HealthCare Middle East & Africa - Issue 9

NO.1 HEALTHCARE & PHARMA INDUSTRY MAGAZINE

HealthCare MIDDLE EAST & AFRICA

PHARMA MANUFACTURING COMPANIES IN AFRICA

ANNE WAITA Co-Founder, Nairobi Radiotherapy and Cancer Centre THE WEIGHTY SHOWDOWN Big pharmas race to multi-billiondollar anti-obesity drugs market REVITALIZING AFRICA’S PHARMACEUTICAL LANDSCAPE: From dependency to innovation and self-sufficiency COUNTRY FOCUS : NIGERIA

NAIROBI RADIOTHERAPY & CANCER CENTRE

Uniting care and innovation in the fight against cancer in Kenya

DISEASE FOCUS: HIV/AIDS

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YEAR 2 | ISSUE NO. 9 NOV/DEC 2023

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EASTERN AFRICA’S BIGGEST HOSPITALS, WELLNESS & HEALTH TECHNOLOGIES TRADE SHOW CONFIRMED SPEAKERS

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STEVE OKEYO

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Group CEO, Hospital Holdings Investment

CEO, Kenya Healthcare Federation

Chair, Kenya Association of Pharmaceutical Industry

DR. AKUA OWUSU AMARTEY

PROF. JESSE OTEGBAYO

ELTON FREDRICK AFAR

Deputy CEO, Technical Operations, FDA Ghana

Chief Medical Director & CEO, University College Hospital, Ibadan, Nigeria

CEO, Equity Health Insurance, Ghana

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EDITORIAL

MIDDLE EAST & AFRICA

Year 2 | Issue No.9 | Nov-Dec 2023 FOUNDER & PUBLISHER Francis Juma SENIOR EDITOR Benjamin Opuko EDITORS Lorraine A. Wangui | Vincent Moranga BUSINESS DEVELOPMENT DIRECTOR Virginia Nyoro BUSINESS DEVELOPMENT ASSOCIATE Elly Okutoyi HEAD OF DESIGN Clare Ngode DESIGN Yvonne Njambi CINEMATOGRAPHER Newton Lemein ACCOUNTS Jonah Sambai

PUBLISHED BY: FW Africa P.O. Box 1874-00621, Nairobi Kenya Tel: +254 20 8155022, +254725 343932 Email: info@fwafrica.net Company Website: www.fwafrica.net

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HealthCare Africa (ISSN 2307-3535) is published 6 times a year by FW Africa. Reproduction of the whole or any part of the contents without written permission from the editor is prohibited. All information is published in good faith. While care is taken to prevent inaccuracies, the publishers accept no liability for any errors or omissions or for the consequences of any action taken on the basis of information published.

HIV/AIDS Chronicles: Milestones, innovations, and the ongoing quest for a cure that remains elusive

A

s we reflect on nearly four decades since the Pasteur Institute's discovery of the first case of Acquired ImmunoDeficiency Syndrome (AIDS), it's essential to consider the ongoing collective efforts against Human Immunodeficiency Virus (HIV). In 2022, approximately 39 million people worldwide were living with HIV. At the end of December 2022, 29.8 million people of people living with HIV had access to antiretroviral therapy, up from 7.7 million in 2010, indicating notable progress in access to antiretroviral therapy (ART) as reported

by UNAIDS. In this global context, the story of progress and challenges unfolds. While only five African countries met the ambitious 95-95-95 targets set by UNAIDS, the "FastTrack" targets strategy aims to prevent 28 million new HIV infections by 2030. The milestones along the HIV care continuum indicate advancements in treatment; however, disparities persist, particularly in developing nations where access to new antiretroviral drugs remains a significant challenge.

The evolution of HIV treatment has seen a significant transformation since the introduction of the first antiretroviral therapy in 1987. Currently, more than 30 antiretroviral drugs, including innovative long-acting regimens like Cabenuva and Lenacapavir, contribute to a dynamic market valued at US$22.38 billion in 2022, projected to reach US$25.49 billion by 2030.

Leading the global HIV treatment market are pharmaceutical giants such as Gilead Sciences, GlaxoSmithKline, and Merck & Co. The anticipation of new drugs and impending patent expirations signals the arrival of groundbreaking products like Sunlenca, VH184, Capsid, bNAbs, and the weekly pill Islatravir.

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In the realm of enhanced drug delivery systems, ViiV Healthcare leads with autoinjector devices for self-administration.

The prospect of ultra-long-acting treatments injected every four to six months signals a transformative shift in HIV care.

Preventive interventions, including long-acting injectable PrEP like Apretude, demonstrate a dedicated commitment to realizing an AIDS-free generation. Telehealth initiatives, exemplified by MYDAWA's project in Kenya, underscore the importance of accessibility and discretion in expanding the reach of PrEP. Despite strides in scaling up HIV services for children, the treatment gap persists.

Collaborations between Gilead Sciences, CHAI, and Penta ID network aim to address this gap with dispersible HIV treatments designed for children. UNICEF's report on children living with HIV emphasizes the urgent need for improved access to prevention, care, and treatment services.

While progress in HIV treatment has expanded, challenges persist, particularly in Africa. Ongoing trials of preventive HIV vaccine candidates and the relentless pursuit of antiretroviral therapies by the National Institute of Allergy and Infectious Diseases signal hope for transformative therapeutic options.

As we navigate the intricate landscape of HIV/AIDS, these milestones and innovations underscore the progress achieved and the challenges that demand humanity’s unwavering commitment. The quest for a cure remains elusive, but with each step in research, we move closer to a future free from the shadow of HIV/AIDS.

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HealthCare

1

Contents

24

NAIROBI RADIOTHERAPY & CANCER CENTRE Uniting care and innovation in the fight against cancer in Kenya

ANNE WAITA - Co-Founder, Nairobi Radiotherapy and Cancer Centre 2

YEAR 2 | ISSUE NO. 9 NOV/DEC 2023

NOV/DEC 2023 | HEALTHCARE MIDDLE EAST & AFRICA

IN EVERY ISSUE 4

Editorial 6 News Updates 26 Appointments Updates 63 Medical Devices & Innovations

20

TOP 10 Pharma manufacturing companies in Africa HEALTHCAREMEA.COM

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40

THE WEIGHTY SHOWDOWN Big pharmas race to multi-billion-dollar anti-obesity drugs market

REVITALIZING AFRICA'S PHARMACEUTICAL LANDSCAPE: From dependency to innovation and selfsufficiency

HEALTHCAREMEA.COM

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COUNTRY FOCUS: NIGERIA Nigeria's Healthcare System on the mend

DISEASE FOCUS: HIV/AIDS Significant milestones in HIV/AIDS care reached, as search for elusive cure remains

NOV/DEC 2023 | HEALTHCARE MIDDLE EAST & AFRICA

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NEWS UPDATES ACCREDITATION

Saudi German Hospital in Dammam Attains Center of Excellence Accreditation in Metabolic and Bariatric Surgery from Surgical Review Corporation SAUDI ARABIA — The Surgical Review Corporation (SRC) has conferred the Center of Excellence in Metabolic and Bariatric Surgery accreditation upon the Saudi German Hospital in Dammam, a part of the esteemed Saudi German Health (SGH) group. This recognition underscores SGH's commitment to delivering exceptional patient care and advancing innovations in weight loss and metabolic surgery. Makarem Sobhi Batterjee, President and Vice Chairman of Saudi German Health, expressed that the accreditation strengthens their dedication to medical excellence and comprehensive patient care, contributing to advancements in metabolic and bariatric surgery.

The recognition aligns with SGH's broader mission to establish the first-ever multi-site healthcare system outside the United States.

Recently launching the Sigma Theta Tau International Honor Society of Nursing chapter in Saudi Arabia, SGH continues to promote nursing research and evidence-based practice. The SRC's accreditation signifies the hospital's ability to provide high-quality care through a multidisciplinary approach, advanced technology, and qualified professionals in metabolic and bariatric procedures, demonstrating SGH's commitment to elevating healthcare standards. Makarem Sobhi Batterjee expressed pride in the achievement,

highlighting it as a significant milestone that reinforces SGH's dedication to excellence in healthcare.

PARTNERSHIP

Genentech and Nvidia join forces to revolutionize drug discovery with generative AI

USA — Roche's Genentech unit and Nvidia have entered into a groundbreaking partnership to transform the discovery and development of therapeutics through the utilization of generative artificial intelligence (AI). Head of Research and Early Development at Genentech, 4

Aviv Regev, highlights the potential of this collaboration, emphasizing the unlocking of scientific discoveries with incredible speed and unprecedented scale.

The initial focus is on optimizing Genentech's drug discovery AI models within its "lab in a loop" framework.

This innovative approach aims to unravel complex biomolecular patterns, enhancing the success rates of research and development. The "lab in a loop" methodology involves iteratively feeding extensive experimental data into computational models, creating an iterative loop that refines the computational model.

Genentech and Nvidia anticipate multiplicative benefits for patients and the broader healthcare ecosystem. The collaboration plans to utilize Nvidia's AI supercomputer in the cloud, DGX Cloud, to accelerate these models. Genentech

NOV/DEC 2023 | HEALTHCARE MIDDLE EAST & AFRICA

also aims to integrate Nvidia's BioNeMo, a generative AI cloud service for drug discovery, directly into computational drug discovery workflows.

This collaboration builds on Nvidia's recent investments in AI-led drug discovery and Genentech's commitment to AI as a tool to streamline drug discovery timelines.

THIS INNOVATIVE APPROACH AIMS TO UNRAVEL COMPLEX BIOMOLECULAR PATTERNS, ENHANCING THE SUCCESS RATES OF RESEARCH AND DEVELOPMENT.

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A SPECIAL PAVILION AT

EXPANSION

GE HealthCare strengthens presence in Saudi Arabia with Riyadh headquarters opening SAUDI ARABIA — GE HealthCare has inaugurated its new regional headquarters in Riyadh, Saudi Arabia, demonstrating its commitment to supporting the kingdom's Vision 2030 healthcare transformation agenda.

Mohammad El Khoury, General Manager for GE HealthCare in Saudi Arabia, emphasized the pivotal role the regional headquarters plays in fostering a resilient and sustainable healthcare industry. The move aligns with Saudi Arabia's Health Sector Transformation Program, a key component of Vision 2030.

GE HealthCare's expansion in the region also includes the launch of its

online service shop, catering to the specific needs of healthcare facilities.

The shop offers 24/7 access to medical equipment spares and accessories, supporting the uptime of GE Healthcare's devices. The company's presence in Saudi Arabia aims to drive progress and transformation in the healthcare sector, addressing evolving needs with innovative solutions. GE HealthCare is showcasing its state-of-the-art imaging devices and diagnostic solutions at the Global Health Exhibition in Riyadh, contributing to the kingdom's digital health goals and building an efficient, patient-centered healthcare ecosystem.

INVESTMENT

UK allocates £100 million for AI integration in life sciences and healthcare

UNITED KINGDOM — The UK government has earmarked £100 million (US$121.6 million) to accelerate the integration of artificial intelligence (AI) in life sciences and healthcare.

Prime Minister Rishi Sunak emphasized that these funds will be strategically directed toward areas where the swift implementation of AI holds the HEALTHCAREMEA.COM

most promise for groundbreaking advancements in the treatment of diseases, with a focus on conditions like cancer and dementia. This initiative is part of the Life Sciences Vision, involving key stakeholders to address healthcare challenges with agility.

The AI Life Sciences Accelerator Mission, backed by the UK’s strengths in secure health data and AI, aims to unlock innovation in healthcare. The funding will facilitate the exploitation of health data for timely identification of individuals at risk of dementia, supporting clinical trials and enhancing new treatments. The initiative also seeks to build data infrastructure and enhance lives of those with mental health conditions. Meanwhile, in the US, President Biden's executive order emphasizes AI safety, security, and equity in healthcare, aligning with global calls for enhanced regulation of AI in the health sector.

