African leaders and global partners have unveiled a bold 10-year regional vision to transform how essential health products are financed, produced, and delivered, aiming to ensure that everyone in the African Region can access affordable, quality-assured medicines and health technologies.
The vision emerged from the Blue-Sky Visioning and Think Tank Workshop held in Johannesburg from 25 to 27 November 2025, where policy-makers, technical experts, and development partners collaborated to lay the groundwork for a Regional Strategy on Market Shaping and Supply Chain for Essential Health Products (2025–2035). The strategy establishes 14 strategic pillars designed to modernize Africa’s fragmented health systems and build resilient, efficient supply chains capable of withstanding global shocks.
This initiative marks a paradigm shift from the region’s current donor-dependent and fragmented health product landscape toward a coordinated, self-reliant system. Currently, only 35 percent of essential medicines are consistently available in public health facilities, and out-of-pocket spending can represent up to 90 percent of total health costs in some countries, exposing millions to catastrophic financial risk. In nations like Malawi, where external aid accounts for up to 65 percent of health spending, sudden funding shocks leave systems highly vulnerable. Donor support remains heavily skewed toward vertical programs, with one-third of aid allocated to HIV/STI control and 14 percent to malaria, while less than one percent addresses noncommunicable diseases. A recent WHO assessment revealed that 56 percent of African countries are already facing shortages of essential health products, from vaccines and tuberculosis medicines to treatments for neglected tropical diseases and NCDs, with some facilities temporarily closing due to stock-outs.
The new strategy seeks to revamp production and access through local manufacturing, pooled procurement, and coordinated, shock-resistant supply chains. By prioritizing regional procurement platforms and strategic warehousing, it aims to reduce dependence on emergency imports, which proved inadequate during the COVID-19 pandemic when 38 African countries urgently requested medical supplies. The strategy is aligned with the African Medicines Agency (AMA) mandate and leverages the African Continental Free Trade Area (AfCFTA) to cut or remove tariffs on locally manufactured health products. It also promotes domestic resource mobilization and innovative financing tools, including debt-for-health swaps and health impact investment platforms, moving Africa toward sustainable, homegrown solutions rather than donor-driven models.
“This meeting is about reimagining what is possible when African countries take the lead in designing resilient and self-reliant systems to deliver essential health products. We are building a future where no community is left behind due to stock-outs, inefficiencies, or unaffordable prices,” said Dr. Adelheid Werimo Onyango, Director for Health Systems and Services at the WHO Regional Office for Africa.
Participants at the workshop applied a “blue-sky thinking” approach to tackle long-standing bottlenecks, exploring innovative ways to strengthen governance, improve financing, accelerate digital transformation, promote local production, modernize waste management, and enhance emergency preparedness. These discussions laid the foundation for a future-proof supply chain ecosystem that can withstand emerging challenges.
The initiative aligns with major regional and global frameworks, including the African Union’s Pharmaceutical Manufacturing Plan, the AMA mandate, the WHO Access to Medicines Roadmap, and Sustainable Development Goal 3.8 on universal access to essential medicines and vaccines. Bianca Baluta, Health Policy Expert at the European Union, emphasized the significance of international support: “The European Union is committed to advancing equitable access to essential health products across Africa. By supporting this regional strategy, we are investing in resilient health systems, stronger supply chains, and sustainable solutions that safeguard health for all.”
Once finalized, the strategy will serve as a unified blueprint to strengthen market systems, expand access to affordable, high-quality health products, and reinforce Africa’s health security over the next decade.
