Study backs local drug production and financing amid rising malaria burden

Kenya became the first country in Africa to locally produce sulfadoxine–pyrimethamine plus amodiaquine (SPAQ) in 2024. This WHO-approved drug is used for seasonal malaria prevention.

Only six pharmaceutical firms on the continent have achieved WHO-prequalification. Most antimalarial drugs are still imported from India and China, yet climate change is also expected to expand malaria zones, increasing demand and exposing the limits of this external dependency.

The projected burden of malaria is expected to be heaviest in high-prevalence countries like Nigeria and the Democratic Republic of the Congo. According to a study published in The Lancet, these two nations could face the highest increases in malaria cases and deaths if funding cuts continue. The study evaluated 27 countries in total, using high-resolution spatial data and intervention-specific inputs to generate its estimates.

In 2022, governments in malaria-endemic countries contributed over $1.5 billion to malaria response efforts. Of this amount, $400 million was allocated to treatment through public health systems, while $1.1 billion supported broader control initiatives. This represented a $400 million increase from 2021. South Africa is currently funding its entire malaria programme through national and provincial budgets and Benin has increased its malaria allocation by 28.5 percent for 2025.

The Africa Centres for Disease Control and Prevention has launched the Africa Health Financing strategy to increase domestic resource mobilisation. Concurrently, the African Union is advocating for a reassessment of the Abuja Declaration, which calls for 15 percent of national budgets to be allocated to health. These initiatives aim to reduce reliance on unstable donor support.

The study also highlights that several African countries are developing local solutions to meet their malaria control needs. This includes investments in domestic manufacturing of medicines, vaccines, diagnostics and vector control tools. The authors argue that, with adequate support, local innovation could address emerging challenges such as drug resistance and help stabilise health systems amidst global funding cuts.

In November 2023, Kenya’s Universal Corporation Limited became the first African pharmaceutical company to receive World Health Organization approval to produce sulfadoxine–pyrimethamine plus amodiaquine (SPAQ). This drug is used to prevent seasonal malaria in children during high-risk periods, such as the rainy season. Previously, Africa relied on imported generics from India and China to meet the demand for SPAQ.

A previous report by Unitaid in April 2024 identified several challenges hindering antimalarial drug production in Africa. These challenges include high manufacturing costs, lack of affordable financing, limited infrastructure, weak regulatory systems and inadequate technical capacity. Currently, only six pharmaceutical firms on the continent have achieved World Health Organization prequalification. Most antimalarial drugs are still imported from India and China.

To address these barriers, Unitaid recommends a coordinated strategy that includes regional production of active pharmaceutical ingredients, investment in bioequivalence and bioanalytical laboratories, technology transfer and quality assurance support. It also advocates for market-shaping interventions such as pooled procurement and long-term contracts to boost demand for African-made drugs. These measures aim to strengthen Africa’s health security and reduce dependence on imports.

Donor dependence is a risk to the stability of malaria control efforts in Africa. Fluctuating funding priorities can stall progress and disrupt supply chains. 

To achieve sustainable progress, it is essential to strengthen national health systems, promote local manufacturing, diversify funding sources and implement country-led policies that are grounded in regional realities.