Securing Continental Access to Life-saving Essential health products (SCALE): The AUDA-NEPAD Game Plan

Globally, the need to ensure every individual has reliable access to quality healthcare services without financial hardship is espoused in the SDG 3: Good Health and Wellbeing under the principle of Universal Healthcare Coverage (UHC). In Africa, this aspiration has been championed through different forums, platforms and initiatives. Starting from Abuja Declaration that aimed at having governments allocate at least 15% of their budgets to health to recent establishment of African Medicines Agency (AMA) as a continental agency to oversee the regulation of health products and technologies. In each phase of the developments, the focus has always been on how to create an enabling ecosystem for the different players to do their part while guaranteeing patients access that they need.

Regarding access to essential health products, the push for a continental strategy was birthed during the HIV/AIDS pandemic in the 1990’s. In the early 2000, the need was so high that African Union Heads of States called for the development of a pharmaceutical manufacturing strategy for the continent in 2005. This led to the development of the Pharmaceutical Manufacturing Plan for Africa (PMPA) which was adopted in 2007. In 2012, the Business Plan was adopted to operationalize implementation and provide a roadmap for developing the pharmaceutical manufacturing sector.

Anchored on the premise of PMPA, AUDA-NEPAD established the African Medicines Regulatory Harmonization (AMRH) initiative in 2009. Grounded on the understanding that regulatory frameworks in the continent were nascent and the burden of substandard and falsified medicines was high, the AMRH organized and coordinated regulatory systems strengthening efforts at national, regional and continental levels. This was further jolted by COVID-19 which created momentum for the ratification of the AMA Treaty leading to establishment of AMA. With AMA in place, the question that begets the continent is how do we get the other levers to work towards growing Africa’s pharmaceutical manufacturing sector?

I have been privileged to be part of this next phase in Securing Continental Access to Life-saving Essential Health Products in the continent which happens to be the name of the initiative being championed by the AUDA-NEPAD to complement regulatory efforts by AMA. This past week in Lusaka, Zambia we deliberated on the architecture and driving pillars for SCALE which I’ll share briefly about in this article.

In the journey towards ensuring reliable access to health products continentally, we have often acknowledged there are different levers and most importantly an understanding that the industry has a social and economic imperative. Health as a social need must be guaranteed and that’s only possible when there is reliable access to safe, effective and quality medical countermeasures. On the economic front, local production is a driver to economic development through job creation, foreign exchange preservation, taxes and even a health security in the event of global disruptions. Additionally, economic productivity of a nation is anchored on healthy citizens and therefore this complements the second pillar.

For the industry to grow and deliver on these goals, SCALE recognizes that the industry must be competitive in quality standards to match regulatory requirements while at the same time be guaranteed market access. On the other hand, all these aspirations are grounded on the fact that the continent needs competent professionals and capable institutions to deliver on the different pillars of growth for the industry and the continent.

SCALE is anchored on 6 pillars. At the centre of SCALE are three core pillars. First, Health Technology Assessment (HTA) ensures that procurement and reimbursement decisions are guided by evidence, value and public health impact. This matters because scarce resources must be directed toward the products and technologies that deliver the greatest benefit. Second, pharmaceutical manufacturing competitiveness strengthens the ability of African manufacturers to meet quality standards, satisfy regulatory requirements and compete in regional markets. Without this pillar, local production remains a policy slogan rather than an investable proposition. Third, health product supply chains and commodity security focus on the systems that move products from factory or port to patient, with reliability, integrity and accountability. Together, these three pillars answer the most practical question in health access: what should be bought, who can produce it competitively, and how will it reach people consistently?

Complementarily, there are three supporting pillars, because no health product ecosystem works on technical design alone. Workforce and institutional capability provide the human and organizational capacity to run HTA systems, strengthen manufacturing quality and manage procurement and distribution professionally. Data, digitalization and AI create visibility across the value chain, improving forecasting, decision-making and performance management. Advocacy and communication mobilize political commitment, public trust and long-term investment. These are not add-ons. They are the enabling conditions that allow the core pillars to function at scale and endure beyond individual projects or funding cycles.

The strongest argument for SCALE is not simply that Africa needs better access to health products; but that Africa now has the policy history, institutional progress and market urgency to act in a more integrated way. SCALE gives AUDA-NEPAD a development-focused mechanism to connect industrial growth, public health priorities and health security. It complements AMA rather than duplicates it: AMA strengthens the regulatory environment, while SCALE helps make the broader ecosystem work. That distinction is critical. If Africa wants reliable access to lifesaving products in normal times and resilience in times of crisis, the continent must move beyond siloed programmes and invest in a system that links demand, production, distribution, skills, data and political commitment.

SCALE is compelling precisely because it is both practical and strategic. It responds to immediate health access gaps, but it also advances broader continental goals: stronger local industry, better use of public resources, improved health security and a more self-sustaining African health ecosystem. For that reason, this is the right moment for SCALE – not as another initiative in the landscape, but as the organizing framework that can connect the work already underway and turn it into measurable, continent-wide impact.