Pooling drug reviews across Africa

What is it like to know that a new drug exists – and has been proven safe and effective – but that it simply isn’t available where you live, and you might die without it? This was the reality for millions of Africans during the AIDS crisis in the 2000s. Even when tenofovir was approved in the US in 2001, most Africans couldn’t access it for nearly a decade, instead having to rely on a cheaper but toxic alternative that roughly a third of patients would abandon due to its side effects. These delays have shortened but remain prevalent across much of the world today.
The new magazine In Development has a great article on one solution: pooling regulatory reviews across countries, so that manufacturers don’t have to file separately in each one and overstretched agencies don’t duplicate each other’s work. The European Medicines Agency effectively does this across Europe, and the African Medicines Agency, launched in 2025 to do something similar across Africa. I learnt a lot from the piece about how it came about and the problems it faces today. Some of the continent’s biggest pharmaceutical markets haven’t signed on, some countries refuse to accept each other’s assessments, and the whole project runs on donor funding without a clear path to self-sufficiency.