India's pharmaceuticals, local production and public health security in sub-Saharan Africa: a comparative study

Indian pharmaceutical firms are increasingly targeting sub-Saharan Africa and influencing prospects there for local production. Policymakers in international organisations (e.g. UNIDO, GIZ) and in sub-Saharan Africa recognise a high disease burden and a reliance on imported medicines. They are keen to develop local pharmaceutical production on the continent. However, these initiatives face a competitive challenge from Indian imports. India is known by groups such as Médicines Sans Frontières as the "pharmacy of the developing world" for its relatively low-cost supply of medicines across the global South. At the same time, doubts have been expressed about the quality and future supply of Indian pharmaceuticals. This proposed research will explore the role of India's pharmaceutical industry in sub-Saharan Africa. It asks: How does India's trade in generic pharmaceuticals impact on local production and public health security within sub-Saharan Africa?

The research will identify the extent of Indian pharmaceuticals' presence within sub-Saharan Africa's South-South trade, focusing on three main regions - East, West and Southern Africa (comparing selected smaller and larger countries within each). The project will adopt a global value chain (GVC) and global production network (GPN) analytical framework to map the relationship between different actors involved in this South-South trade. Empirical research involves collection and analysis of secondary trade data and primary interviews with key stakeholders (policymakers, firms, and NGOs). It will examine the role of various actors (e.g. firms, industry associations, states, international organisations) in South-South trade. The relationships between these stakeholders involved in the supply of pharmaceuticals for sub-Saharan Africa will also be explored. This will facilitate explanation of:
1) The role of Indian firms in governing South-South value chains, i.e. influencing rules, standards and expectations for participation, and thus shaping development outcomes in pharmaceuticals;
2) Upgrading possibilities for African firms from participating in these South-South value chains, including expanding local manufacturing;
3) State policies (e.g. industrial policies, public procurement) shaping the dynamics of Indian imports and local production.
Comparative lessons will be drawn, both between African countries/regions and from India for Africa, through a focus on the different types of policies employed at a national and regional level within Africa and India, and their relative degrees of success.

This project will provide the first cross-regional study within Africa of the Indian pharmaceutical industry and its implications for local production. The project will be of particular relevance for national, regional and international policymakers keen to address the significant industrial and health challenge of an improved supply of pharmaceuticals. It is also of relevance to those policymakers increasingly recognising global value chains and production networks as key components of global trade.

Academic outputs will include academic journal articles and a book. The project will have a strong knowledge exchange component, guided by a stakeholder advisory group throughout the research, and involving policy workshops, blogs, and briefing notes to enhance research impact.

This research will build impact through ongoing and direct engagement with the principle beneficiaries, namely policymakers for sub-Saharan Africa pharmaceuticals and South-South trade/global value chains. The aim is to influence stakeholders' strategies to improve health security in sub-Saharan Africa and to promote better development outcomes from South-South trade.

The key primary beneficiaries will be policymakers concerned with the sourcing of generic pharmaceuticals for sub-Saharan Africa. National governments, regional blocks (e.g. SADC, EAC, ECOWAS), the African Union Commission, and international organisations (e.g. WHO, Global Fund) with both health and industrial interests could benefit from the findings. In the first 15 months, key African pharmaceutical policymakers will be met in person, at industry exhibitions and the African Pharmaceutical Summit, to introduce the project and identify these user's information needs. Following ongoing dialogue with these actors, a series of regional knowledge exchange workshops (in East, West and Southern Africa) with key African policymakers and in-person meetings with representatives of relevant international organisations will be conducted in year 3. A research brief will be created specifically for African policymakers providing cross-regional perspectives on the challenges, from both a health and industrial aspect, of pharmaceuticals supply. Tailored research briefings will also be created for African firms, on upgrading strategies, and for Indian firms, on forms and challenges of market access. Arising out of the value chain approach adopted, a briefing note will be created on "Value chain analysis and South-South pharmaceuticals trade". Short commentaries will also be submitted to policy-oriented publications in sub-Saharan Africa and India.

A second key focus is the global value chain policy audience. International organisations are increasingly interested in global value chains, as reflected in recent, major reports (e.g. by African Development Bank, UNCTAD, WTO and World Bank). These policymakers will also be engaged early in the design phase to gauge information needs. Representatives of these international organisations will be invited to participate in a policy-oriented "South-South value chains and production networks" workshop in year 3. This event will facilitate knowledge exchange in a cross-sectoral manner in order to influence better practice regarding South-South industrial and trade strategies which could leverage greater benefits for developing countries.

The project also has a range of wider beneficiaries beyond the countries and regions in question. Pharmaceuticals policymakers, NGOs and companies with interests in health and industrial development issues, as well as those focused on South-South trade and development, could also benefit. To engage with this wider audience, I will provide short research-informed postings to a dedicated project blog and website, the development@manchester blog and to the Guardian Global Development website. These efforts will seek to promote wider awareness of issues around pharmaceutical supply and health insecurity in sub-Saharan Africa.

The engagement with pharmaceutical policymakers, as well as firms, will ultimately promote learning about different national and regional experiences of imported (mostly Indian) and locally produced medicines within sub-Saharan Africa. This knowledge exchange, along with outputs produced, will aim to create a better understanding of, and to influence key stakeholders to introduce, industrial and trade policies that will serve the health interests of sub-Saharan Africa.