India is often called the “Pharmacy of the Global South” and for African countries, public health and Indian pharmaceuticals are deeply interconnected.
According to data from public health agencies such as the World Health Organization (WHO), Africa bears almost a quarter of the global disease burden, with a disproportionate share of HIV, tuberculosis and malaria cases.
According to data from the United Nations Economic Commission for Africa and Nigeria’s pharmaceutical regulatory agency, NAFDAC, India supplies about 40% of Africa’s imported medicines, making it the continent’s largest pharmaceutical trade partner.
From Nigeria to Kenya and South Africa, Indian generic medicines are the backbone of public health systems.
Across the continent, they provide low-cost antibiotics, HIV antiretrovirals, malaria and tuberculosis medicines, insulin, blood pressure medicines and common painkillers used by millions of people every day.
a critical logistics corridor
The system is working because Indian medicines are affordable, reliable and moved through one of the most efficient logistics corridors in the world.
Medicines manufactured in Indian hubs such as Hyderabad, Ahmedabad and Mumbai regularly pass through Gulf cargo hubs in Dubai, Doha and Abu Dhabi before reaching African ports and airports.
Pharmaceutical materials received from China and Europe also move through the same network.
Medicines pass through Gulf hubs thanks to the state-of-the-art logistics required for temperature- and climate-sensitive medicines, such as some vaccines. Logistics hubs in the Gulf have greater capacity to handle large shipments originating from India and destined for African markets.
The system relies on predictable shipping schedules, relatively cheap freight traffic, and stable Gulf transit routes.
But Iran’s closure of the Strait of Hormuz has disrupted commercial shipping from the Gulf, while war-risk premiums have soared, freight costs have soared and airlines have rerouted or reduced cargo capacity through Gulf airspace.
Rising oil prices are also increasing manufacturing and transportation costs for pharmaceutical companies.
Unlike Europe or the US, most African countries do not maintain large drug stores. European states often order several months’ worth of stock for essential medicines, while major US distributors may hold up to six months’ inventory.
In contrast, many African systems rely on fixed-time procurement cycles and limited buffer stocks. This means that delays quickly become shortages.
Supply of basic medicines disrupted
Remi Adesun, a veteran pharmaceutical executive whose company works with global pharmaceutical supply chains, told DW that the crisis is exposing a deeper structural vulnerability than just temporary freight disruption.
“Africa is heavily dependent on Indian generic and Asian pharmaceutical supply chains, even where medicines are assembled locally, as active pharmaceutical ingredients (APIs), excipients and packaging materials are still largely imported from India and China,” Adesun said.
According to Adesun, the current struggle is driving up costs in nearly every layer of the pharmaceutical chain, from APIs, petroleum-based packaging, freight and shipping insurance to diesel, financing and long transit times.
He said the price of a paracetamol input has reportedly almost doubled, while the price of some raw materials has increased by 40 to 50%.
Adesun said manufacturers have been able to pass on only a fraction of those increases because African markets are already economically weak.
The medications most sensitive to disruption are the basic building blocks of primary health care such as antibiotics, diabetes and hypertension medications, routine injectable medications, and common pain relievers.
In many African clinics, patients can expect to receive these medications every day.
Cold-chain drugs pose an even greater challenge. Vaccines, insulin and other temperature-sensitive medicines move largely through air cargo networks, making them particularly vulnerable to aviation disruptions in the Gulf.
Cargo experts warned that lost air capacity cannot be easily replaced, creating a backlog that could take weeks to clear.
A serious health crisis in Africa
The India-Africa Forum Summit, scheduled to begin in New Delhi tomorrow, was postponed due to the Ebola outbreak centered in the Democratic Republic of the Congo and Uganda.
WHO’s Africa Office reported at the end of 2025 that more than half of African countries were facing shortages of essential health products, including vaccines and tuberculosis drugs.
Sudan has reportedly seen vital medicines stranded in Dubai’s ports, while Botswana recently declared a public health emergency related to shortages of medicine and medical supplies.
For doctors, the results are immediate.
Medical professional and health communicator Rajeev Jayadevan said these interruptions in treatment could be dangerous for patients with chronic or infectious diseases.
“Patients are sometimes forced to reduce dosages or interrupt treatment altogether,” Jayadevan told DW.
He said the broader risk lies in how quickly supply shocks turn into system-wide stress in already fragile health systems.
“In settings with limited buffers and inconsistent supply chains, even small disruptions can translate into wide treatment gaps across facilities,” he said.
“For tuberculosis, interrupted treatment increases the risk of multi-drug-resistant TB, which is harder to treat and more expensive. For conditions like glaucoma, delays can lead to blindness.”
Can Africa reduce its dependence?
The current drug supply shock has revived the debate about local drug manufacturing in Africa.
Javin Bhinde, a pharmaceutical industry expert and director of India-based consultancy Syncor, told DW that India has deep structural roots on the continent.
“For many decades, India has supplied affordable, critically needed medicines, especially antiretrovirals, to Africa,” Bhinde said.
He said several major Indian pharmaceutical companies, including Cipla, Sun Pharma and Dr Reddy’s Laboratories, have set up subsidiaries and manufacturing facilities in Africa to strengthen local supply.
But Bhinde said the current conflict has exposed how fragile supply chains are.
“Shipments have been rerouted, logistics and insurance costs have increased and critical input materials for the Indian pharma industry are under pressure,” Bhinde said.
Pharmaceutical executive Adesun said Africa’s drug security challenge is about more than manufacturing more medicines locally.
Weak procurement systems, delayed public procurement, opaque distribution networks and poor supply-chain visibility often turn external shocks into full-blown supply crises.
“What looks like a drug price increase is actually a supply-chain sovereignty test,” Adesun said.
“Local manufacturing is essential, but it will not be enough unless it is linked to predictable purchasing, supply-chain visibility and last-mile accountability.”
Edited by: Wesley Rahn