Advancing African Medicines Agency through Global Health Diplomacy for an Equitable Pan-African Universal Health Coverage: A Scoping Review

Abstract

The African continent is home to 15% of the world’s population and suffers from a disease burden of more than 25% globally. In this COVID-19 era, the high burden and mortality are further worsened due to inequities, inequalities such as inadequate health systems, scarce financial and human resources, as well as unavailability of inexpensive medicines of good quality, safety, and efficacy. The Universal Health Coverage ensures that people have access to high-quality essential health services, secure, reliable, and affordable essential medicines and vaccines, as well as financial security. This paper aimed at addressing the critical need for a continental African Medicines Agency (AMA) in addressing the inequities and the role of global health diplomacy in building consensus to support the ratification of the Treaty of AMA. A literature review was done in Scopus, Web of Science, MEDLINE/PubMed, and Google Scholar search engine to identify the critical literature in the context of study objectives. All the articles published after 2015 till 2021 in the context of AMA were included. African Health Strategy 2016–2030 highlighted the importance of an African regulatory mechanism for medicines and medical products. Through global health diplomacy (GHD), the African Union and its partners can negotiate and cooperate in providing infrastructural, administrative, and regulatory support for establishing the AMA. The paper emphasizes the South–South cooperation and highlights the contributions of India and China in the supply of medicines and vaccines to Africa. A strong AMA created through GHD can be a vital instrument in utilizing Trade-Related Aspects of Intellectual Property Rights (TRIPS) flexibilities extension and an ideal partner for European and other regional regulatory authorities seeking to stem the tide of counterfeit, sub-standard, or fake products.

The capacity of young national medicine regulatory authorities to ensure the quality of medicines: case of Rwanda

“…These findings were also reported by MTaPS which conducted a study in seven African countries and two Asian countries to evaluate the registration systems of medicines used in maternal, newborn and child healthcare [ 21 ]. One of the solutions to the lengthy registration process may be the strengthening of the existing harmonization of medicines regulation in the East African Countries [ 10 , 22 ] and the proposed African Medicines Agency (AMA) [ 9 , 23 ].…”

Pandemic preparedness and response: exploring the role of universal health coverage within the global health security architecture

“…51 Such an approach includes ensuring equitable access to medical countermeasures and affordable medicines and supplies through the full use of flexibilities and waivers for public health, such as those under the Agreement on Trade-Related Aspects of Intellectual Property Rights. 52 , 53 Through diplomatic and legislative means, an instrument for pandemic preparedness and response and more enforceable IHR amendments provide novel opportunities to codify and prenegotiate obligations and mechanisms for equity in the development and distribution of vaccines, diagnostics, personal protective equipment, and treatments in low-income and middle-income countries before, during, and after health emergencies.…”

Access to medicines through global health diplomacy

“…For example, African Medical Agency has recently evolved from health diplomacy and continues to encourage governments’ participation to contribute to the ATM. 24 Table 2 summarises the various high-level political declarations and roadmap for ATM.…”

“…So far, COVAX has distributed over 1 billion doses of COVID-19 vaccines to around 144 participants. 23 There is a great scope for GHD to move things forward through global partnerships, negotiations, and emphasizing health security, which can only be achieved through equity. For example, African Medical Agency has recently evolved from health diplomacy and continues to encourage governments' participation to contribute to the ATM.…”