be common to other African nations. Challenges such as technology and infrastructure gaps, regulatory hurdles, fragmented market demand, limited economies of scale, and weak integration into global supply chains. At the core of each challenge are two overarching barriers that hinder the development of pharmaceutical manufacturing at every stage: insufficient capital investment and persistent regulatory constraints.
Figure 1: Pharmaceutical value chain in Africa. Source
Financial Barriers & Possible Solutions
Financing remains the biggest hurdle to building a resilient local pharmaceutical industry. Without adequate capital, East Africa cannot overcome import dependency or achieve health security. Although total health spending has risen in many countries, majority of the support has come from external aid, while domestic public spending effort has not kept pace. In East and Southern Africa, domestic general government health expenditure (GGHE-D) fell from ~2.6% to ~2.3% of GDP between 2000-2002 and 2013-2015, underscoring constrained fiscal space for health and dampening local market signals to investors.
Governments are central to financing local pharmaceutical production, but the high capital costs involved cannot be met by public funds alone. Therefore, strategies such as blended financing, where public or philanthropic funds are combined with private sector investment, may help alleviate cost burdens for the various stakeholders involved. Moreover, governments and development partners can attract private investment by creating a predictable market environment and signalling steady demand.
In the EAC, several countries have already taken practical steps to overcome financial barriers. Ethiopia’s Kilinto Pharmaceutical Industrial Park, developed with the support of the government and World Health Organisation (WHO), offers ready-made infrastructure that reduces upfront costs for incoming firms, making investment more feasible. In Uganda, targeted reductions in tariffs and fees for local producers have lowered production costs and evidently encouraged expansion, resulting in higher domestic drug output.
Regulatory Challenges & Harmonisation
Regulatory reform is as critical as capital for reducing import reliance. Without harmonised and efficient regulation, local manufacturers cannot compete, leaving East Africa locked in dependency. Kenya currently tops other EAC countries in investment attractiveness, having received over $750m in foreign direct investments (FDI). Yet the nation faces a counterfeit crisis with at least 17 % of its antibiotics and antimalarials found to be counterfeit or substandard. Counterfeits pose significant health risks such as drug resistance, treatment failures and possible organ damage seeing as some have been found to contain rat poison, mercury and cement. Moreover, Kenya’s Pharmacy and Poisons Board issued 32 drug recalls in 2024, up from 18 in 2023, pointing to persistent quality threats due to porous borders, illegal online sellers and repackaging schemes.
To combat regulatory challenges, the EAC established the East African Community-Medicines Regulation Harmonisation (EAC-MRH) which aims to synchronise registration, and regulation systems across partner states. Harmonisation could cut national assessment timelines from ~24 months to about 8-14 months. For example, instead of seeking separate approvals in multiple EAC countries, each with different requirements and timelines, manufacturers would only need to undergo a single review recognised across the region. This efficiency lowers regulatory costs, particularly for small and medium-sized local firms that operate on tight margins.
Figure 2: Regional preferential trade agreements where African countries participate. Source
Additionally, regional harmonisation strengthens oversight of cross-border trade, helping to curb the circulation of counterfeit and substandard medicines, which in turn would enhance public confidence in locally produced drugs, benefiting both consumers and manufacturers. For example, Operation African Star was a collaboration between Kenya, Uganda and the United States that successfully seized 115,000 illicit pharmaceutical units and bolstered cross-border policing. Furthermore, harmonisation opens up the possibility of greater economies of scale, making local production more competitive against imported pharmaceuticals and increasing the likelihood of attracting investors.
Innovative Digital & Enforcement Interventions
Consumer trust is essential for local manufacturing to displace imports. One of the solutions to strengthen trust has come through the innovative utilisation of digital tools. A notable example is mPedigree in Kenya, which allows consumers to check the authenticity of medicines instantly via SMS codes. This mobile-based system, an example of the benefits of leapfrogging, empowers patients, pharmacists, and health workers to avoid counterfeit drugs. As consumer confidence increases, local manufacturers can secure their market share.
Additionally, policy and enforcement innovations can further reinforce the credibility of East African pharmaceutical supply chains. In July 2025, Kenya’s Pharmacy and Poisons Board (PPB) CEO Fred Siyoi called for stronger regional cooperation to safeguard pharma trade, highlighting the country’s Pharmaceutical Authentication and Traceability Program (PATP). In pilot areas, PATP cut counterfeit circulation by as much as 15%, proving the value of combining technology with enforcement. For local manufacturers, this kind of regulatory support is essential in reducing unfair competition from counterfeiters, and it also enables supply chain monitoring as well as quality assurance.
Conclusion
East Africa’s pharmaceutical sector stands at a crossroads: remain import-dependent and vulnerable, or invest in local manufacturing for health security and economic resilience. The region faces persistent challenges such as high import reliance, limited local capacity, and financial and regulatory barriers. All of which constrain the region’s ability to meet domestic healthcare needs.
To build a more resilient and self-sufficient pharmaceutical sector, East Africa must deepen regional cooperation, scale proven policy innovations, and strategically invest in both infrastructure and technology transfer. Success stories from Ethiopia’s Kilinto Industrial Park, Uganda’s tariff reforms, and Kenya’s digital authentication programs reveal that progress is possible when governments, private investors, and international partners align efforts. If scaled across the EAC, such initiatives could reduce dependency on imports, enhance access to essential medicines, and position the region as a competitive hub for pharmaceutical manufacturing, ultimately safeguarding health security and advancing the universal pursuit of longer, healthier lives.