Landmark VPAG agreement to save £14 billion in NHS medicine costs over next five years

UNITED KINGDOM — The UK's National Health Service (NHS), along with the government and the Association of the British Pharmaceutical Industry (ABPI), has entered into a groundbreaking agreement called the Voluntary Scheme for Branded Medicines Pricing, Access, and Growth (VPAG). Set to reshape the NHS, the VPAG aims to save £14 billion (US$17.4 billion) in medicine costs over the next five years.

Running until December 31, 2028, the VPAG replaces the existing medicine pricing agreement and introduces measures to control spending on branded medicines. It features a yearly cap on total sales value, a levy for sales exceeding the cap, and an annual growth rate for sales. An affordability mechanism for older medicines is also included, supporting lower payment rates for more innovative medicines.

Health and Social Care Secretary Victoria Atkins and Chancellor of the Exchequer Jeremy Hunt lauded the deal, emphasizing its broad benefits, including savings, rapid access to medicines, and investments in research and manufacturing. The pharmaceutical industry will invest £400 million (US$499 million) over five years as part of the VPAG, contributing to UK innovation and healthcare initiatives.

The VPAG builds on the NHS's commercial capabilities and aligns with the government's commitment to life sciences.

NOV/DEC 2023 | HEALTHCARE MIDDLE EAST & AFRICA

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EASTERN AFRICA’S BIGGEST HOSPITALS, WELLNESS & HEALTH TECHNOLOGIES TRADE SHOW & CONFERENCE JULY 18-20, 2024 | Sarit Expo Centre, Nairobi, Kenya

Africa

Hospitals Expo

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The Africa Hospitals Expo (formerly Africa Health Expo) will bring together visitors and delegates from Africa and across the World to discover the latest in healthcare delivery services from leading local, regional and international hospitals and other healthcare and wellness providers to an audience from Kenya, Eastern Africa and Africa at large.

Look forward to engaging with leading specialty hospitals, multispecialty hospital chains, wellness and care centres plus providers of the latest personal health and wellness products and services from Africa and beyond.

Plan to attend the highly-engaging clinical talks that will be addressed by professionals and consultants in the healthcare sector in Africa.

CONTACT US:

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NEWS UPDATES WHO initiates global rollout of recommended malaria vaccine, beginning in Cameroon CAMEROON — A historic moment in the global fight against malaria has unfolded as shipments of the world’s first World Health Organization (WHO)recommended malaria vaccine, RTS,S, have commenced. The initial delivery of 331,200 doses arrived in Yaoundé, Cameroon, extending the vaccination effort beyond the countries involved in the malaria vaccine pilot program. This marks the beginning of a broader scaleup of vaccination efforts targeting the highest-risk areas across the African continent, where malaria poses a significant health threat, especially to children under five. Malaria accounted for 95% of global cases and 96% of related deaths in Africa in 2021.

Since 2019, Ghana, Kenya, and Malawi have administered the RTS,S vaccine through the Malaria Vaccine

Implementation

Programme

(MVIP),

resulting in a notable 13% reduction in all-cause mortality for eligible children.

The success of the pilot program has paved the way for a second malaria vaccine, R21, currently under WHO review for prequalification.

The comprehensive WHOrecommended package for malaria control involves various measures, and the introduction of vaccines is expected to strengthen overall access to malaria prevention, offering a significant breakthrough in combating the disease.

Key stakeholders, including Gavi, WHO, UNICEF, and partners, are collaborating to scale up malaria vaccination efforts, with the potential to save tens of thousands of lives annually. The global community anticipates the impact of this initiative as a game-changer in the fight against malaria.

FUNDING

Emzor Pharmaceuticals Secures €13.85 Million EIB Loan to Boost Local API Production in Nigeria

NIGERIA — Emzor Pharmaceuticals has achieved a groundbreaking milestone in addressing Nigeria's pharmaceutical production deficiencies by securing a €13.85 million (US$14.7 million) loan from the European Investment Bank (EIB). The financial agreement, 8

announced during the EU-Nigeria strategic dialogue, aims to support the construction of Sub-Saharan Africa's first Active Pharmaceutical Ingredients (APIs) manufacturing facility. The loan, covering up to 60% of the total project cost, is crucial for completing the stateof-the-art US$23 million plant, expected to be operational by February 2024.

Initially focusing on four anti-malaria APIs, the facility plans to expand into three more therapeutic areas, generating over 500 job opportunities. Emzor aims to reduce Nigeria's over 90% reliance on API imports, significantly impacting the pharmaceutical value chain and enhancing competitiveness against foreign counterparts. The strategic move aligns with the Nigerian government's Vision 2030 and Health Sector Transformation Program, emphasizing the importance of drug security and local manufacturing to combat diseases

NOV/DEC 2023 | HEALTHCARE MIDDLE EAST & AFRICA

like malaria, which poses a significant health concern in the region. The project contributes to elevating manufacturing standards, creating jobs, and advancing the provision of essential medicines in Nigeria and beyond.

THE FINANCIAL AGREEMENT AIMS TO SUPPORT THE CONSTRUCTION OF SUB-SAHARAN AFRICA'S FIRST ACTIVE PHARMACEUTICAL INGREDIENTS (APIS) MANUFACTURING FACILITY.

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GOVERNMENT & REGULATORY

Ugandan MPs urge Ministry of Health to harmonize CT-scan user fees UGANDA — The Committee on Government Assurances and Implementation in Uganda has urged the Ministry of Health to provide a consistent stance on user fees for computed tomography (CT) scan services at government hospitals. The call comes after an oversight visit to the eastern region revealed discrepancies in the Ministry's position on charges for CT scans. The Permanent Secretary of the Ministry of Health, Dr. Diana Atwine, had earlier directed the waiver of fees for CT scan services at Masaka Regional Referral Hospital, acknowledging that

patients from low-income families might be unable to afford the costs.

However, during the visit to Mbale Regional Referral Hospital, MPs discovered conflicting information, with hospital directors indicating charges for CT scans. The Committee emphasized the need for a uniform policy on CT scan fees across government hospitals to prevent exploitation and ensure consistency in service delivery.

Members of Parliament pledged to address the issue in the upcoming parliamentary session, considering it a matter of national importance.

INSURANCE

AAR Insurance Kenya introduces ShwAARi medical health cover for flexible and affordable healthcare solutions

KENYA — AAR Insurance Kenya has unveiled its latest product, the ShwAARi medical health cover, designed to provide flexible and affordable healthcare solutions for Kenyans. Launched simultaneously in Nairobi and across nine branches in key locations, ShwAARi features an innovative single-limit option, simplifying medical insurance and offering transparency and affordability. Dr. Patrick Gatonga, AAR Insurance Group CEO, emphasized HEALTHCAREMEA.COM

European Patent Office invalidates Moderna's COVID-19 vaccine patent

the commitment to improving clients' lives through quality healthcare services and acknowledged collaboration with key partners.

ShwAARi addresses the healthcare coverage gap, especially for individuals aged 50 and above, contributing to the solution for old-age-related disease burdens and financial strains on households. The product offers customizable options, premium payment flexibility, and coverage for dental and optical services, with sustainability embedded through a commitment to plant a tree for every policy issued.

AAR Insurance's collaboration with technology partner M-Tiba enhances the insurance process's simplicity and empowers individuals to manage their healthcare effectively. ShwAARi is hailed for its affordability, accessibility, and flexibility, marking a significant milestone in AAR Insurance's mission to enhance insurance penetration in Kenya while prioritizing health and wealth for all.

GERMANY — Moderna has encountered a significant setback as the European Patent Office invalidates the patent (European patent no. 3,718,565 B1) for its mRNA-based COVID-19 vaccine, Spikevax. This development led to a nearly 4% decline in Moderna's shares. The invalidated patent is crucial to Moderna's COVID-19 vaccine technology, covering betacoronavirus vaccines using RNA polynucleotides.

While the company plans to appeal, this decision adds complexity to Moderna's ongoing legal battles in the mRNA technology domain. The legal disputes involve Pfizer/BioNTech, Alnylam Pharmaceuticals, and Arbutus Biopharma. Moderna's claims have faced opposition from competitors, contributing to uncertainties in the legal landscape.

The European Patent Office's decision comes amidst declining demand for COVID vaccines, resulting in a reported 50% decline in third-quarter sales for Moderna. The legal costs associated with these lawsuits, along with financial strain, highlight the magnitude of the legal battles. Despite the challenges, Moderna anticipates optimistic sales projections for its vaccines. A favorable legal outcome could not only cover costs but also strengthen the company's patent defense.

NOV/DEC 2023 | HEALTHCARE MIDDLE EAST & AFRICA

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NEWS UPDATES

Alameda Healthcare Group and Varian forge strategic collaboration to elevate cancer care in Egypt and beyond EGYPT — Alameda Healthcare Group has entered into a significant memorandum of understanding (MoU) with Varian, a Siemens Healthineers company, aimed at revolutionizing cancer care in Egypt and beyond. The collaboration includes establishing an Alameda site as a reference center for Varian products in the Middle East and Africa, facilitating knowledge transfer, and developing cutting-edge medical technologies. Dr. Fahad Khater, Chairman of Alameda Healthcare Group, emphasized the commitment to elevating healthcare standards in Egypt.

The partnership builds on the technology roadmap agreed upon between Siemens Healthineers and Alameda, ensuring the installation, replacement, and maintenance of advanced medical technology across Alameda’s facilities. Laurent Amiel, President of Radiation Oncology Solutions at Varian, highlighted the collaboration's dedication to enhancing patient outcomes and expanding access to high-quality treatment. The MoU covers the supply and maintenance of Varian products, digital health solutions, education and training programs, clinical pathway advisory services, and support for hospital design. This collaboration signifies a transformative step forward in healthcare excellence and cancer care across Egypt, the Middle East, and Africa.

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PHARMACEUTICALS

Malaria vaccine linked to 13% decline in child mortality

AFRICA — The initial implementation of the first malaria vaccine has shown promising results, bringing hope for future advancements in malaria control. Dr. Kate O’Brien, Director of the Department of Immunization, Vaccines, and Biologicals at the World Health Organization (WHO), highlighted a 13 percent reduction in all-cause mortality

among eligible children in the pilot regions of Kenya, Ghana, and Malawi.

The vaccine, RTS, S/ASO1, demonstrated effectiveness in preventing malaria in children and is expected to have a significant public health impact, potentially saving nearly half a million lives annually in the African region. Building on this success, nine additional sub-Saharan African countries plan to introduce the vaccine into routine immunization programs in early 2024.

Dr. O’Brien also emphasized the growing global momentum in human papillomavirus (HPV) vaccination programs, with increased coverage and efforts to reduce cervical cancer burdens. However, concerns were raised about the global resurgence of measles, emphasizing the need for increased support to countries in re-establishing routine vaccination programs and preventing large-scale outbreaks of vaccine-preventable diseases.

PHARMACEUTICALS

Pharmaceutical giants compete in booming U.S. weight-loss drug market amid escalating obesity rates USA — Major pharmaceutical companies like Novo Nordisk and Eli Lilly are capitalizing on the soaring obesity rates in the United States with their respective weight-loss drugs, Wegovy and Zepbound. Novo Nordisk reported a remarkable 174% surge in obesity care sales in the first three quarters of 2023, primarily driven by Wegovy's success.

Eli Lilly strategically priced Zepbound at a 20% discount compared to Wegovy, aiming to attract employers to include weight-loss drugs in insurance benefit plans.

Approximately one-third of U.S. adults were classified as obese in 2021, prompting heightened demand

NOV/DEC 2023 | HEALTHCARE MIDDLE EAST & AFRICA

for effective weight-loss treatments.

Novartis and Eli Lilly face potential competition from Pfizer and Amgen, developing oral and injectable obesity medications, respectively. The success of these drugs may impact the medical device market and reduce reliance on weight-loss surgeries. Companies are emphasizing overall health benefits to increase insurance coverage, potentially making weight-loss management more accessible and affordable. The booming U.S. weight-loss drug market is projected to reach US$100 billion by 2030, driven by rising obesity rates and increasing demand for effective treatments.

