Senegal has just experienced a worrying situation concerning the supply of pharmacies and public health care structures with infusion solutions, essential drugs in the treatment of numerous pathologies, in particular for maintaining the hydration of patients and administering drugs by intravenous route.
Supply disruptions at the level of all private and public distributors have been noted for several weeks with several negative consequences: 1. Difficulty in caring for patients, in a context of an outbreak of influenza, which aggravates its consequences on public health. 2. Increased risk of medical complications due to lack of appropriate treatment; 3. Work overload for medical staff who must manage the shortage; 4. Potential increase in healthcare costs for patients and the healthcare system (prolongation of length of hospitalization). Beyond infusion solutions, this crisis highlights the need to develop a pharmaceutical industry that is viable, sustainable and adapted to the health needs of populations. The government has already updated the Pharmacy law in 2023 and issued implementing decrees in favor of the development of the sector.
It remains for our State, the urgency to take measures complementary to the reforms already adopted to strengthen the national production of medicines and other pharmaceutical products. Senegal currently imports 95% of its medicines and 99% of its vaccines. In value terms, more than 180 billion FCFA (260 million euros) were used to acquire medicines abroad in 2023 compared to 150 billion FCFA in 2019. This strong dependence on imports makes the country vulnerable to fluctuations. of the international market and supply disruptions affecting foreign producers.
The local pharmaceutical industry has only half a dozen producers, including a producer of solutions, but it is unable to perform despite the significant financial commitment made by the State in favor of two industrial units in difficulty. The measures expected by all stakeholders will contribute to making the economic environment for local pharmaceutical production which competes with imports more attractive. Most manufacturers abroad benefit from support policies from their State (very low-cost electricity, subsidies, various exemptions, tax rebates on invested capital), allowing them to limit any risk of competition in importing countries. like in Africa by applying the lowest prices.
This is a strategy of cost domination of small African markets south of the Sahara, incapable of ensuring a sufficient level of price competitiveness in the face of the numerous brakes and obstacles they must face in the production of medicines. generic ones including the fragmentation of borders and regulations. This phenomenon is beginning to hit France, which is struggling to maintain a pharmaceutical industry faced with increasingly high prices due to the growing importance of innovative molecules intended for the treatment of chronic non-communicable diseases and the gradual abandonment of the production of molecules. simple (generic), which have become unprofitable. Very recently, SERVIER laboratories entrusted the Indian generic manufacturer Microlabs with the responsibility of producing Amoxicillin for the French market. In Senegal, medicine is making great strides. The first kidney transplants were carried out in 2023 by a team of Senegalese surgeons.
In vitro fertilization and medically assisted procreation have become commonplace. The marrow transplant is in the works. For diabetes and high blood pressure, conditions which affect a significant part of the population in Senegal (respectively 6% and 24% prevalence rate-WHO 2022), the complications can be improved, bringing a better quality of life to patients. It is up to Pharmacy to adapt by providing this medicine with the innovative medicines it requires. These molecules unfortunately remain inaccessible to most Senegalese people despite the efforts of pharmacists on prices, and their availability is not assured, given the very low weight of the African drug market (2% of the world market).
Most of these medications are not registered in Senegal (excluding visa); they are imported with special authorization from the Senegalese Regulatory Authority, and are subject to frequent disruptions in supplies from European suppliers. The year 2025 will mark the 4th anniversary of the adoption in October 2021 by the State of Senegal of an ambitious recovery plan for the pharmaceutical industry intended to reduce the risk of future shortages and strengthen Senegal’s pharmaceutical sovereignty. The new Senegal 2050 Development Plan presents in its 2024-2034 Master Strategic Plan the pharmaceutical industry as an engine of growth that is part of pillar 3 of manufacturing industries.
This is the key moment for our new leaders to press the start button by adopting the key measures: – Strengthening the governance of reforms through the introduction of the Delivery Unit into the State budgetary architecture from Senegal; the support of the PTF is to be hired but cannot be lasting.
– Support for the Senegalese Pharmaceutical Regulatory Agency to enable it to reach and maintain WHO level 3 maturation guaranteeing a stable and functional regulatory system; – Diligent and strategic treatment of the cost of production factors that is still too high (electricity, VAT on inputs and equipment at the customs cordon, etc.), preventing local producers from ensuring a satisfactory level of competitiveness in the face of imports and hampering their chances to export in the sub-region; Community customs measures make it possible to circumvent certain obstacles linked to the taxation of imported inputs but they are cumbersome to implement and monitor.
– Access to public markets: SEN-PNA must be able to boost local industry through medium-term performance contracts, in order to enable it to benefit from volume effects on production costs. To do this, the State will have to provide it with substantial financial resources which will enable it to be sufficiently supplied while respecting its payment deadlines.
– Customs facilitations granted to the two future pharmaceutical hubs which will soon be created on Senegalese territory, thus contributing to improving the availability and distribution of medicines in the sub-region. – Advocacy For the record, the Senegalese State aims to cover a third of the needs for medicines by 2030 and up to 50% by 2035, representing a challenge of 230 billion FCFA for local production since the pharmaceutical market will double between 2020 and 2035 (according to a McKinsey-2021 study). However, these efforts must be supported by continued political and financial commitment to ensure the health security of the country’s 40 million inhabitants in 2050.
By Dr Jules-Charles KÉBÉ
Pharmacist
Managing Director – Duopharm Sa Pca- Parenterus Sa
