By Tatum Anderson
Africa is stepping up efforts to manufacture its own life-saving medicines, so that it does not have to rely on supplies from Western pharmaceutical companies.
Production of HIV/Aids drugs is already under way in Tanzania
A Ugandan drugs importer, Quality Chemicals, plans to begin manufacturing drugs to treat people living with HIV/Aids at a plant in the capital, Kampala, from June next year.
It has formed a joint venture with Indian pharmaceutical firm Cipla to produce the medicines at a fraction of the cost of some Western drugs.
Construction of its new factory is expected imminently.
Quality Chemicals is one of a number of burgeoning ventures in sub-Saharan Africa to begin local production of HIV/Aids treatments, known as anti-retroviral drugs, as well as anti-malarial medicines.
Ghana, Tanzania, the Democratic Republic of Congo and Ethiopia are just a few countries with similar aspirations.
"It's a huge thing, the business of local production. It's becoming really hot on the African agenda," said Dr Mohga Kamal Smith, health policy adviser at Oxfam, which campaigns for affordable access to medicines.
"African leaders realise that they are totally dependent on the whim of pharmaceutical companies outside their countries."
The manufacture of anti-retroviral drugs has been confined to foreign firms located in Africa and a tiny number of home-grown companies, such as South Africa's Aspen Pharmacare.
African firms want to make drugs instead of importing them
The boost in local production in other countries is driven by the fact that access to affordable and effective medicines, which is already a huge challenge, is becoming increasingly unreliable.
According to the World Health Organization (WHO), by the end of last year, only 17% of the 4.7 million people in sub-Saharan Africa in need of anti-retroviral treatments were receiving them.
In Africa, there are no national healthcare systems like the NHS to pay for drugs and campaigns to provide free treatment are not yet able to cope with the numbers of patients in need of medicines.
As a result, a great many African patients are forced to pay for their own drugs. Many cannot afford to do so.
There have been high-profile moves by US and European pharmaceutical companies to slash prices for anti-retroviral drugs.
UK drugs giant GlaxoSmithKline (GSK), for instance, says it has provided a number of patented anti-retroviral drugs at not-for-profit prices to the poorest African countries since 2000.
It also signed eight deals allowing other companies to copy some of its drugs at more affordable prices.
Work has yet to begin on an HIV drugs factory for Uganda
The problem is that some drugs do not fall under these cut-price schemes: particularly newer, often more effective drugs - so-called second-line treatments.
These are vital as patients around the world inevitably become resistant to the current generation of drugs.
In the past, when Western drug prices have been too high, African countries have traditionally turned to Indian companies, which have made copies of drugs designed in the West at lower prices.
At those times, up to 80% of these copycat generic drugs supplied to some African countries came from India.
But the supply of Indian drugs is threatened, say charities. India tightened up its patent laws last year to satisfy its international commitments at the World Trade Organization (WTO), so that local generics firms cannot so readily copy newer foreign drugs.
The expected effect of this controversial law is a dwindling supply of second-line treatments.
Medecins Sans Frontières (MSF), which treats patients in Africa, says patent laws are already stifling generic drug production. It estimates second-line drugs can be as much as seven times more expensive than the most affordable drugs available.
In Kenya, for example, MSF pays $1400 (£750) per patient every year for second-line drugs, compared to only $200 for existing medication.
Anti-retroviral drugs have been made in DR Congo since 2004
George Baguma, director of marketing at Quality Chemicals in Uganda, said: "The Indian patent law will deny countries like Uganda cheaper generics of new molecules.
"This will mean death to the millions of people on therapy in Africa."
GlaxoSmithKline says these newer drugs, like its own abacavir medicine, are more expensive because they are far more complex drugs to make than existing ones, even for generic companies.
However, a GSK spokesperson said the company had begun negotiations to introduce not-for-profit pricing in the future.
"The situation is really fluid and as demand changes, we will respond to it," she said.
"We have a good track record of making sure we get drugs to people who need it most."
Given the uncertainty over the prices of foreign supplies, Quality Chemicals' Mr Baguma says it is vital to have a constant supply of drugs for those Ugandans already being treated, as well as to meet the future explosion in demand for treatment.
"It is important for us to be self-sufficient," he adds.
The company says it will take advantage of the fact that under WTO rules, the world's poorest countries are able to copy drugs without breaking patent laws.
Cipla will bring its considerable resources and know-how in drug manufacture.
Self-sufficiency seems to be the watchword for numerous other African countries, from Malawi to Nigeria.
In east Africa, Tanzanian Pharmaceutical Industries (TPI) began producing drugs at the beginning of the year, and can now manufacture enough to treat 100,000 people a month for an annual cost of about $150 a patient.
Many Africans do not get Aids treatment because of lack of funds
Ramadhan Madabida, chief executive of TPI, says self-sufficiency in manufacturing drugs is also vital, because it encourages long-term economic growth in a country such as Tanzania.
A joint venture between the government and private interests, TPI has invested about $17m from domestic pension funds to upgrade its facilities in an effort to make effective anti-retroviral and anti-malaria drugs.
And in west Africa, Dan Adams Pharmaceuticals, formed last year by a Chinese and Ghanaian tie-up, plans to manufacture anti-retroviral and anti-malaria drugs for both local and international markets.
Two Ethiopian firms are rumoured to have plans to manufacture drugs locally.
For these companies, the challenge now is to manufacture drugs to rigorous international standards, says Philippa Saunders, an external consultant on pharmaceutical issues with Oxfam.
But not everyone believes patents are the primary cause of poor access to medicine in the developing world.
Some industry observers say lack of national healthcare funding, medical staff, transport infrastructure are also to blame.
Indeed, the prices of medicines rarely have anything to do with patents according to Trevor Jones, director of research and development at the Wellcome Foundation, quoted in a recent WHO report on intellectual property and public health.
"Companies set prices largely on the willingness/ability to pay, also taking into account the country, disease and regulation," he said in a statement.