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HEALTHCARE DELIVERY

The United Arab Emirates set to launch its first hospice compassionate community initiative, leveraging social capital to provide holistic end-of-life care.

The collaboration aligns with Burjeel Holdings' commitment to enhancing palliative care services in the UAE and is poised to transform the nation's healthcare landscape by offering extensive support to patients and families facing life-limiting illnesses.

UAE — Burjeel Holdings and Londonbased St. Christopher’s Hospice are set to revolutionize palliative care in the United Arab Emirates (UAE) through a groundbreaking partnership.

Dr. Neil Arun Nijhawan, Director of Palliative and supportive Care at Burjeel Cancer Institute, emphasized the initiative's goal to connect patients requiring palliative care with those willing to provide meaningful assistance.

The collaboration includes the establishment of the UAE's first hospice, functioning as a center of excellence in palliative care. The hospice aims

to create a supportive and serene environment for patients and their families, addressing the emotional, physical, and psychological aspects of end-of-life care.

This strategic alliance, supported by a memorandum of understanding (MOU), also encompasses joint research and educational initiatives, establishing a palliative care research base in the UAE. The partnership aims to develop specialized training pathways for healthcare professionals, ensuring the delivery of high-quality palliative care.

The hospice will be a focal point for a

THIS STRATEGIC ALLIANCE ALSO ENCOMPASSES JOINT RESEARCH AND EDUCATIONAL INITIATIVES, ESTABLISHING A PALLIATIVE CARE RESEARCH BASE IN THE UAE.

UAE, Indonesia to build a new 100-bed cardiology hospital in Surakarta INDONESIA — The Ministry of Foreign Affairs (MOFA) of the United Arab Emirates has officially announced a collaborative effort with the Ministry of Health of the Republic of Indonesia for the construction of a new UAEIndonesia Hospital for Cardiac Diseases in Central Java.

A cooperation agreement was signed by His Excellency Ahmed Ali Al Sayegh, the Minister of State to the UAE Cabinet, and Budi Gunadi Sadikin, the Minister of Health of Indonesia. The 100-bed cardiology hospital, located in Solo Techno Park in Surakarta, Central Java, aims to enhance the health sector in Indonesia with funding provided by HEALTHCAREMEA.COM

the UAE government.

Expressing gratitude, Gunadi Sadikin acknowledged the UAE's contributions, stating that the hospital's construction would accelerate healthcare and cardiological services, benefitting residents of Surakarta and surrounding areas. Ambassador Husin Bagis emphasized the facility's importance in strengthening ties between the UAE and Indonesia, contributing to sustainable development goals, particularly in the health sector. The UAE-Indonesia Hospital for Cardiac Diseases is poised to provide crucial medical services to the local population.

NOV/DEC 2023 | HEALTHCARE MIDDLE EAST & AFRICA

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NEWS UPDATES

Ibn Sina Pharma to invest over US$6.4 million in expanding operations and infrastructure in Egypt EGYPT — Ibn Sina Pharma, a prominent pharmaceutical player, is set to invest 200 million Egyptian pounds (over US$6.4 million) in Egypt within the next year. This strategic move follows the company's impressive financial performance, reporting a Q1 2023 revenue of EGP 72.554 million (US$2.3 million), marking a 22.18% YoY increase.

According to IQVIA, Ibn Sina Pharma currently holds a substantial 23.7% market share in the distribution of pharmaceuticals in Egypt, positioning itself as a leading player in the industry.

Mohamed Shawky, Head of Ibn Sina Pharma’s Investor Relations Sector,

highlighted the company's focus on improving cash receipts cycles, with

a notable reduction from nine days in September 2022 to one day in September 2023.

The company's EBITDA witnessed a remarkable 101% increase in the first nine months of 2023, reaching EGP 23.8 billion. Ibn Sina Pharma's investment plan aims to enhance its market share and profitability, focusing on imported products with higher profit margins. The funds will support marketing, distribution, and infrastructure upgrades, reflecting the company's commitment to expanding its footprint and technological capabilities in Egypt.

PARTNERSHIP

Dammam Pharma and MSD partner for localized diabetes medication manufacturing in Saudi Arabia Production is set to commence in the first quarter of 2024, as outlined in the cooperation agreement.

The signing ceremony, attended by the Minister of Industry and Mineral Resources Bandar Ibrahim Alkhorayef, signifies a significant milestone in enhancing diabetes treatment accessibility, contributing to economic growth, and supporting the goals of the National Strategy for Industry in Saudi Arabia.

SAUDI ARABIA — Dammam Pharma Co. has entered into a strategic partnership with Merck Sharp & Dohme International (MSD) to manufacture type 2 diabetes medications in the Kingdom of Saudi Arabia (KSA). This initiative aligns with the objectives of KSA's Vision 2030, focusing on increasing local production of safe, effective, and affordable pharmaceuticals.

Abdallah Nabil, General Manager of MSD in Saudi Arabia, emphasized the significance of the collaboration, marking a crucial step towards 12

localizing the pharmaceutical industry.

The project is poised to transfer highly specialized pharmaceutical technologies to the Kingdom, fostering new investment opportunities and generating employment.

The joint effort aims to establish the first-of-its-kind factory in the Middle East and North Africa (MENA) region for producing type 2 diabetes drugs.

The partnership not only addresses the anticipated demand within KSA but also paves the way for exporting these medications to regional markets.

NOV/DEC 2023 | HEALTHCARE MIDDLE EAST & AFRICA

THE JOINT EFFORT AIMS TO ESTABLISH THE FIRST-OF-ITSKIND FACTORY IN THE MIDDLE EAST AND NORTH AFRICA (MENA) REGION FOR PRODUCING TYPE 2 DIABETES DRUGS.

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Africa

Hospitals Expo

July 18-20, 2024 Sarit Expo Centre, Nairobi, Kenya

DISCOVER LATEST PHARMA TECHNOLOGIES & PHARMACEUTICAL COMPANIES.

WHAT’S ON SHOW? • Pharma manufacturers and distributors of drugs • Pharma manufacturing equipment and packaging • Pharmacy chains and chemists • Construction, plant and infrastructure solutions • Utilities and support services and equipment • Manufacturing and process automation solutions • Water and waste management solutions

info@fwafrica.net +254 725 343932 HEALTHCAREMEA.COM

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13

NEWS UPDATES

Bayer faces unprecedented US$8.3 billion market loss amid legal setbacks and drug study halt GERMANY — Bayer AG, the German pharmaceutical and agriculture giant, has encountered its most substantial market decline ever, witnessing a staggering €7.6 billion (US$8.3 billion) loss in market value.

The plunge is attributed to major legal setbacks and the discontinuation of a crucial drug-development study, prompting a share decline of up to 19% in Frankfurt trading.

New CEO Bill Anderson faces intensified pressure to articulate a robust turnaround strategy, including potential conglomerate breakup discussions. The challenges stem from Bayer’s troubled Monsanto acquisition, looming patent expirations, and recent legal defeats, including a €1.5 billion (US$1.6 billion) payout order related to weed killer Roundup.

The discontinuation of the experimental drug, asundexian, aimed at compensating for anticipated patent expirations, dealt a blow to Bayer's estimated peak sales and raises uncertainties about the company's future strategic moves.

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ACQUISITION

Merck & Co. to acquire Caraway Therapeutics for up to US$610 million USA — Merck & Co. is set to acquire Caraway Therapeutics, a private biotech firm, in a deal valued at up to US$610 million. The strategic move emphasizes Merck's expansion in neurodegenerative disease research.

Caraway specializes in studying cellular waste disposal mechanisms, with a focus on the ion channel TRPML1, crucial for lysosome-mediated waste removal. Merck's interest aligns with potential applications for treating Parkinson's disease and addressing rare diseases.

The deal involves an upfront payment, to be recorded this quarter, and milestone payments. The acquisition reflects Merck's confidence in Caraway's emerging pipeline and follows the pharmaceutical giant's broader trend

of significant dealmaking in 2023, including the acquisition of Prometheus Therapeutics and a substantial payment to Daiichi Sankyo for cancer drugs access.

FUNDING

ARCH Cold Chain Solutions Fund unveils state-of-the-art cold storage facility in Nairobi KENYA — The ARCH Cold Chain Solutions Fund has launched Cold Solutions Kenya, the continent's first-ofits-kind cold storage facility in Nairobi's Tatu City Special Economic Zone. With a significant US$81 million in funding, including a notable US$15 million from the European Investment Bank, the facility addresses critical challenges in pharmaceutical cold chain storage and distribution in Africa.

Serving as a holistic solution provider, the facility, spanning 17,700 square meters, focuses on pharmaceuticals with a capacity for 18,000 tonnes of temperature-sensitive goods.

It emphasizes environmental sustainability, targeting LEED Gold Certification and aiming for 30% of energy needs from off-grid renewable sources. The facility's sophisticated logistics system ensures traceability

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and accountability in the pharmaceutical supply chain. With expansion plans in key cities, it aims to reach a combined cold storage capacity of 100,000 tonnes, making impactful contributions to healthcare logistics, food safety, and waste reduction.

WITH A SIGNIFICANT FUNDING, THE FACILITY ADDRESSES CRITICAL CHALLENGES IN PHARMACEUTICAL COLD CHAIN STORAGE AND DISTRIBUTION IN AFRICA.

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INVESTMENT

Global Dental Services Group secures US$50 million investment from Qatar Investment Authority to expand presence across India

QATAR — Global Dental Services (GDS) Group has successfully secured a US$50 million equity investment from

the Qatar Investment Authority (QIA) to fuel its expansion plans in India.

GDS Group, the parent company of Clove Dental, a prominent tech-enabled dental platform in India, now owns and operates 340 clinics across 24 cities.

The strategic investment, following a recent US$66 million funding round, brings the cumulative investment to US$116 million.

The funds will be utilized to scale Clove Dental's clinic network, broaden service offerings, and develop a therapeutic oral care product range.

The investment aligns with the launch of a direct-to-consumer brand, LoveMySmile (LMS), focusing on smile correction solutions.

GDS emphasizes innovation, employing computer vision and AIbased technologies to maintain clinic

hygiene. QIA's investment signifies a diversification strategy into India's healthcare sector, marking a significant milestone in its expanding investment portfolio in the country's thriving economy.

THE FUNDS WILL BE UTILIZED TO SCALE CLOVE DENTAL'S CLINIC NETWORK, BROADEN SERVICE OFFERINGS, AND DEVELOP A THERAPEUTIC ORAL CARE PRODUCT RANGE.

UNAIDS urges revitalized support for community-led HIV initiatives amid declining funding SWITZERLAND — UNAIDS, in its annual World AIDS Day Report, has emphasized a critical shift towards communityled interventions in the fight against HIV. The report, articulated by UNAIDS Executive Director Winnie Byanyima, addresses concerns over diminishing financial support to community-led organizations, impacting HIV prevention and treatment services.

Byanyima underscores the detrimental effects of restrictive laws and policies on marginalized communities and calls for urgent action from governments and international partners. The report challenges the prevailing narrative, positioning communities as leaders rather than problems.

A UN political declaration aims for community-led organizations to deliver significant portions of testing, HEALTHCAREMEA.COM

treatment, and prevention services by 2025, with targets to eliminate punitive laws and reduce stigma.

Amidst the report's urgency, the recent

US Congress's failure to reauthorize funding for PEPFAR adds uncertainty to the future of the world's largest global health aid program.

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NEWS UPDATES

Jamjoom Pharmaceuticals to allocate US$10 million to Al Salam Bank Algeria, facilitating expansion into African markets ALGERIA — Jamjoom Pharmaceuticals Factory Company (Jamjoom Pharma) plans to disburse approximately US$10 million to Al Salam Bank Algeria, paving the way for its expansion into African and Francophone countries.

The funding is part of Jamjoom Pharma's strategy to explore and expand into key markets, reinforcing its position as a leading pharmaceutical

manufacturing organization in the Middle East and Africa.

The Saudi company, known for products across therapeutic areas, aims to utilize the banking facility to finance the acquisition of a pharmaceutical manufacturing facility and address short-term working capital requirements.

