Gates Foundation leads workforce growth in Africa

From the newsletter

The global philanthropic organisation, Gates Foundation, has experienced the highest growth in senior staff among major health organisations in Africa. Our analysis of the past 12 months reveals a 16% increase in senior staff and a remarkable 35% rise in their business development team. Currently, the Gates Foundation has a $7 billion investment in Africa, primarily focused on health initiatives, which likely accounts for this expansion.

• The foundation's major funding areas include polio eradication, HIV, tuberculosis, and malaria. In tuberculosis, for example, the foundation has invested heavily in a promising vaccine candidate, M72, which is currently on its third trial and could be the first new TB vaccine in over 50 years.

• The Gates Foundation operates in 14 countries, similar to Path, a global non profit health organisation, and surpassing the Africa-based philanthropic health institution Amref, which operates in only six countries.

More details

• Chris Hani Hospital ranks second in senior staff expansion, with an increase of 11%. Affiliated with the University of the Witwatersrand Medical School, it is the third-largest hospital in the world. Covering 173 acres, the hospital has over 3,200 beds and a total staff of 6,700. With 429 buildings spanning 233,795 square metres, it plays a crucial role in training medical professionals alongside other major teaching hospitals in Johannesburg.

• In contrast, pharmaceutical companies are struggling with growth. Aspen and Cipla both report a decline in employee expansion, with an increase of only 2% each. Experts suggest that the pharmaceutical sector in Africa faces significant challenges due to an overreliance on imports, weak regulatory systems, limited local production of raw materials, lack of regional coordination, and high healthcare costs.

• While several African countries have some level of pharmaceutical production, only a few, including South Africa, are capable of producing active pharmaceutical ingredients, with most relying on imported components. Poor cross-border trade and limited access to health insurance result in essential medicines being both expensive and inaccessible, undermining Africa's ability to respond to health crises and everyday healthcare needs.

• Cipla’s stagnant staff growth of 2% over the past year may soon change, following a $50 million investment in its South African subsidiary, Cipla Medpro. This funding aims to reduce inter-group debt and strengthen the company's financial structure. If successful, it could enhance operations and profitability for Cipla Medpro and its subsidiaries.

• Although Amref has enabled access to healthcare for over 30 million people in Kenya alone between 2018 and 2022, its low senior staff growth rate of just 5% across Africa is puzzling. The number of projects in its portfolio has continuously increased, from 145 projects in 2018 to 193 in 2022, with Kenya leading in project implementation.

• Since 2017, Amref has secured a total of $505 million in funding specifically for malaria and tuberculosis, including a significant grant of $408 million issued in July 2024. However, Amref has also reportedly lost over $30 million due to cuts in US funding, which may be linked to its slow growth over the past year.

Our take

• To strengthen the pharmaceutical sector in Africa, countries should adopt common regional strategies. This involves setting milestones, encouraging research, enhancing regulation, and fostering coordination for the impactful and harmonised implementation of policies.

• Improving access to medicines requires the enforcement of drug quality standards, the capacity building of regulatory agencies, and the alignment of intellectual property laws with health objectives. Regional cooperation, sustainable financing, and partnerships are essential to protect public health and ensure access to safe and effective medicines.

• Manufacturing support should include education reform, funding, and feasibility studies. Governments should invest in traditional medicine, develop skilled human resources, promote research-industry partnerships, and allocate 2% of national budgets to pharmaceutical innovation.