As Africa’s health sector faces challenges including high costs and limited access to essential medical supplies, experts say that a solution lies in pooling resources across the continent to collectively procure medicines and other health products including vaccines. They made the observation on Wednesday, March 26, in Kigali, during a consultative workshop to strengthen coordination between regional pooled procurement mechanism (PPMs) and the African Pooled Procurement Mechanism (APPM). They as well as discussed the modalities for establishment of a joint information sharing platform. The workshop was organised by the Africa Centres for Disease Control and Prevention (Africa CDC) and co-hosted by the East African Community (EAC) and the University of Rwanda/EAC Regional Centre of Excellence for Vaccines, Immunization and Health Supply Chain Management. ALSO READ: EAC to cut medical product costs through pooled procurement model Dr. Loko Abraham, the Chief Executive Officer of Rwanda Medical Supply, said that to truly ensure Africa's health security, the continent must build its own capacity to produce medical products and technologies, pointing out that pooled procurement is a key part to this agenda. Pooled procurement, he said, not only reduces costs but also ensures market stability by creating predictable demand for manufacturers. To illustrate the impact of such a mechanism, he provided a stark comparison. “In Gavi-supporting countries, the full immunization of a child with 11 antigens costs $24. In the United States, the same vaccines cost $1,300,” he said. Gavi, the Vaccine Alliance, is a public-private partnership that helps vaccinate half the world's children against some of the world's deadliest diseases, according to the World Health Organization (WHO). Abraham indicated that the Small Island Developing States’ (SIDS) pooled procurement mechanism has achieved significant economic savings for its member states, pointing out “in the first pooled procurement conducted in 2022, the initiative realised an average cost reduction of 56 per cent on factory prices across 47 pharmaceutical formulations.” “Beyond cost savings, pooled procurement mechanisms also contribute to resilient and secure supply chains, a key defense against the growing threat of antimicrobial resistance and the circulation of substandard and falsified medicines,” he said. “Economically, it fosters resource utilisation and economies of scale, leading to stronger negotiating power and competitive pricing. Patients will experience reduced out-of-pocket costs while demand consultation is expected to stimulate local manufacturing,” he observed. ALSO READ: Kagame: Africa should aim for new vaccines, therapeutics The power of joining efforts Dr. Stephen Karengera, the Director of the country office of the East African Community (EAC) Regional Centre of Excellence for Vaccines, Immunization, and Health Supply Chain Management, said that the continent should leverage its combined population to have a greater bargaining and purchasing power, highlighting the importance of aggregating demand for health products. He pointed out that demand aggregation can drive down costs and support local industries. “If you combine Rwanda and all of these other countries, in Africa we have 1.3 billion people; [as such] we will be able to manufacture all medicines like India and China. We will be able to make sure the industry is healthy because we aggregate demand,” he stated. Dr. Julius Otim, the Senior Health Officer at EAC, explained that pooled procurement allows countries to combine their resources and negotiate better deals for medicines, leading to lower prices and improved access. He pointed out that the pooled procurement mechanism for the East African Community has now established an [online] platform for information sharing. “That platform is going to provide all the people who procure public medicines with a place where they can get information in terms of quality medicines, suppliers, and medicines which could be substandard in one platform,” he said. “So, our expectation is that we shall reach a point where all the procurement agencies for public medicines in East Africa can put money in one basket and then they buy medicines together,” he stated. With such an initiative, he said that African countries should also prioritise purchasing medical products made domestically, and source them abroad when there are genuine reasons such as falling short of standards. “For example, if we have a manufacturing facility for vaccines in Rwanda, it would be good for the continent to pool resources and buy from Rwanda, meaning that the factory which is making vaccines in Rwanda is supplying all of Africa through pooled procurement. So, that's the framework,” he said. Ody Akhanoba, Director of SME Development at Afreximbank, confirmed that the bank, in June 2024, allocated $2 billion to help kick-start the African Pooled Procurement Mechanism (APPM). Such funding, he said, was in line with seeing how, in partnership with Africa CDC, “we can build out Africa's pharmaceutical value chain such that the continent becomes self-sufficient as far as manufacturing the medical supplies that it needs is concerned.” Eugenia Ingabire, the Trade Policy Officer at the African Continental Free Trade Area (AfCFTA) Secretariat, said that they were committed to contribute to the implementation of the initiative through enabling a single market for health products. “Working together, pooling our resources can help us buy medicines at lower costs,” she said, adding “we should put efforts in making our products instead of relying on imports, Ingabire said.