The move aligns with Algeria's

laws and supports Jamjoom Pharma's commitment to being a key strategic supplier to the Kingdom's public healthcare system, in line with Vision 2030 and the National Transformation Program. The company is also preparing for a domestic initial public offering to sell a 30 percent stake.

PHARMACEUTICALS

Novo Nordisk considers flexible pricing model for Wegovy to enhance global access DENMARK — Novo Nordisk CEO Lars Fruergaard Jørgensen has stated that the Danish pharmaceutical company has no plans to reduce the price of its weightloss drug Wegovy (semaglutide).

However, to improve global access to the drug, Jørgensen revealed that Novo Nordisk is exploring innovative "buy now, pay later" options. This approach involves discussions with healthcare systems to establish pricing models allowing upfront adoption of Wegovy, with payments deferred.

Jørgensen acknowledged the challenge of justifying substantial

upfront payments when long-term savings are anticipated. Wegovy, known for aiding weight loss, has demonstrated cardiovascular benefits, with a 20% risk reduction in major adverse events.

Novo Nordisk is introducing the drug in Europe, considering lower costs but potential reimbursement limitations.

The company aims to share the risk to facilitate broader adoption while maintaining flexibility in pricing schemes. Despite its high US list price, Novo Nordisk is working on making Wegovy more accessible globally, particularly in Europe.

WEGOVY, KNOWN FOR AIDING WEIGHT LOSS, HAS DEMONSTRATED CARDIOVASCULAR BENEFITS, WITH A 20% RISK REDUCTION IN MAJOR ADVERSE EVENTS.

DIGITAL HEALTH

PureHealth launches Dawak, an innovative online digital pharmacy platform in the UAE UAE — PureHealth has introduced Dawak, a pioneering online digital pharmacy platform aimed at simplifying medication access, purchase, and consumption for patients across the United Arab Emirates (UAE).

The Dawak application, part of PureHealth's global platform strategy, streamlines the prescription-delivery 16

ecosystem, providing a seamless experience with features such as medication administration, timely reminders, and comprehensive information.

Users can schedule drug delivery at their preferred time and location through the user-friendly platform.

The pilot phase, currently available to

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patients of Abu Dhabi Health Services (SEHA), aligns with the UAE's digital transformation journey. The Dawak platform, developed in collaboration with Dell Technologies, signifies PureHealth's commitment to healthcare innovation, artificial intelligence, and patient-centric solutions, contributing to the national vision of socio-economic growth.

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PARTNERSHIP

Saudi Ministry of Health collaborates with VitalAire Arabia to launch Diabetes Center of Excellence SAUDI ARABIA — The Ministry of Health of Saudi Arabia has partnered with VitalAire Arabia to establish a cutting-edge Diabetes Center of Excellence (CoE) in the region. VitalAire Arabia, a part of the international home healthcare company VitalAire, will lead the project, focusing on diabetes management, sleep apnea, and respiratory care. The CoE aims to treat around 6,000 Type 1 diabetes mellitus patients with a value-based healthcare approach, emphasizing high-quality services across the Kingdom of Saudi Arabia.

The center plans to enhance patient journeys through comprehensive education programs, individualized care

plans, and outcome measurement. The collaboration, marked by a Memorandum of Understanding, signifies the commitment to patient-focused healthcare solutions, contributing to the continuous improvement of care standards. VitalAire Arabia, with over 25 years of experience in diabetes therapy, aligns its ambition with the CoE's objectives, aiming to become a global leader in chronic patient care at home. With Saudi Arabia ranking high globally in diabetes prevalence, this collaboration aligns with the country's Vision 2030 and exemplifies a transformative step towards patientcentric healthcare services in the region.

UK reports first human case of swine flu strain H1N2, source under investigation

PARTNERSHIP

23andMe and GSK renew partnership with a US$20 million data licensing agreement

UNITED KINGDOM — Genetic-testing company 23andMe and pharmaceutical giant GSK have extended their collaboration through a non-exclusive data licensing agreement, giving GSK one year of access to 23andMe's extensive consumer DNA data repository for a substantial fee of US$20 million. This renewed partnership builds upon their five-year relationship, HEALTHCAREMEA.COM

enabling GSK to utilize genetic data from approximately 80% of 23andMe's gene-testing customers who consented to share their data for research.

While 23andMe is widely known for its consumer DNA-testing kits, this collaboration allows GSK to leverage the vast genetic database for pharmaceutical research. The companies' initial partnership in 2018 focused on identifying disease-relevant genes and drug targets. Under the new agreement, GSK will have full ownership of drug discovery programs initiated during the one-year access period.

In return, 23andMe may be eligible for downstream royalties in specific instances. The collaboration comes as 23andMe faces a security challenge, notifying customers about a breach in its "DNA Relatives" feature, which has prompted investigations and temporary disabling of certain features to ensure user privacy.

UNITED KINGDOM — The UK Health Security Agency (UKHSA) has confirmed the first human case of the H1N2 swine flu strain, resembling one found in pigs. The infected person, identified through routine surveillance, experienced respiratory symptoms and has fully recovered.

The UKHSA is conducting contact tracing to prevent further spread, with the source of infection yet unknown.

Despite no contact with pigs, questions about the origin persist. The H1N2 variant has caused around 50 global human cases since 2005, unrelated to the current strain genetically. Routine national flu surveillance, utilizing testing and genome sequencing, detected the case.

While early data suggests differences from previous cases, the investigation is ongoing, supported by veterinary and scientific expertise. The H1N2 strain in question is not linked to the 2009 swine flu pandemic, marking a distinct viral lineage.

APPOINTMENTS UPDATE Dr. Ezekiel Onyonka Mecha appointed first African representative on World Endometriosis Society Board

AAR Hospital appoints Dr. Aysha Edwards as new CEO KENYA — AAR Hospital has appointed Dr. Aysha Edwards as its new Chief Executive Officer (CEO), effective from November 9, 2023. Dr. Edwards, a highly qualified medical professional, holds a Bachelor of Medicine, Bachelor of Surgery (MBBS) degree, and a Postgraduate Degree in Emergency Medicine from the University of the West Indies. With over a decade of leadership experience, she has played key roles in Kenya and abroad.

Previously serving as the Director of Clinical Services at AAR Hospital, Dr. Edwards has been instrumental in commissioning the hospital, emphasizing patient satisfaction, operational efficiency, and expanding healthcare services. Her diverse experience includes roles as an emergency medical doctor, acting medical service and research director, and leading the establishment of a private wing for COVID-19 patients.

Dr. Edwards succeeds Dr. Ken Muma, the outgoing CEO, who served commendably for one-and-a-half years.

The appointment has been praised

by Steve Okeyo, the Group CEO, who expressed confidence in Dr. Edwards' leadership abilities, foreseeing positive impacts on patient care, community well-being, and fostering a culture of excellence within the institution.

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KENYA — Dr. Ezekiel Onyonka Mecha, a Senior Lecturer in the Department of Biochemistry at the University of Nairobi, has been appointed to the board of directors of the World Endometriosis Society (WES).

This significant appointment positions him as the first African representative on the board.

Endometriosis affects approximately

1 in 10 women globally, causing chronic inflammation and potential scar tissue outside the uterus. Dr. Mecha, previously on the Global Liaison Committee, is now the sole African representative on the board, emphasizing his dedication to endometriosis awareness and research.

He directs Endometriosis East Africa, focusing on diagnostic biomarkers and collaborating internationally. His advocacy in Africa includes seminars, media appearances, and forming an endometrial lobby. Dr. Mecha's role highlights global collaboration's importance in advancing endometriosis research. The World Endometriosis Society, committed to evidence-based practices, aims to enhance the lives of affected women through education, advocacy, clinical care, and research.

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Cardiology expert Dr. Vijaysinh Namdeo Patil takes helm at Nairobi West Hospital's Cath Lab and Interventional Cardiology Unit KENYA — Nairobi West Hospital welcomes Dr. Vijaysinh Namdeo Patil as the Director of the Cath Lab and Interventional Cardiology, heralding a new era in advanced cardiac care. With an illustrious career spanning over 12 years, Dr. Patil's extensive qualifications include an FNB in Intervention Cardiology and recognition as a Fellow of the Society for Cardiovascular Angiography and Interventions (FSCAI) and Fellow of the European Society of Cardiology (FESC).

The hospital expressed privilege at his appointment, anticipating collaborative efforts to enhance healthcare interventions and foreseeing a lasting impact on patient treatment outcomes.

Dr. Patil's notable achievements include pioneering surgeries in Kenya and substantial contributions to cardiac care innovation. His multifaceted expertise encompasses adult and cardiac interventions, structural heart disease therapies, and a range of diagnostic procedures. Nairobi West Hospital, committed to providing affordable, high-quality healthcare, continues its legacy of prioritizing the well-being of the community, with a focus on various medical specialties, including cardiology.

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FDA Names Dr. Namandjé Bumpus principal deputy commissioner, succeeding Janet Woodcock USA — Dr. Namandjé Bumpus, current Chief Scientist at the FDA, is set to become the agency's Principal Deputy Commissioner, succeeding Janet Woodcock, who retires in early 2024 after 35 years of service.

Dr. Bumpus, a driving force in the FDA's scientific initiatives, will continue the agency's commitment to being a

BD appoints Dr. Ronald Silverman as executive vice president and chief medical officer USA — Medical technology giant BD (Becton, Dickinson and Company) has appointed Dr. Ronald Silverman as its new Executive Vice President and Chief Medical Officer, effective December 4, 2023. Dr. Silverman, succeeding Dr. William Sigmund, will lead BD’s Medical Affairs organization, focusing on endto-end medical affairs across business units, regions, and the central team.

His role involves driving innovation in BD’s product pipeline to meet evolving patient needs and ensuring the safety and compliance of the existing product portfolio. With a wealth of experience, Dr. Silverman joins from 3M Health Care, where he served as Senior Vice President and Chief Medical Officer.

His transition follows 3M's strategic decision to spin off its healthcare business. Dr. Silverman, certified by The American Board of Plastic Surgery, brings a robust background, including academic appointments at the University of Maryland and Johns Hopkins schools of medicine, and notable contributions to patents, publications, and textbooks.

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Rentschler Biopharma appoints Dr. Günter Stempfer as Site Head for Laupheim facility

premier science-based organization. Her extensive background in drug metabolism and antiviral impacts positions her well for the role. Commissioner Robert Califf expressed confidence in Dr. Bumpus's ability to uphold the FDA's scientific legacy. As Chief Scientist, she played a pivotal role in advancing research, safety, and integrity. Her past involvement in crucial decisions, such as the withdrawal of controversial drug Makena, reflects her dedication to public health safety.

Her priorities as Principal Deputy Commissioner include overhauling the FDA's Office of Regulatory Affairs, responsible for inspections and safety-related actions. Dr. Bumpus faces the challenge of succeeding a legendary leader and aims to continue transparent and accessible public health communication.

GERMANY — Rentschler Biopharma, a leading contract development and manufacturing organization (CDMO) for biopharmaceuticals, has named Dr. Günter Stempfer as Site Head for its Laupheim facility in Germany, effective December 1, 2023. In this role, Dr. Stempfer oversees the Site Leadership Team, focusing on identifying improvement opportunities, ensuring the development and production of complex biopharmaceuticals, and implementing innovative changes.

Reporting to Chief Operating Officer Christiane Bardroff, Dr. Stempfer's appointment aims to enhance operational excellence and sustainability at the headquarters' site. With over 25 years of experience in the biopharmaceutical industry, including leadership roles at Sandoz and Novartis, Dr. Stempfer emphasizes efficient, accurate, and timely delivery, aligning with Rentschler Biopharma's commitment to providing effective medicines for seriously ill patients.

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TOP 10 PHARMA MANUFACTURING COMPANIES IN AFRICA By Market Capital

his article explores the top 10 pharmaceutical companies in Africa, emphasizing their market capitalization as of December 1, 2023. Derived from stock exchange listings such as JSE, Nigeria Stock Exchange, Egyptian Stock Exchange, and Moroccan Stock Exchange, the rankings highlight the companies leading in market value. The pharmaceutical industry's pivotal role in healthcare is underscored, driving medical advancements and contributing significantly to the global economy. Market capitalization, often referred to as Marketcap represents the total value of publicly listed

companies and is calculated by multiplying the share price by outstanding shares.

