Ask Our Client: Working with China to end AIDs in Africa? Why?

Today marks the annual ‘World AIDS Day’, and therefore also marks a perfect time to reflect on a series of projects that Development Reimagined delivered for UNAIDS China this year in a bid to break down silos and facilitate catalytic partnerships. We sat down with our client who had the vision to make these projects a reality: Amakobe Sande – UNAIDS China Country Director – to understand her experience of the projects, and what they mean for China-Africa health cooperation… 

  • Ms Sande, when we first started working with you this year, the first project you commissioned was to provide Investment Profiles of the Health Markets of 21 African Countries. Why?

The need was clear. 47% of people in African countries still do not have access to essential and good quality medicines, and populations are continuing to grow. Currently, Africa imports 70% of its pharmaceutical products, and only 34 of the 55 African countries possess some level of pharmaceutical production. This affects access to affordable and high quality HIV drugs as much as it does other types of health products, and it is unsustainable, particularly in the context of high trade deficits (and therefore forex problems) and demand for local jobs. Many African countries are therefore increasingly committed to creating and nurturing well-functioning pharmaceutical industries, and providing essential medicines to their own growing populations as part of those plans.  There is therefore an opportunity for Chinese companies, with government support, to relocate their pharmaceutical manufacturing to African countries, not only providing cheaper but high-quality drugs but also jobs, technology and skills transfer. However, there is an information gap and many Chinese investors are not at all aware of the landscape of Pharmaceutical manufacturing opportunities in Africa. There are literally a handful of Chinese companies actually manufacturing in African countries. So the aim for the country profiles, which will be launched in China in just a few days – December 4th – was to bridge this gap.

  • We’re excited for its launch. The report will be available in both English and Chinese, and it will hopefully provide critical and persuasive information to Chinese companies and others to get them started on their journey to manufacture in African countries. What about the second, related project that we worked on with you, the ‘Orientation on Access to Medicines & Local production’ project. What goals did you hope would be achieved?

Nothing beats human to human interactions and connections. UNAIDS alongside our partners – Bill and Melinda Gates Foundation and China International Health Exchange and Cooperation Center, National Health Commission (IHECC) – wanted to provide a platform to support African leaders and healthcare stakeholders who are keen to leverage the “China Opportunity” to drive local production in their Pharmaceuticals industry, and increase access to high-quality medicines. We wanted to connect these African stakeholders with Chinese health industry stakeholders – financiers, pharmaceutical companies, regulators and more. We believed that facilitating such connections would enable the African stakeholders drive towards their goal with increased focus and access. In addition, we thought it would be important for them to have a first-hand experience of how China has developed its pharmaceutical industry.

  • What was your impression of the work that we delivered?

Development Reimagined exceeded my expectations! Let’s start with the Orientation:

  • It was facilitated so professionally. Everything from invitation and visa letters to the steering of the sessions was handled so smoothly. For example, each participant received very detailed and professional welcome packs and logistical notes that helped provide them important information to help them maximize the Orientation;
  • Thanks to DR’s unique suggestion of using Chatham House rules the participants spoke candidly and in-depth, and it led to very productive sessions. DR was able to encourage the participants to engage with one another and develop action plans and it was refreshing to see that level of engagement.
  • The report that was produced on the Orientation was phenomenally put together. It was done within 4 days of the meeting and was full of substantive and useful takeaways that helped provide participants with actionable recommendations and summaries that they could report back on. This was one of the first times I didn’t have to ask for an entire overhaul of a report – and believe me that is an achievement!
  • The team was also incredibly committed, and put in more hours than they had budgeted for and had been contracted to deliver.

Overall it was truly impressive. The same can be said of the work that was delivered on the 21 Country profiles. The DR team did their research diligently, engaged in several back and forth discussions with us on cover design, graphic design for each country page and were accommodating to our very specific requests from the office here as well as in Geneva – many of which, went above the original scope of work.

  • What were key takeaways from both projects?

Look, although the intent for strong and win-win partnership between China and African stakeholder, the reality is that implementation is constrained by knowledge gaps and misalignment. For example, it was clear from the orientation that:

  • there is a mismatch between financing needs and the type of financing available
  • Chinese outbound investment is constrained by limited market knowledge of the African continent.
  • African parties have limited knowledge of how to leverage China’s health commitments or resources.

This only strengthens my belief that such projects are truly valuable. In fact, one of the recommendations coming out of the orientation was for all relevant stakeholders – UNAIDS, Gates, IHECC, and the AU to convene a follow-up orientation but bringing in even more private and industrial sector representatives who can form the basis of strong local partnerships with Chinese companies.

  • Are there any exciting projects or partnerships that came out of the Orientation?

Yes, indeed there are! During the orientation itself some of the delegates formed parternships and signed MoUs. Building on the success of this orientation, we also hope to do another next year for some of the French and Portuguese speaking countries on the continent, and we will also be incorporating a China-Africa health partnerships session during the NEPAD Africa Pharma Meeting that will be held early in 2019.

  • Going forward what do you think actors involved in the Africa-China health space should do next?

There are three main actors to consider – African country governments, Chinese stakeholders, and international actors like the African Union, UN or Gates Foundation, for example. African countries need to urgently develop sector strategies for pharmaceutical manufacturing and undertake competitiveness advantage or bottleneck studies for pharmaceutical investment by Chinese Companies and develop roadmaps to address those bottlenecks. Not every African country is well-suited for local pharmaceutical manufacturing or every kind of it -. determining competitive advantages is thus key! For Chinese stakeholders, there is a need to boost regulation of drugs to help African countries overcome issues with sub-standard or falsified drugs. And for the African Union, I believe a main priority should be to secure technical assistance to complete modalities for the creation of a “Fund for Africa Pharmaceutical Development” that they can appropriately pitch to Chinese stakeholders to raise investment. For other actors such as the UN, we should continue to provide information for both Chinese and African stakeholders and sponsor more of such orientations/summits and analysis. 

  • For clients considering engaging DR, what three-words would you use to sum-up DR?

Innovative. Responsive. Results-focused.

Thank you so much for your time, Ms. Sande. UNAIDS has been a pleasure to work with and we look forward to working with UNAIDS again.

Amakobe Sande is the UNAIDS Country Director and Representative in the People’s Republic of China.

December 2018

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