The Global Fund has just made history – now it must start a revolution

Mail & Guardian

21-05-2025

HIV treatment has, for the first time, been made in Africa.
On 6 May 2025, a quiet revolution took place. The Global Fund to Fight Aids, Tuberculosis and Malaria announced it had, for the first time in its history,
For many outside Africa, this might seem like a footnote in global health procurement logistics. For us on the continent, it is nothing short of history. It's a symbolic and literal act of African solidarity, scientific excellence and economic assertion.
Africa is standing up and saying: 'We will no longer be the last in line for our own survival; we are the source of our own solutions.'
This is not just about pills in blister packs. It is about power, ownership and self-determination in a world where Africa has too often been positioned as a passive recipient of generosity rather than a co-architect of its future.
We are on the cusp of a new era, one where African science, African economies and African futures are not afterthoughts in the global health agenda, but drivers of it.
From political independence to pharmaceutical liberation
Sixty years after many African nations won political independence, the continent is still shackled in economic and technological dependency. Nowhere is this more apparent than in the pharmaceutical sector. Despite bearing the highest burden of HIV globally, Africa has historically relied on imports for between
More than 25 million Africans are living with HIV. Many rely on daily antiretroviral therapy to survive. Ensuring consistent, affordable and sovereign access to these treatments is not optional, it is urgent. But this moment also has implications beyond HIV. It can catalyse African manufacturing in drugs for TB, malaria and non-communicable diseases, vaccines and its pandemic preparedness.
The Global Fund's procurement is the first stone in what could be a continental avalanche of pharmaceutical innovation and a positive step towards the Africa Centres for Disease Control and Prevention's goal to produce 60% of vaccine needs domestically by 2040 through the
From an economic perspective, this move could reshape access to medicines. The benefits of local pharmaceutical production are well-documented but rarely supported at the scale required.
Jobs, cost savings and resilience to health shocks
When medicines are imported, African governments pay not only for the product but also for shipping, import duties and the often-exploitative pricing structures of external manufacturers. Local production, when scaled,
African manufacturers are more likely to understand the price sensitivities of their domestic markets, making them natural allies in the fight for affordable treatment.
When Africa produces at scale, we negotiate from strength. A diversified supply landscape
A robust pharmaceutical sector means more than factories, it means engineers, scientists, quality-assurance professionals, logisticians and educators. It builds a value chain that uplifts entire communities and redirects millions in procurement spend into local economies.
The ripple effect is massive: GDP growth, regional trade and reduced foreign currency outflows.
The Covid-19 pandemic exposed the fragility of international medical supply chains. African countries were left scrambling for vaccines, oxygen and personal protective equipment. By strengthening domestic pharmaceutical capacity, we insulate our public health systems from geopolitical shocks and ensure more consistent access to life-saving drugs.
Four steps to secure systemic change
This procurement cannot remain an isolated incident, a singular success trotted out at conferences and summits. It must spark a movement. A revolution in how global health actors approach access, equity and economic justice in Africa.
Here's what must happen next:
1. Global Fund must make local procurement a permanent policy.
The fund and other major donors, such as Unitaid, must make local sourcing of commodities a default, not a deviation. Pepfar (before Trump got hold of it) was leading the way, aiming for 70% of its funding to go to local partners, but medicines and vaccines were still largely imported.
Policies must be put in place to favour regional production when quality and cost-effectiveness are assured. The success in Kenya should lead to similar procurement from South Africa, Nigeria, Ghana and Senegal, all of which have growing pharmaceutical capabilities.
2. It is time for African governments to move from rhetoric to investment.
Local businesses cannot thrive without local demand. Tax incentives, infrastructure support and subsidies for research and development must be mobilised to grow local pharmaceutical industries. More importantly, governments must commit to procuring from African manufacturers, not only for export, but for national programmes.
3. Regional collaboration must replace national silos.
The African Medicines Agency, operated by the AU, must fast-track regional regulatory harmonisation. This will allow a medicine approved in one country to move freely across borders, removing duplication and accelerating access. A thriving continental pharmaceutical market is only possible if we dismantle bureaucratic barriers.
4. Civil society must hold all stakeholders accountable.
We, the people, cannot afford to be passive in this process. Civil society must monitor procurement decisions, expose backroom deals that favour multinationals and demand transparency in donor policies. Every dollar spent outside Africa, when there is a qualified African supplier is not just lost income, is a political betrayal
We are the generations of return
For centuries, Africa has been mined for its resources, such as gold, diamonds and rubber. Now, the world mines the continent for data, clinical-trial volunteers and intellectual labour. But we are the generations of return. We are bringing back sovereignty to our laboratories, dignity to our procurement systems and power to our people.
This procurement by the Global Fund must be remembered not just as the first time an African-made HIV treatment was purchased, but as the last time it was considered unusual.
It is the beginning of something long overdue — a health system made by us, for us, accountable to us. The symbolism is rich. The politics are radical. The economics are clear.
Let the rest of the world catch up.
Tian Johnson is the founder and strategist of the African Alliance, a pan-African health justice advocacy group.