The African top 10 Pharma Companies ranking focuses on the biggest companies on Africa's stock exchanges, with the ranking determined by the market capitalization (total value of the listed shares) as of December 1, 2023. This ranking provides insights into Africa's pharmaceutical landscape, showcasing major players in the complex and vital market dedicated to researching, developing, manufacturing, and distributing drugs and healthcare treatments.

TOP 10 PHARMA MANUFACTURING COMPANIES IN AFRICA

1 Aspen Pharmacare Holdings As of December 2023, Aspen Pharmacare Holdings boasts a market capitalization of US$4.43 billion, positioning it as the 2729th most valuable company globally, according to data from African 'Xchanges. The market cap, a measure of a publicly traded company's total market value based on outstanding shares, solidifies Aspen Pharmacare's financial standing.

The current share price for Aspen Pharmacare Holdings (APN) stands at ZAR 184.56. On the Johannesburg Stock Exchange (JSE), APN concluded its recent trading day (Friday, December 1, 2023) at 185.26 ZAR per share, marking a 0.1% gain from the previous closing price of 185.13 ZAR. Aspen Pharmacare's year-to-date performance on the JSE reflects a notable 35.9% increase from its initial share price of 136.33 ZAR at the beginning of the year, securing its 25th position on the exchange.

The South Africa-based pharmaceutical giant operates 20

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globally, focusing on post-patent branded medicines across diverse markets. With 23 manufacturing facilities spanning 15 sites, Aspen Pharmacare holds a significant presence in both emerging and developed markets.

Additionally, as Africa's largest pharmaceutical company, Aspen Pharmacare has a substantial deal in place with Johnson & Johnson for vaccine supply, reinforcing its strategic role in the healthcare landscape. Listed on the JSE under the ticker symbol "APN," Aspen Pharmacare Holdings holds the 31st position in market value on the exchange, contributing about 0.425% to the Johannesburg Stock Exchange's equity market.

Country: South Africa Market cap: US$4.43 Billion Website: www.aspenpharma.com

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2

Sothema Pharmaceuticals

Sothema Pharmaceuticals, Morocco's leading pharmaceutical company, holds the top position in market capitalization for 2023, valued at US$732.59 million. Engaged in the representation, purchase, and sale of a diverse range of products, including pharmaceutical, chemical, health-related, biological, veterinary, plant-based, cosmetic, and scented items.

Sothema operates both in Morocco and overseas. CEO Lamia Tazi revealed the company's expansion strategy, indicating plans for a second plant in East Africa following its venture in Senegal, where it produces various products, including anti-malarial drugs. Tazi expressed that the company has been exploring opportunities in East Africa for the past two years and anticipates raising capital once a partnership

deal is secured.

Sothema's growth aligns with Morocco's broader plan to extend health insurance, contributing to the surge in demand for pharmaceuticals within the second-largest pharmaceutical industry in Africa. Additionally, Sothema is actively developing cannabis-based treatments for pain management and epilepsy, with an expected market release in the next two years. Despite inflation impacting production costs, Sothema reported a 9.3% profit growth last year, reaching 282 million dirhams (US$27.2 million).

Country: Morocco Market cap: US$732.59 million Website: www.sothema.com

3 Adcock Ingram Holdings Ltd. Adcock Ingram Holdings Ltd., a prominent South African pharmaceutical manufacturer, holds a market capitalization of ZAR 9.16 billion (US$ 487098022), contributing approximately 0.047% to the total equity market of the Johannesburg Stock Exchange. Listed on the Johannesburg Stock Exchange (JSE) under the ticker symbol "AIP," Adcock Ingram is committed to delivering high-quality products that enhance health and wellbeing in the markets it serves. The current share price for Adcock Ingram Holdings Ltd. (AIP) stands at ZAR 54.00*US$ 2.87). Closing at 54.00 ZAR per share on the JSE's last trading day (Friday, December 1, 2023), AIP experienced a 0.4% decrease from its previous closing price of 54.21 ZAR (US$ 2.88). Initiating the year with a share price of 50.50 ZAR,

Adcock Ingram has achieved a 6.93% increase in its year-todate performance, ranking 141st on the JSE. Over the past three months (Sep 5 - Dec 1, 2023), Adcock Ingram Holdings stands as the 167th most traded stock on the Johannesburg Stock Exchange. With a total traded volume of 7.43 million shares, valued at ZAR 399 million, AIP recorded an average of 117,957 traded shares per session across 14,476 deals during this period. Notably, the stock reached a volume high of 1.48 million on November 28th and a low of 961 on November 23rd.

Country: South Africa Market Cap: US$489.8 million Website: www.adcock.co.za

4 Egyptian International Pharmaceuticals (EIPICO) Egyptian International Pharmaceuticals (EIPICO), a prominent player in the Egyptian pharmaceutical industry, holds a market value of US$187 million. Specializing in antibiotics, lyophilized products, and spansule capsules, EIPICO boasts a diverse portfolio of 400 pharmaceutical products across 25 therapeutic classes. The company has secured its position as a leader in Egypt, commanding a 22% market share of the nation's total pharmaceutical product exports in 2021.

EIPICO extends its influence beyond Egypt's borders, exporting its products to over 70 countries, encompassing regions in Europe, Africa, Asia, Latin America, and

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Commonwealth countries. Notably, the company plays a crucial role in Egypt's pharmaceutical export landscape, contributing 26% of the country's total pharmaceutical product exports. EIPICO's commitment to manufacturing high-quality pharmaceuticals has established it as a key player in both the domestic and international markets. For further details, the company's website can be accessed at www.eipico.com.eg.

Country: Egypt Market value: US$187 million Website: www.eipico.com.eg

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TOP 10 PHARMA MANUFACTURING COMPANIES IN AFRICA By Market Capital 5 Ibsinia Pharma

Ibnsina Pharma, a key player in Egypt's pharmaceutical sector, commands a market value of US$137 million. Initially founded in 2001 as Ibnsina Laborex Pharma, a pharmaceutical distribution company in collaboration with the French Eurapharma Group, it underwent a significant transformation in 2006. At that time, the Egyptian partners acquired full ownership, leading to its rebranding as Ibnsina Pharma.

Specializing in pharmaceutical distribution, Ibnsina Pharma manages a robust portfolio comprising products from over 350 Egyptian and multinational companies. Catering to a vast clientele of more than 35,000, including pharmacies, hospitals, retail outlets, and wholesalers, the company has positioned itself as a major distributor in the region.

Ibnsina Pharma's impressive client roster includes over 46,000 customers in Egypt, with notable suppliers such as

6 Minapharm Pharmaceuticals

Minapharm Pharmaceuticals, a leading force in Egypt's pharmaceutical sector, commands a market value of US$89 million. Renowned for its steadfast dedication to scientific excellence and patient well-being, Minapharm is a key player in the pharmaceutical landscape. The company boasts a diverse portfolio of medications covering various therapeutic areas, such as immunology, infectious diseases, and oncology, reflecting its commitment to addressing healthcare challenges through innovative solutions. Minapharm's cutting-edge research and development endeavors underscore its pledge to deliver highquality treatments.

The roots of Minapharm Pharmaceuticals trace back to the 1950s with the establishment of the first privately-owned factory

7 MeCure Industries

MeCure Industries, a company listed on the Nigerian Stock Exchange (NGX) since November 7th, 2023, trades under the ticker symbol “MECURE” on the NGX. A total of 4,000,000,000 (Four Billion) ordinary shares were admitted to trading, representing the total issued share capital of the Company, with one of the largest market capitalization on the Standard Segment of the NGX’s Growth Board.

MeCure Industries currently stands as the 41st most valuable stock on the NGX, holding a market capitalization of NGN 52 billion (US$65.86 million), representing approximately 0.133% of the Nigerian Stock Exchange equity market.

As of the last trading day on December 1, 2023, MeCure Industries closed at a share price of NGN 12.99, recording an 8.3% gain from its previous closing price of 12.00 NGN (US$0.015). The company's remarkable performance is further highlighted by its IPO day closing 22

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Pfizer, Glaxo, and AstraZeneca. The company operates a nationwide distribution network, boasting more than 50 operational sites, including distribution hubs and central warehouses, supported by a fleet of approximately 600 vehicles.

In a strategic move, the company expanded its reach by establishing AIM for investment and consulting in healthcare in November 2020, coupled with the acquisition of a 75% stake in "3elagi tech" for US$1.4 million. Subsequently, in November 2021, Ibnsina further diversified its portfolio by founding Ramp Logistics and Digi 360 Software, reinforcing its commitment to innovation and growth in the healthcare sector.

Country: Egypt Market value: US$137 million Website: www.ibnsina-pharma.com

in Egypt, Heliopolis Pharmaceutical Laboratories. Although activities ceased in the 1960s, it re-emerged as Minapharm Pharmaceuticals in 1992, marking a new era of growth. The company, employing 1,400 people, has positioned itself as a significant contributor to the healthcare sector.

In a notable development, Minapharm Pharmaceuticals, along with its wholly-owned Berlin-based subsidiary, ProBioGen AG, announced the creation of ProBioGen's subsidiary, MiGenTra, in Berlin in May 2021.

Country: Egypt Market value: US$89 million Website: www.minapharm.com

price of 2.96 NGN (US$0.0037) on November 7, 2023, resulting in an impressive 339% gain, ranking it 12th on the NGX in terms of yearto-date performance.

MeCure Industries has emerged as the 39th most traded stock on the Nigerian Stock Exchange in the past week (Nov 24 - Dec 1, 2023). With a total trading volume of 15.7 million shares across 803 deals, valued at NGN 170 million, the average number of shares traded per session is 2.62 million (US$3,268). Notably, the volume reached a peak of 4.73 million on November 28th, while the lowest recorded volume was 1.38 million on November 29th during the same period.

Country: Nigeria Market cap: US$65.86 million Website: www.mecure.com HEALTHCAREMEA.COM

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Africure Pharmaceuticals Ltd

Africure Pharmaceuticals Ltd, established in 2017, is a prominent player in the African pharmaceutical landscape with a market capitalization of US$57.07 million. Functioning as a manufacturer and distributor, the company specializes in providing high-quality essential medications across the continent. Holding a Global Business Licence issued by the Financial Services Commission, Africure's core activities include investment holding, pharmaceutical product trading, and procurement. Boasting a diverse portfolio of nearly 300 products, the company addresses various therapeutic areas, offering critical care solutions for non-communicable diseases prevalent in Africa.

Listed on the Stock Exchange of Mauritius, Africure

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anticipates achieving annual revenues of approximately US$35-36 million, driven by the sustained growth of its core businesses. The company expresses gratitude to its stakeholders, including employees, customers, and investors, for their unwavering support. The company aims to enhance local manufacturing capacities in Sub-Saharan Africa, fostering self-sufficiency and reducing dependence on pharmaceutical imports.

Country: Mauritius Market Cap: US$57.07 million Website: www.africurepharma.com

Cipla QCIL

Cipla Quality Chemical Industries Limited (Cipla QCIL), listed on the Uganda Securities Exchange (USE) since September 17th, 2018, holds a market capitalization of US$50.4 million, securing its position as the 12th most valuable stock on the USE, contributing approximately 1.19% to the Uganda Securities Exchange equity market.

Cipla QCIL commenced the year with a share price of UGX 60.00 (US$ 0.16), experiencing a 12.5% decline in valuation, ranking it ninth on the USE in year-to-date performance.

Over the past three months (Aug 31 - Dec 1, 2023), Cipla QCIL stands as the sixth most traded stock on the Uganda Securities Exchange, recording a total volume of 1.34 million shares valued at UGX 77.6 million (US$20,362).

