Supply Chains in Africa: Toward Stronger Resilience and Pharmaceutical Sovereignty
By Annie RANDRIANTSALAMA
Strategic Monitoring Officer-Madagascar CCM
In the face of repeated health crises — COVID-19, Ebola, cholera — Africa has uncovered a major vulnerability: its health supply chains. Stock-outs, dependence on imports, fragmented markets, and limited logistics infrastructure have highlighted an undeniable truth: health security depends as much on strong clinical systems as on efficient, integrated, and sustainably financed supply chains.
In November 2025, the African Forum on Strengthening Health Supply Chains (FARCAPS) brought together public sector actors, regional organizations, and technical partners in Djibouti to take stock of progress and define priorities for the continent.
Pharmaceutical sovereignty: a strategic challenge
Dependence on imports remains high across these regions, exposing health systems to logistics cost fluctuations, disruptions in global trade, and prolonged procurement timelines. The forum underscored the urgent need to scale up local and regional production, establish coordinated industrial hubs, and harmonize regulations at the continental level.
Algeria’s experience inspired participants: supported by strong political commitment and a structured pharmaceutical industry, the country now meets 92% of its national needs. The lesson is clear — pharmaceutical sovereignty is achievable when built on strategic investment, effective regulation, and coordinated industrial planning. For ESA and WCA, the priority is to promote complementary regional specializations rather than duplicating costly efforts.
Central medical stores: at the heart of transformation
Central medical stores are the strategic link between financing, procurement, and real access to care. They help prevent stock-outs, ensure quality, regulate markets, and combat falsified medicines. However, they face persistent challenges: weak governance in some cases, aging infrastructure, limited financial capacity, and growing demand pressure.
The forum emphasized the importance of professionalizing these institutions, digitizing their information systems, and strengthening regional cooperation to secure access to essential health products.
Digitalization and innovation: tangible results
Several countries are already demonstrating the potential of digitalization. In Djibouti, the FLEX Supply/eLMIS system has reduced stock-outs, improved inventory accuracy, and expanded coverage of health facilities. These advances show that digital supply and inventory management can transform logistics performance, reduce waste, and improve access to care — even in challenging contexts.
The last mile: a persistent challenge
Despite progress, reaching the “last mile” remains the greatest challenge. In remote or border areas, high transport costs and infrequent deliveries slow access to medicines and health products. The forum encouraged the deployment of public–private hybrid models, the use of innovations such as drones, and the creation of decentralized regional warehouses to bring stocks closer to communities.
Falsified medicines and financing: two major challenges
Illicit markets remain a serious threat, undermining public trust and endangering millions of lives. The response requires stronger regulatory authorities, improved product traceability, and active engagement of civil society.
At the same time, the sustainability of supply chains depends on financing. In many countries, health budgets remain insufficient. To ensure lasting resilience, national investments must increase, innovative financing mechanisms must be developed, and funding must align with real logistics capacity.
Toward integrated and resilient supply chains
The forum’s message is clear: supply chains are a strategic function, not merely an operational one. Their resilience is essential to health security, and pharmaceutical sovereignty must be pursued at the regional level. Digitalization, coordination, and governance lie at the heart of transformation, and populations in fragile or border areas must remain a priority.
Today, Africa is progressing at different speeds, but a shared vision is emerging integrated, regional, sustainably financed supply chains capable of absorbing shocks. For the ESA and WCA constituencies, advocacy within the Global Fund should support investment in national systems, transparent governance, recognition of last-mile costs, and the development of African regional production and procurement mechanisms.