From the newsletter
Africa’s pharmaceutical sector is missing out on a $4.5 billion annual market for drug-resistant TB treatment. The new WHO-recommended BPaLM regimen, with over 85% treatment success, relies on four antibiotics; bedaquiline, pretomanid, linezolid and moxifloxacin, none of which are currently manufactured on the continent.
The all-oral six-month treatment plan, recommended by the World Health Organization in 2022, replaces older treatments that were harder to complete and lasted 9 to 18 months or longer. Local manufacturing of the antibiotics would allow Africa to capture a share of the multi-billion-dollar TB market.
While this may take time, immediate business entry points include distribution and logistics, licensing partnerships, expanding diagnostics capacity and developing patient support or adherence services.
More details
Multidrug-resistant tuberculosis (MDR-TB) is caused by bacteria resistant to isoniazid and rifampicin, the two most powerful first-line TB drugs. It affects over 62,000 Africans every year. Drug resistance arises from incorrect prescriptions, poor-quality medicines among others. MDR-TB remains treatable with second-line drugs, but these are costly and require long treatment courses.
In Africa, MDR-TB continues to impose a serious public health burden, with the WHO estimating 62,000 new cases annually, highlighting the persistent need for effective, accessible therapies across the continent. Local manufacturing of the four BPaLM antibiotics could allow African pharmaceutical companies to capture a share of a multi-billion-dollar market.
While establishing production will take time, immediate entry points exist for health businesses to benefit from the rising demand for drug-resistant TB treatment and related services. Access to timely diagnosis and effective treatment remains uneven, making drug-resistant TB a persistent public health and market challenge, with unmet demand for quality care across the continent.
Strengthening distribution networks offers a dual opportunity. Reliable logistics and supply management of BPaLM regimens can capture revenue from a growing market while increasing access for patients. Licensing agreements with global manufacturers can also allow African companies to legally produce or import BPaLM antibiotics and increase access.
Diagnosis and management of drug-resistant tuberculosis (DR-TB) remains a serious challenge in Africa. Companies investing in rapid molecular tests or culture facilities can generate revenue from equipment, reagents and more. Patient support programmes, including adherence monitoring and counselling, also provide additional business services.
Our take
The ultimate solution in reducing the TB burden in Africa is local manufacturing of the key antibiotics, which would secure sustainable access and reduce reliance on imports.
TB response in Africa cannot succeed if essential medicines don't reach the most neglected communities in good time.