Notably, a volume high of 812,200 shares was achieved on November 21st during this period.The recent acquisition

by Africa Capitalworks SSA 3, a Mauritius-based investment

vehicle, marked a significant shift in ownership from India's Cipla Group. Valued at US$25 million (UGX 94.2 billion), this transaction ensures Africa Capitalworks becomes the new majority shareholder, acquiring a 51.18 percent stake.

The acquisition secures essential rights to technology for manufacturing antiretroviral drugs and antimalarials for Cipla QCIL. While the company will undergo a name change, dropping "Cipla" and reverting to "Quality Chemical Industries Ltd," the management remains unchanged. The strategic move

by Africa Capitalworks signals a new phase of collaboration for increased growth in the healthcare sector within the region.

Country: Uganda Market Cap: US$50.4 million Website: www.ciplaqcil.co.ug

10 Fidson Healthcare Limited Fidson Healthcare Limited, a prominent player in the pharmaceutical industry in Nigeria, specializes in the manufacturing and sale of pharmaceutical and nutraceutical products. The company's diverse product portfolio includes over-the-counter, consumer products, spanning various drug classes such as antacid and ulcer care, anti-diabetic, antimalaria, anti-diarrhea, anti-psychotic, osteo-care, pain relief, colds and flu, thrombo-prophylactics, and cardio-vascular products. Established in 1995 with its headquarters in Shomolu, Nigeria, Fidson Healthcare has been a listed entity on the Nigerian Stock Exchange (NGX) since April 6th, 2008. Trading under the ticker symbol “FIDSON” on the NGX, the company currently holds the 48th position in market valuation on the exchange, with a market capitalization of NGN 39 billion HEALTHCAREMEA.COM

(US$49.40 million), representing approximately 0.1% of the Nigerian Stock Exchange equity market.

Over the past three months (Sep 4 - Dec 1, 2023), Fidson Healthcare stands as the 80th most traded stock on the Nigerian Stock Exchange. During this period, it demonstrated a total trading volume of 29.5 million shares, involving 2,084 deals, with a total value of NGN 440 million (US$0.55 million).

The average number of traded shares per session reached 467,488.

Country: Nigeria Market cap: US$49.40 million Website: www.africurepharma.com

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NAIROBI RADIOTHERAPY & CANCER CENTRE Uniting care and innovation in the fight against cancer in Kenya USER INTERFACE OF REMEDIAL HEALTH DIGITAL APP

By BENJAMIN OPUKO 24

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COMPANY FEATURE: The Nairobi Radiotherapy and Cancer Centre

ANNE WAITA - CO-FOUNDER, RADIOTHERAPY AND CANCER CENTRE

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n the heart of Nairobi's bustling Kilimani area, tucked away behind the Coptic Hospital, lies a beacon of hope that has touched the lives of countless individuals in their battle against cancer. The Nairobi Radiotherapy and Cancer Centre (NRCC) is more than just a medical facility; it is a testament to the enduring power of dedication, innovation, and the unwavering belief that quality healthcare should be within reach for all. Established by the visionary Mrs. Anne Waita and her partner in the year 2005, the journey of NRCC, from its humble origins in a modest room to its current status as a state-of-the-art cancer treatment centre, is nothing short of extraordinary.

Reflecting on those early days, Mrs. Waita, the Co-founder of NRCC, fondly recollects, "Back then, we were both employed, grappling with our own work-related challenges. So, we ventured into side hustles. I distinctly recall our humble beginnings, crafting red herring gum with a

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small poker machine. Have you ever seen those peculiar growths that people sometimes get after shaving? Those unsightly bumps, often blue, that can appear anywhere on the body? That's where we started, with that machine. At the time, there was virtually no competition in the region."

Armed with sheer determination and an unwavering commitment to their vision, Anne and her partner embarked on their journey from a single room, initially offering superficial radiotherapy services, primarily focusing on conditions like keloids and mycosis fungoides.

However, their aspirations knew no bounds.

"Starting out in a single room, we eventually outgrew our space and sought a more suitable location. Some high-class hotels didn't quite meet our clients' needs, so we faced the challenge of relocating to a private medical center. Due to the size of the machines, we could only secure a basement space at the Upper Hill Medical Center.

It was there that we acquired a larger machine, enabling us to expand our radiotherapy work and broaden our services," Mrs. Waita explains.

As the demand for deep therapy treatment grew, NRCC made a significant leap forward by acquiring a 250Kv Orthovoltage equipment in October 2008. This technological advancement allowed them to provide both superficial treatment (SXT) and deep therapy treatment (DXT), addressing cancerous tissues on the skin's surface and deep within the body.

Recognizing this transformative growth and service expansion, the center rebranded itself as the Nairobi Radiotherapy and Cancer Centre, officially becoming a limited company on April 24, 2009.

"Fast forward to 2018, nearly two decades later. Yes, that's right, around 18 years to be precise. When we began in 2005, our business was modest. We even stored our machine in a garage, sharing office space with several other doctors. We've come a long way from there," Mrs. Waita narrates with a profound sense of pride.

As the business continued to thrive, Anne made the life-altering decision to leave her corporate job and commit herself fully to managing NRCC. Assuming the role of general manager, she embraced the responsibilities that came with running the business. Little did she know that the future held even greater challenges and opportunities on this remarkable journey.

Today, NRCC stands tall as a symbol of hope, extending vital cancer treatment services to patients not only in Nairobi but also in Embu and Nyeri, courtesy of its strategically HEALTHCAREMEA.COM

located branches. The accreditation from NHIF for oncology services further solidifies its unwavering commitment to ensuring that cancer treatment is accessible to all Kenyans.

A COMPREHENSIVE HEALTHCARE ECOSYSTEM In Kenya, where infectious diseases and cardiovascular conditions have long been the predominant health concerns, cancer has quietly emerged as the nation's third-leading cause of morbidity. Precise national data on this growing issue remains elusive, but estimates paint a grim picture: approximately 39,000 new cancer cases arise each year, resulting in the tragic loss of over 27,000 lives. What's even more concerning is that 60% of these cases affect individuals under the age of 70. Amidst a troubling rise in cancer incidence, the Nairobi Radiotherapy Centre Ltd. (NRCC) stands as a beacon of hope and a healthcare ecosystem that transcends the conventional role of a treatment facility. Within its walls, a network of vital units collaborates tirelessly in the unrelenting battle against cancer.

Nairobi Radiotherapy and Cancer Centre

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embodies a comprehensive approach to cancer care, including personalized treatment planning, advanced radiotherapy, empathetic chemotherapy services, accessible medication therapy management, clinical pathology support, blood transfusion services, bone disease diagnosis, and a wide array of patient-centric services. Going beyond medical care, NRCC acknowledges the profound psychological and emotional challenges of cancer, offering counselling and support for patients and their families.

Mrs. Waita, the driving force behind NRCC, emphasizes the dedication of her staff, stating, "Our team boasts years of experience in the field of oncology, and their unwavering commitment to delivering the highest standards of care and support to our patients, families, and caregivers is unparalleled. We believe in a holistic approach to nursing care, acknowledging that patients have unique physical, psychological, and spiritual needs." Mrs. Waita deeply values her team's contributions, saying, "I appreciate my team every day for their unwavering commitment to caring for very sick patients with compassion

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COMPANY FEATURE: The Nairobi Radiotherapy and Cancer Centre

and a smile. They make the challenging work look effortless, and I am truly grateful for their dedication."

Recognizing the vital role her team plays, Mrs. Waita invests in their continuous training and development, stating, "I believe that by empowering our staff with knowledge and skills, we can provide even better patient care and achieve improved outcomes. Additionally, fostering a culture of learning and growth is not only beneficial to our team but also vital for our business as it allows us to create more partnerships and collaborations within the healthcare community."

FORGING CRUCIAL PARTNERSHIPS FOR AFFORDABLE CANCER CARE “One of the pivotal strategies we've diligently implemented at NRCC involves forging robust partnerships with all major insurance companies, including the National Hospital Insurance Fund (NHIF). We fully recognize that cancer treatment often comes with a substantial financial burden, and the out-of-pocket expenses can prove insurmountable for many patients," Mrs. Waita passionately elaborates.

Despite the formidable financial challenges,

CUTTING-EDGE NM 830 SPECT/CT SYSTEM AT NAIROBI RADIOTHERAPY AND CANCER CENTRE

ERGONOMIC PATIENT TROLLEY'S AT NAIROBI RADIOTHERAPY AND CANCER CENTRE.

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also consumes valuable time." Consequently, she emphasizes, "We have dedicated ourselves to establishing a holistic approach to patient management, one that comprehensively addresses all facets of their care."

Mrs. Waita astutely points out, "Cancer is, in essence, a chronic illness, distinct from acute conditions like malaria, which may involve prescribing medication and sending the patient home." She underscores, "Our commitment to our patients extends far beyond the mere provision of treatment. We remain deeply engaged with them, offering unwavering support and care throughout their journey. It's imperative to emphasize that our compassionate approach is not limited to the patient alone; we extend our steadfast support to their caregivers, recognizing the profound impact of cancer on the entire support network."

NRCC remains resolute in its commitment to making cancer care accessible. "It's heartening to note that a significant majority of Kenyans are now covered by NHIF, with approximately 95% of the population enrolled," she proudly declares.

"To ensure that patients can access our services, especially as they commence their treatment journeys, we engage in close collaboration with them to explore various financing options. Our overarching objective is to proactively address any potential financial obstacles early in the treatment process. Our strategic focus revolves around delivering top-tier, yet affordable, healthcare."

Furthermore, NRCC wholeheartedly acknowledges that cancer patients often grapple with additional health issues, such as hypertension or diabetes. To streamline and simplify the healthcare journey, we have painstakingly designed our facilities to encompass comprehensive care under one roof.

Mrs. Waita highlights the conventional practice, stating, "The conventional practice of treating cancer in isolation and then directing the patient to separate facilities for other health concerns not only escalates costs but

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NRCC’S QUEST FOR CUTTING-EDGE RADIATION THERAPY TECHNOLOGIES At NRCC, commitment to embracing cuttingedge radiation therapy technologies goes beyond being a mere choice; it's a deeply ingrained commitment that defines its mission. Mrs. Waita firmly declares, "Technological advancements are reshaping the landscape of cancer treatment and the broader medical field. We are steadfast in our dedication to investing in technology and nurturing collaborative relationships with fellow medical centres."

This unwavering commitment to staying at the forefront of technological progress is an integral part of NRCC's identity. Mrs. Waita explains, "In the past, acquiring advanced equipment represented a significant capital investment. However, the healthcare arena has evolved, and numerous manufacturers now offer innovative partnership models that alleviate the need for outright purchase."

She continues, "Instead, we have the option to enter into rental agreements, which allows us to maintain financial flexibility and ensure our equipment remains up-to-date with the latest technological advancements. This is truly a game-changer in the field, and it aligns perfectly with our active pursuit of excellence. The only challenge we encounter relates to government taxation policies, which can place a substantial burden on us."

When it comes to our collaborative efforts with equipment manufacturers, there is no onesize-fits-all solution. Mrs. Waita underscores this point, saying, "We engage with a diverse range NOV/DEC 2023 | HEALTHCARE MIDDLE EAST & AFRICA

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COMPANY FEATURE: The Nairobi Radiotherapy and Cancer Centre

AN INSIDE VIEW OF ONE OF THE CANCER PATIENTS' WARDS, FEATURING A COMFY HOSPITAL BED.

OUR AIM IS TO INSPIRE INDIVIDUALS TO PROACTIVELY SEEK HEALTHCARE, ENGAGE IN SCREENING, AND MAKE LIFESTYLE CHOICES THAT CONTRIBUTE TO THEIR OVERALL WELL-BEING. TO ACHIEVE THIS, WE'VE INSTITUTED VARIOUS PROGRAMS AND INITIATIVES. of multinational companies, including our close partnership with GE HealthCare. While we are still in discussions regarding a specific equipment acquisition deal due to the high associated costs, it remains a matter of priority. Recent economic challenges may have temporarily slowed down the process, but we remain committed to making this investment within the next two years."

She further emphasizes the diversified approach NRCC adopts: "It's important to understand that there isn't a single company that can fulfill all our requirements. We strategically partner with various manufacturers to address distinct aspects of our cancer centre’s needs.

