Policy decisions about whether to import essential drugs from
reputable companies or to promote local manufacture, and if so,
at what level, should be based on a careful situation analysis
and on a realistic appraisal of the feasibility of domestic
production.39 When formulating a policy the most important
objective should be to get quality essential drugs to the people
who need them, at prices that they and their country can afford.
Pharmaceutical production can be classified into three levels.
Primary production includes the manufacture of active
pharmaceutical ingredients and intermediates; secondary
production includes the production of finished dosage forms from
excipients and active substances; and tertiary production is
limited to the packaging of finished products or repackaging of
bulk finished products. Make or buy? Many governments are
politically interested in developing or maintaining local
manufacturing capacity and in increasing self-reliance. There
may be a complex mixture of health and econom