As global health governance becomes increasingly fragmented, the upcoming IAFS IV provides an opportunity to reposition healthcare cooperation around pharmaceutical resilience, local manufacturing, and shared health security
This piece is part of the series 'India–Africa Relations at a Strategic Crossroads: IAFS IV and Beyond'
The upcoming India–Africa Forum Summit takes place at a defining moment for global health governance. The COVID-19 pandemic exposed deep inequalities in access to medicines, vaccines, diagnostics, and health technologies, particularly across developing countries. Simultaneously, geopolitical tensions, supply-chain disruptions, and the growing securitisation of healthcare have intensified calls for more resilient and regionally diversified pharmaceutical systems. Within this changing global environment, India and African countries possess an important opportunity to redefine their health cooperation through a more strategic and mutually beneficial pharmaceutical partnership.
India has long played a major role in Africa’s healthcare landscape. Often described as the “pharmacy of the Global South”, India supplies a significant proportion of generic medicines used across the continent. Indian pharmaceutical companies such as Cipla, Sun Pharmaceutical Industries, and Dr. Reddy’s Laboratories have contributed substantially to improving access to affordable antiretroviral drugs, anti-malarial medicines, vaccines, and essential therapeutics across African markets. Indian-supported programmes in telemedicine, health training, and technical cooperation have also strengthened broader healthcare engagement between both regions.
The next phase of India–Africa health cooperation must move beyond a conventional trade relationship toward a partnership based on co-production, technology transfer, industrial development, and health sovereignty.
However, contemporary global realities suggest that the existing framework of cooperation, largely centred on pharmaceutical exports and medical assistance, is no longer sufficient. Africa still imports nearly 70 to 80 percent of its pharmaceutical products, leaving many countries highly vulnerable to external shocks and global supply disruptions. The pandemic demonstrated the risks associated with excessive dependence on external manufacturing centres when vaccine nationalism and export restrictions disrupted access to essential health products worldwide.
The next phase of India–Africa health cooperation must move beyond a conventional trade relationship toward a partnership based on co-production, technology transfer, industrial development, and health sovereignty. This transition aligns with the ambitions of the African Union and the Africa Centres for Disease Control and Prevention, both of which have prioritised local pharmaceutical manufacturing under the New Public Health Order for Africa framework.
An important dimension of this transformation lies in pharmaceutical industrialisation. Africa’s pharmaceutical market is expanding rapidly due to demographic growth, urbanisation, and rising healthcare demand. Yet the continent continues to face structural challenges, including weak industrial capacity, fragmented regulatory systems, limited financing, and inadequate research infrastructure. India’s experience in building a globally competitive generic pharmaceutical industry under conditions of resource constraint offers valuable lessons for African countries seeking to strengthen local pharmaceutical ecosystems.
Crucially, some Indian firms have already demonstrated more locally embedded models of engagement in Africa. Shalina Healthcare represents one of the most significant examples of this evolving partnership. Unlike firms focused primarily on exports, Shalina has established extensive distribution, manufacturing, and supply-chain operations in 35 African markets. Its model reflects a shift from simple pharmaceutical trade toward deeper industrial and commercial integration within African healthcare systems.
The significance of such partnerships extends beyond medicine accessibility. Local manufacturing and distribution networks contribute to employment generation, industrial diversification, supply-chain resilience, and long-term health security. As African governments increasingly seek to reduce dependency on imported medicines, partnerships with Indian firms capable of supporting local value addition will become strategically important.
Collaboration in biotechnology, genomic surveillance, and mRNA technologies could also help position India and Africa more competitively within emerging global health industries.
Vaccine manufacturing represents another major area for future cooperation. The pandemic accelerated African ambitions to produce at least 60 percent of the continent’s vaccine requirements locally by 2040. Indian vaccine producers such as Serum Institute of India and Bharat Biotech are well-positioned to support these goals through technology transfer agreements, joint research initiatives, and manufacturing partnerships. Collaboration in biotechnology, genomic surveillance, and mRNA technologies could also help position India and Africa more competitively within emerging global health industries.
Equally important is regulatory cooperation. Africa’s pharmaceutical market remains fragmented across multiple national regulatory systems, creating inefficiencies and increasing vulnerabilities to counterfeit or substandard medicines. The operationalisation of the African Medicines Agency creates new opportunities for collaboration between Indian pharmaceutical regulators, African institutions, and industry stakeholders. India’s experience in pharmaceutical quality assurance, generic drug regulation, and industrial scaling could support efforts toward regulatory harmonisation and stronger continental governance mechanisms.
India and African countries also share common interests in reforming global health governance. Both have consistently advocated for more equitable access to medicines and greater flexibility within international intellectual property regimes. The debates surrounding the Trade-Related Aspects of Intellectual Property Rights waiver during the COVID-19 pandemic highlighted the importance of coordinated South–South diplomacy in challenging structural inequalities within global healthcare systems.
India itself remains dependent on external suppliers, particularly China, for many active pharmaceutical ingredients, exposing vulnerabilities within its own pharmaceutical supply chains. Sustainable cooperation will therefore require greater investment in regional production networks, research collaboration, and supply diversification.
Nevertheless, the future of India–Africa pharmaceutical cooperation will require addressing several persistent challenges. African policymakers increasingly emphasise the need for genuine technology transfer, local capacity development, and fairer industrial partnerships rather than relationships centred primarily on imports and market access. At the same time, India itself remains dependent on external suppliers, particularly China, for many active pharmaceutical ingredients, exposing vulnerabilities within its own pharmaceutical supply chains. Sustainable cooperation will therefore require greater investment in regional production networks, research collaboration, and supply diversification.
The forthcoming summit offers an important opportunity to reposition health cooperation as a central pillar of India–Africa relations within an increasingly fragmented global order. Rather than framing healthcare engagement narrowly through aid diplomacy or pharmaceutical exports, both sides should pursue a model centred on co-development, technological partnership, and collective health resilience.
First, India and African partners should establish an India–Africa Pharmaceutical Manufacturing and Technology Transfer Fund to support regional manufacturing hubs, joint ventures, and local pharmaceutical production facilities across the continent.
Second, the summit should launch an India–Africa Health Innovation Network connecting universities, biotechnology institutes, pharmaceutical firms, and public health agencies to facilitate collaborative research on vaccines, infectious diseases, and non-communicable diseases affecting the Global South.
Third, India and the African Medicines Agency should institutionalise a regulatory cooperation mechanism focused on harmonisation, medicine quality standards, technical training, and pharmaceutical governance capacity-building.
Ultimately, a deeper India–Africa pharmaceutical partnership would advance not only commercial and developmental objectives but also broader geopolitical goals. In a world increasingly shaped by strategic competition, health insecurity, and fragmented supply chains, stronger South–South cooperation in healthcare may become an essential foundation for a more equitable and resilient global order.
Ken Kalala Ndalamba is an economist and senior analyst.
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