For example, we collaborate with BD for 30

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certain requirements, while another company supports our laboratory needs. This diversified approach ensures that we have access to the best equipment and technology available across different domains of our Cancer Centre."

SPREADING HOPE AND HEALTH THROUGH CORPORATE SOCIAL RESPONSIBILITY At the Nairobi Radiotherapy and Cancer Center (NRCC), a profound commitment to corporate social responsibility unfolds, extending far beyond the realm of medical treatment. Mrs. Anne Waita reveals, "The Nairobi Radiotherapy and Cancer Center operates in Kilimani, with additional branches in Nyeri and Embu. We're dedicated not only to the treatment of cancer patients but also to the broader mission of raising awareness and promoting a healthy lifestyle within the community. Our aim is to inspire individuals to proactively seek healthcare, engage in screening, and make lifestyle choices that contribute to their overall well-being. To achieve this, we've instituted various programs and initiatives."

Even amid the challenges posed by the COVID-19 pandemic, NRCC remained resolute in its commitment to the community through an

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array of programs. Mrs. Waita explains, "One of the programs we've been actively involved in is community outreach. Even during the peak of the COVID-19 pandemic, we collaborated closely with Nairobi County to conduct these initiatives, which allowed us to reach out to the community, provide vital information, and raise awareness about cancer prevention and early detection."

Within NRCC itself, a beacon of support resides—a dedicated support group comprising both patients and caregivers. These individuals are not just beneficiaries but also powerful advocates, spreading awareness in their respective communities. Mrs. Waita highlights, "Particularly, October is a busy month for us as it marks Breast Cancer Awareness Month. During this time, we engage in various activities and call upon our support group members to participate actively in spreading the message of early detection and prevention."

Collaboration stands as a cornerstone of NRCC's corporate social responsibility. Mrs. Waita elaborates, "Furthermore, we actively collaborate with other cancer-focused organizations and groups. For instance, we've partnered with a national group for cancer patients. Whenever they conduct outreach programs, they involve

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us to provide the crucial medical aspect of these outreach efforts."

"This includes screenings and medical guidance. We also participate in events such as walks organized by these groups, demonstrating our support and unwavering commitment to the cause. Our ultimate goal is to underscore that cancer is a manageable condition, especially when detected early in stages one or two, as opposed to more advanced stages. By actively engaging in these community efforts, we aim to make a significant impact on raising awareness and encouraging healthier lifestyles and proactive healthcare-seeking behavior in the community," Mrs. Waita emphasizes.

However, NRCC's commitment transcends geographical boundaries. She states, "We are firmly committed to reaching out to as many communities as possible whenever we are called upon, and this extends beyond our immediate area. In Nyeri, for instance, we collaborate with Consolata Mathari Hospital, one of Kenya's largest hospitals. Through this partnership, we can reach communities by leveraging the network of churches, particularly the Catholic Church, which plays a significant role in healthcare outreach."

AN NRCC LAB TECHNOLOGIST PERFORMING A BIOPSY TEST

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COMPANY FEATURE: The Nairobi Radiotherapy and Cancer Centre

PRIORITIZING RADIATION SAFETY AND COMMUNITY WELL-BEING In the realm of ionizing radiation, safety is not just a priority – it's an absolute imperative. At the Nairobi Radiotherapy and Cancer Centre (NRCC), the commitment to ensuring high levels of safety for both employees and the surrounding community is not just a duty; it's a way of life.

Mrs. Waita reveals, "Regarding safety measures, especially concerning ionizing radiation, ensuring the highest level of quality and safety is paramount for both our patients and the surrounding community. We have several measures in place to guarantee safety."

In the complex world of radiation therapy, where the invisible force of ionizing radiation holds the key to cancer treatment, NRCC has constructed a fortress of safety measures to protect all involved. She continues, "First, all the walls housing our equipment are constructed with lead, which is a standard procedure to contain radiation. Additionally, we have a dedicated team responsible for quality assurance and safety. This team conducts regular checks to ensure that there are no leaks or irregularities in the radiation shielding, which is essential for both the community and our team."

The emphasis on safety is not confined to structural integrity alone. NRCC has implemented a system that places each individual working in the radiation room under a protective shield of information and monitoring. Mrs. Waita explains, "Furthermore, we employ a system where every individual working in the radiation room wears a dosimeter badge. This dosimeter badge measures the amount of radiation exposure an individual receives."

These unobtrusive badges serve as vigilant guardians, silently tracking the radiation dosage each employee encounters during their noble work of saving lives. She continues, "At the end of each month, these dosimeters are sent to an institution we collaborate with, which thoroughly reviews and checks the radiation exposure levels for each person. This process ensures that everyone working with the equipment is within the recommended dosage limits and adheres to safety standards.

We maintain meticulous records for each month and compile annual reports, which are crucial in retaining our license to operate."

Mrs. Waita firmly affirms, "Our commitment to safety and quality is unwavering, and we take every precaution necessary to protect both our patients and our team.

NAVIGATING THE CHANGING LANDSCAPE OF CANCER CARE However, the journey towards progress is fraught with formidable challenges. Mrs. Waita paints a stark picture of these hurdles, underscoring their gravity. She reveals, "Recent statistics from the National Cancer Institute of Kenya shed light on the magnitude of the challenge. In Kenya, a nation grappling with the escalating cancer crisis, there are merely 27 radiotherapy technologists and 38 oncologists. These numbers fall woefully short when compared with the surging demand 32

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for cancer treatment, leaving a gaping void in the healthcare landscape."

The evolution of NRCC to its current stature has been marked by profound transformations. Mrs. Waita reflects, "To put things into perspective, when we initially embarked on our journey into chemotherapy, there were only about 10 oncologists available in the entire country. The medical landscape has undergone significant changes since those early days, with cancer's prevalence and complexity increasing exponentially."

Yet, as the centre strives for excellence, it continues to confront these formidable challenges head-on. Mrs. Waita candidly discusses their ongoing efforts, stating, "To surmount these formidable obstacles, we are actively exploring the possibility of partnering with private equity firms. This strategic move is driven by a stark reality: cancer management is an immensely costly endeavor. Relying solely on personal funds or immediate payments from authorities and insurance companies is not sustainable. We recognize that growth is imperative, and we remain steadfast in our commitment to expanding our capacity to provide quality, affordable, and accessible cancer care to all those in need."

Despite these formidable challenges, a ray of hope shines HEALTHCAREMEA.COM

Mrs. Waita emphasizes, "As for accolades and recognitions, while we have received testimonials and expressions of gratitude from patients and colleagues, we are continually striving to make a more significant impact. While we may not have garnered specific awards yet, our focus remains on changing people's lives positively each and every day. It's our mission to provide high-quality

THE ENCOURAGING NEWS IS THAT NAIROBI UNIVERSITY HAS TAKEN A SIGNIFICANT STEP FORWARD

BY ESTABLISHING A DEDICATED DEPARTMENT FOR TRAINING IN THE FIELD OF ONCOLOGY, AND OTHER INSTITUTIONS HAVE FOLLOWED SUIT.

on the horizon. Mrs. Waita's eyes gleam with optimism as she envisions the future of cancer care in Kenya. She explains, "The encouraging news is that Nairobi University has taken a significant step forward by establishing a dedicated department for training in the field of oncology, and other institutions have followed suit. They are actively bolstering their human resources in response to the burgeoning demand for cancer care. It's a promising development that holds great potential for the future," she says with palpable excitement.

BEYOND ACCOLADES: NRCC'S DEDICATION TO IMPACTFUL HEALTHCARE AND PATIENT WELL-BEING In healthcare, where each day is a battle to save lives and heal the suffering, accolades and awards may serve as milestones, but the true measure of success lies in the lives touched and the difference made. At the Nairobi Radiotherapy and Cancer Centre (NRCC), this profound understanding is etched into their very foundation.

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cancer care and to contribute to improving healthcare outcomes, and we are dedicated to making a meaningful difference in the lives of our patients."

For NRCC, the pursuit of excellence and the quest to make a lasting impact on the community transcend mere titles and trophies. It's a journey that unfolds with every patient they treat, every life they touch, and every step they take toward a brighter and healthier future. Mrs. Waita affirms, "We are committed to our journey of growth and excellence, and we believe that with continued dedication and hard work, we will achieve recognition and awards in the future as we continue to positively impact our community and beyond."

The future for NRCC is marked by ambitious aspirations and unwavering dedication. She continues, "While the process of securing such partnerships may take time, it is a step we are actively pursuing. Once we receive the necessary funding and support, we will be able to further streamline our operations and ensure that we can provide our patients with the best possible care without undue delays." HCMEA NOV/DEC 2023 | HEALTHCARE MIDDLE EAST & AFRICA

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THE WEIGHTY SHOWDOWN Big pharmas race to multi-billion-dollar anti-obesity drugs market

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n the burgeoning landscape of weight-loss drugs, Goldman Sachs Group Inc. anticipates the market to reach a staggering US$100 billion by 2030, led by Eli Lilly & Co. and Novo Nordisk A/S. This aligns with a trend of triple-digit billion sales forecasts, propelled by Novo's Wegovy clinical success in weight and heart risk reduction.

While Barclays estimated a US$100 billion market by 2033 in April, Berenberg previously predicted US$85 billion by 2030. Goldman's projection relies on an estimated 15 million US adults receiving anti-obesity medicine by 2030, out of about 105 million obese or overweight adults, excluding diabetics.

Eli Lilly, a healthcare giant with a diverse drug pipeline, including Mounjaro, currently holds the title of the world's largest healthcare company by market value. Simultaneously, Novo Nordisk recently became Europe's most valuable listed company, riding high on market enthusiasm for its drugs Ozempic and Wegovy. Both companies' shares have experienced significant surges this year.

Novo Nordisk's GLP-1 class drugs, featuring semaglutide as the active ingredient, target both diabetes and weight loss by suppressing appetite and slowing food movement through the digestive tract. Meanwhile, Lilly's tirzepatide, approved as Mounjaro for diabetes has also entered the weight-loss market as Zepbound, with recent obesity approval.

Consensus expects a duopoly for Lilly and Novo Nordisk, capturing 80% of the obesity market in 2030. Urgency for obesity solutions is emphasized by the World Obesity Atlas 2023 forecast, predicting over half the global population overweight or obese by 2035, with costs surpassing US$4 trillion. Addressing this, the UK initiated a £40 million (US$50.6 million) pilot program for advanced weight-loss drugs to ease NHS financial strain. Goldman Sachs Research foresees a substantial AOM market, driven by factors like patient population,

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insurance rates, and key players Lilly and Novo Nordisk competing for dominance.

By BENJAMIN OPUKO

NEW-GENERATION THERAPIES PROMISE TO CUT OBESITY BY GREATER MARGINS In 2013, obesity was officially recognized as a chronic disease, prompting an intensified focus on medical interventions. Traditional antiobesity medications (AOMs) faced limitations in effectiveness and raised safety concerns.

Goldman Sachs Research now foresees a new generation of AOMs, particularly incretinmimetics like GLP-1 receptor agonists, showing promise with more significant weight loss (up to mid-20%) and fewer severe side effects.

These drugs, pioneered by pharmaceutical giants Eli Lilly and Novo Nordisk, mimic GLP-1, signaling fullness to the brain. Eli Lilly's Mounjaro, initially designed as an anti-diabetes drug, has gained approval for obesity treatment, potentially tapping into a substantial market where 40% of US adults grapple with obesity. Mounjaro's sales approached US$1 billion in Q2 2023.

Comparative analysis suggests Tirzepatide’s (Mounjaro, Zepbound) efficacy surpasses Novo Nordisk's semaglutide (Wegovy, Ozempic) in promoting weight loss. Notably, 42.3% of

URGENCY FOR OBESITY SOLUTIONS IS EMPHASIZED BY THE WORLD OBESITY ATLAS 2023 FORECAST, PREDICTING OVER HALF THE GLOBAL POPULATION OVERWEIGHT OR OBESE BY 2035, WITH COSTS SURPASSING US$4 TRILLION. NOV/DEC 2023 | HEALTHCARE MIDDLE EAST & AFRICA

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MARKET TRENDS: Anti-obesity drug market

IN NUMBERS

US$100B PROJECTED OBESITY MARKET SIZE BY 2033.

