India’s growing role in Africa’s healthcare: progress, partnerships, and open questions

Africa’s long-standing healthcare challenge is well documented: a heavy reliance on imported medicines, limited local manufacturing capacity, and uneven access to affordable treatment. Governments, multilateral institutions, and donors have spent decades analysing these gaps, with varying degrees of success in addressing them.

In that landscape, India has emerged as a significant—if sometimes underexamined—player in improving access to medicines across the continent. Through its large-scale production of generic drugs and expanding partnerships in African markets, the country has helped shape how millions access treatment today. At the same time, analysts caution that Africa’s long-term health security will depend on balancing such partnerships with stronger domestic capacity.

According to data from India’s Export-Import Bank and the India Brand Equity Foundation (IBEF), the country’s pharmaceutical exports reached $30.4 billion in the 2024–25 financial year, up from $27.8 billion the previous year. Indian manufacturers are estimated to supply roughly one-fifth of the world’s generic medicines by volume, based on industry analyses.

Africa is a key destination for these exports. The Gavi Vaccine Alliance estimates that between 70 percent and 95 percent of medicines used across the continent are imported, underlining the scale of dependency. Indian pharmaceutical firms have, over the past two decades, become central suppliers in many of these markets.

One of the clearest examples of this impact is in HIV treatment. UNAIDS reports that approximately 80 percent of generic antiretroviral (ARV) medicines procured by low- and middle-income countries are manufactured in India. This dominance is often linked to India’s patent framework and its robust generic drug manufacturing sector.

The effect on pricing has been substantial. The international medical organisation Médecins Sans Frontières notes that the annual cost of first-line HIV treatment has dropped dramatically—from about $10,000 per patient in 2000 to around $100 today.

Studies drawing on procurement data from the World Health Organization (WHO) have also found that generic manufacturers, many of them Indian, supplied medicines at significantly lower prices than originator brands.

Public health experts widely agree that these cost reductions have been critical in expanding access to treatment across sub-Saharan Africa. However, they also point out that global financing mechanisms, donor programmes, and African government policies have played complementary roles in scaling up treatment access.

India’s contribution was also visible during the COVID-19 pandemic. Records from the WHO and UNICEF show that vaccines manufactured by the Serum Institute of India were among the first distributed to African countries through the COVAX facility, including an initial shipment to Ghana in February 2021. In total, millions of doses produced in India were supplied to developing countries during the early phases of the global rollout.

At the same time, the pandemic exposed vulnerabilities in global supply chains, including disruptions when exporting countries prioritised domestic needs. This experience has reinforced calls within Africa to reduce dependence on external suppliers and build resilient local manufacturing systems.

In recent years, Indian pharmaceutical companies have expanded their footprint in Africa beyond exports. Investments in joint ventures, local manufacturing, and technology transfer are increasingly shaping the relationship. Supporters see this as a shift toward more sustainable collaboration, with potential benefits for job creation, skills transfer, and regional production capacity.

India has also been strengthening its regulatory environment, aligning manufacturing standards more closely with international benchmarks. This has improved confidence in the quality of its pharmaceutical products in many markets, though regulators and health experts stress the need for continued vigilance and strong oversight globally.

Trade data from the Pharmaceuticals Export Promotion Council of India indicates continued growth in exports to Africa, with notable increases in countries such as Kenya, Nigeria, and Zimbabwe in 2025. Despite fluctuations in some markets, the broader trend points to sustained engagement between Indian pharmaceutical firms and African health systems.

Beyond medicines, India’s health-related innovations—including low-cost diagnostics and digital health infrastructure—are attracting interest from African policymakers. Some governments are exploring how such models could be adapted locally, particularly in expanding healthcare access in underserved areas.

However, there is growing consensus among African health leaders that partnerships alone are not enough. Initiatives led by the African Union and regional bodies are pushing for increased local pharmaceutical production, aiming to reduce import dependence and improve long-term health security.

Experts argue that the most effective path forward may lie in combining both approaches: leveraging India’s manufacturing expertise and affordability while accelerating Africa’s own industrial and regulatory capacity.

As Africa continues to navigate its healthcare challenges, India’s role is likely to remain significant. The broader question for policymakers is how to structure these partnerships in a way that delivers immediate access to affordable medicines while building a more self-reliant and resilient health system for the future.

Steve Mwangi is an International affairs columnist