By Maureen Mackintosh, Geoffrey Banda, Cecilia Wanjala, Charlotte Cross
Amidst the Covid19 pandemic, the local manufacturing of essential health commodities such as diagnostics, medicines, devices, and basics has become a central concern of health policy. The supply of essential commodities including swabs and hand sanitiser has moved from a research question to a key policy matter across the world. Suddenly, 'supply chains' for health care are no longer just a technical matter of inputs to a health system; they are high politics, central matters of health security. The importance of local capabilities and proximity of manufacturers to the health system has crystallised in the moment of greatest need. And our ongoing ICCA research project has much to contribute.
The ICCA project was built on earlier collaborative Africa-India-UK research that demonstrated the scope for local manufacturing to strengthen local health. When we started working on local health-industrial links around ten years ago, the importance of local manufacturing was largely ignored or dismissed within “global health” policy circles, while at national level, industry and health policies were rarely considered together. A landmark book from that project, Making Medicines in Africa: The Political Economy of Industrializing for Local Health, made the first attempt to collate evidence and arguments for local manufacturing for health in Africa and other low and middle income countries. Yet the readership of that book marks a huge shift in global and local attention to these issues: at 69,000 downloads and counting it is one of its publisher’s top five open access books ever published.
The Making Medicines book’s editorship and authorship, over half from Africa, South Asia and Brazil, reflected the locally understood need for local manufacturing capabilities, among low and middle income countries’ professionals and researchers. Now that recognition is sharper, as high income countries use their financial muscle to compete for essential health medicines, protective equipment – and, in the future, vaccines. Across East Africa, local firms are repurposing to address pandemic requirements. A local recycling firm in Tanzania is making face shields from plastics, while in Kenya, many firms are retooling to supply Covid19 needs. In Kenya, members of the ICCA project from KEMRI are currently involved in ramping up local manufacturing of alcohol-based hand sanitizers and other decontaminants, viral transport media, and oral/nasopharyngeal swabs for use in COVID-19 response.
Promoting local manufacturing capability is not an “extra” in health policy, it is central to long term strengthening of health systems and to coping locally and sustainably with pandemics and epidemics. The ICCA project, by providing evidence to support policy on local production of commodities and services in East Africa in support of better cancer care, aims to contribute to this life-saving agenda.