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tirzepatide users shed at least 15% of their weight within a year, compared to semaglutide's 19.3%.

Semaglutide, authorized for both diabetes and obesity, regulates appetite and blood sugar levels.

Semaglutide, mimicking the GLP-1 hormone, promotes insulin production and induces a sense of fullness. Novo Nordisk's Ozempic, initially intended for type 2 diabetes, gained popularity for off-label weight loss. Wegovy, specifically designed for weight loss, demonstrates a 15% reduction in body weight in studies involving adults with obesity or related conditions.

Tirzepatide drugs Mounjaro and Zepbound, activating GLP-1 and GIP hormone receptors, also contribute to weight loss. Mounjaro, approved for type 2 diabetes, improves blood sugar and insulin resistance. Zepbound, with outcomes surpassing Wegovy, offers an alternative amid medication shortages.

Present data suggests tirzepatide might induce more substantial weight loss. Potentially surpassing Wegovy in weight loss impact, one in three individuals may achieve a 25% reduction in body weight at the highest dose Zepbound.

Zepbound's unique feature, prompting weight loss comparable to bariatric surgery, offers an intriguing alternative. However, semaglutide remains relevant, providing flexibility for doctors

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medication, including adhering to a low-calorie diet, engaging in exercise, and attending weekly counseling sessions for 12 weeks.

Lilly is also striving for approval for another weight loss drug, retatrutide, in the coming years. Simultaneously, the company is conducting multiple clinical trials to explore whether its drugs can effectively treat conditions such as obstructive sleep apnea, nonalcoholic fatty liver disease, and various other chronic diseases.

to tailor medications based on individual patient responses.

BENEFITS BEYOND WEIGHT LOSS In August, Novo Nordisk, the manufacturer of Ozempic and Wegovy, broke new ground by demonstrating in a large clinical trial that these drugs offer health benefits beyond weight loss and diabetes management.

A phase 3 trial involving over 17,000 adults with obesity revealed that Wegovy can reduce the risk of cardiovascular events, including heart attacks and strokes, by 20%. Although earlier trials indicated improvements in blood pressure and cholesterol—significant risk factors for heart disease— standalone studies focusing on heart health are required for regulatory acknowledgment of this benefit by the Food and Drug Administration.

Novo Nordisk recently disclosed results from another clinical trial, indicating that Ozempic can impede the progression of kidney disease in patients with Type 2 diabetes.

Eli Lilly, the creator of the diabetes drug Mounjaro, anticipates approval for weight loss either late this year or early next year. At the 2023 ObesityWeek conference, Lilly presented findings from its SURMOUNT-3 trial, revealing that individuals who took tirzepatide, the active ingredient in Mounjaro, lost approximately 60 pounds (20.9kgs) after 72 weeks, while those on a placebo regained weight. Both groups underwent intensive lifestyle changes before starting the HEALTHCAREMEA.COM

HIGH DEMAND PRODUCTS The soaring demand for Novo Nordisk's semaglutide products, addressing diabetes and obesity, has triggered global shortages. The pharmaceutical giant is responding with significant investments, including a US$2.3 billion expansion in Chartres, France, and a US$6 billion investment in Kalundborg, Denmark.

The French expansion focuses on doubling the site's size and creating 500 jobs, addressing supply shortages and meeting the expanding market. Novo Nordisk plans to redirect resources to Ozempic by reducing Victoza production to alleviate shortages. With Eli Lilly's FDA-approved tirzepatide (Zepbound) posing competition, both companies are racing to expand manufacturing capacities to meet the surging demand for weight-loss and diabetes medications.

Weight-loss drugs like Zepbound, Ozempic, and Wegovy are gaining unprecedented popularity, driven by pharmaceutical promotions and cultural influences. Despite strict regulations on direct-to-consumer advertising, unconventional marketing through events like the Oscars and widespread advertisements has propelled these drugs to household recognition. Concerns about misinformation have led to temporary ad withdrawals, but the demand for weight-loss drugs remains robust, providing opportunities for newcomers like Zepbound.

In a broader context, AstraZeneca's multi-billion-dollar deal with Eccogene aims to develop ECC5004, a new anti-diabetes and obesity drug. This move underscores the industry's commitment to cardiometabolic research and development.

Despite challenges like supply disruptions, pharmaceutical companies are strategically investing to meet the rising global demand for innovative medications targeting obesity and diabetes.

Competitors such as Pfizer and Amgen are also entering the race to develop weight-loss drugs, contributing to the dynamic landscape. Pfizer has been testing two different oral drugs to treat type 2 diabetes and obesity, but is now focusing on one, danuglipron, after phase two trial results.

In December, Amgen reported that in phase one tests of its injectable obesity drug, AMG133, patients showed a weight loss of 14.5% after 12 weeks of treatment. Phase two trials are ongoing, with data expected in 2024, and a product launch is not likely before 2026. While Novo Nordisk and Eli Lilly currently lead the market, new entrants are poised to make an impact in the evolving cardiometabolic treatments sector.

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is debated, with Novo and Lilly advocating prevention of complications, while independent research questions costeffectiveness.

The Institute for Clinical and Economic Review found covering Wegovy at its current price for 0.1% of the eligible population may strain insurers. The push to recognize obesity as a disease intensifies as GLP-1 drug makers invest in educating doctors.

However, high costs and supply constraints also pose challenges as Novo Nordisk expands Wegovy's rollout in Europe. In Germany, where public health insurance doesn't cover weight-loss medications, Wegovy's monthly retail price ranges from 170 to 300 euros, impacting potential users.

Even in Denmark, Wegovy's home market, public health insurance coverage was rejected due to cost considerations.

Norway, Wegovy's second European market, doesn't cover the drug under the public health system. In the UK, initial access to Wegovy is limited to those with a BMI of at least 35 and one weight-related condition under a two-year pilot program.

The German Obesity Society, funded by Novo Nordisk, criticizes such policies, urging public health systems to extend treatment and prevention measures beyond wealthy individuals who can afford out-of-pocket expenses, addressing health inequality for those living with obesity.

PAYERS ARE HESITANT TO COVER WEIGHT-LOSS MEDICATIONS Despite the health risks of obesity, insurance often doesn't cover weight loss medications, with costs exceeding US$1,000 monthly. The perception of obesity as cosmetic rather than a chronic disease contributes to this lack of coverage, affecting older adults and low-income families. While Medicare covers bariatric surgery, it excludes obesity medications, and fewer than 20 Medicaid programs offer such coverage.

The American Medical Association urged coverage, but obstacles include a 2003 law prohibiting Medicare from covering weight loss drugs. Signs suggest a shift, with the Treat and Reduce Obesity Act and the Congressional Budget Office's call for research on weight loss drugs under Medicare.

Employers are also reconsidering, yet challenges persist, especially with the emergence of GLP-1-based treatments like Wegovy and Zepbound, raising concerns about costs despite significant benefits. Insurers impose strict coverage requirements, and employers may cease coverage, creating barriers for patients in need.

The AMA's resolution adds pressure, emphasizing changes in viewing obesity. A decade ago, the AMA officially labeled obesity as a disease. The economic impact of new drugs 38

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HEART BENEFITS, DOCTOR PRESSURE MAY FORCE MEDICARE TO COVER The promising cardiovascular benefits of weight-loss drugs, particularly Novo Nordisk's Wegovy, could catalyze a shift in Medicare coverage. Recent findings may incentivize both government and private insurers to reconsider reimbursement policies for these costly prescriptions. Notably, Medicare has not covered weight-loss drugs since 2006, although specific Medigap and Medicare Advantage plans for retirees provide coverage. Medicaid programs in nine states started covering Wegovy, priced at US$1,349 per month, as of late July.

However, many private insurers currently exclude coverage for GLP-1 drugs prescribed solely for weight loss.

Conversely, Medicare, Medicaid, and numerous private insurers cover Ozempic (US$936 per month) when prescribed for type 2 diabetes but not for weight loss. Coverage for Mounjaro (US$1,023 per month) varies based on individual insurance plans and drug benefits when used for diabetes treatment. The SELECT study by Novo, with full results expected later this year, suggests that most payers might eventually cover weight-loss drugs if prescribed to address or prevent cardiovascular conditions associated with diabetes and obesity.

Experts anticipate increased pressure on insurance companies to cover these drugs, especially with the imminent release of SELECT results. To further support expanded coverage, a bipartisan group reintroduced the Treat and Reduce Obesity Act on July 20, aiming to reverse the federal ban on Medicare coverage for obesity drugs. Lawmakers emphasize the urgency of combating the obesity epidemic and improving HEALTHCAREMEA.COM

access to necessary treatments due to high medication costs and limited options.

Novo Nordisk and Eli Lilly have actively lobbied Congress for the legislation, initially introduced in 2021, endorsing its recent reintroduction. Novo has also engaged with members of the Congressional Black Caucus and influential Black Americans to advocate for Medicare coverage of weight-loss drugs, recognizing the high obesity rates among non-Hispanic Black adults.

The pharmaceutical industry's push for expanded coverage aligns with the federal government's new mandate for drug companies to negotiate with Medicare over successful products. Recent speculation suggests that Ozempic might be a key target for negotiated prices in the future. However, the pharmaceutical industry is challenging the constitutionality of this new law in court.

WEIGHT-LOSS DRUG CRAZE SPURS GLOBAL RISE IN COUNTERFEITS Global demand for weight-loss drugs, particularly Novo Nordisk’s Ozempic, has led to a surge in counterfeit versions, according to industry-backed organizations like the Pharmaceutical Security Institute (PSI).

The PSI, in collaboration with agencies such as Europol, Interpol, and U.S. Homeland Security, is actively working to combat this rise in counterfeits. The demand for drugs like Ozempic, Wegovy, and Eli Lilly’s Mounjaro has increased due

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to the global obesity epidemic and high rates of diabetes.

The drugs, initially approved for diabetes treatment, are now sought after for their off-label use in weight loss.

Counterfeit versions of Ozempic have been discovered in multiple countries, including the UK, Germany, Egypt, and Russia.

The counterfeit drugs pose significant health risks, with authorities urging vigilance and issuing warnings to pharmacies and consumers. In response to the rising threat, law enforcement agencies are intensifying efforts to track and prevent counterfeit weight-loss drugs from entering the market.

The issue is particularly concerning in affluent countries, where these high-priced drugs are being sold. The Medicines and Healthcare products Regulatory Agency (MHRA) in the UK and other health authorities are actively monitoring and addressing the issue. Reports related to potentially falsified GLP-1s, the drug class that includes Wegovy, Ozempic, and Mounjaro, have increased, prompting regulatory agencies to take action against counterfeit drugs.

MHRA said reports related to potentially falsified GLP1s, the class of drug that includes Wegovy, Ozempic and Eli Lilly’s diabetes drug Mounjaro, had risen from two in 2022 to as many as 20 this year. Ireland’s Health Products Regulatory Authority told Reuters that it has confiscated 233 units of counterfeit semaglutide compared with 32 units in 2022.

OUTLOOK AND FUTURE DIRECTIONS The pursuit of anti-obesity medications (AOMs) has intensified due to the global rise in obesity rates, molecular advancements in appetite regulation, and the success of incretins in type 2 diabetes treatment. Late-phase clinical reports suggest the potential for a 20% or greater reduction in body weight, raising questions about the relative ease of achieving this in patients with higher initial body weight.

Novo Nordisk, a key player in this field, has seen remarkable success with its anti-obesity treatment Wegovy, demonstrating a 20% reduction in cardiovascular risk. Sales of Wegovy have quadrupled, and the company is exploring flexible pricing to tap into the growing obesity medication market, projected to reach US$100 billion by 2030. While the US list price exceeds US$1,300 per month, reimbursement challenges persist, limiting accessibility.

Novo Nordisk is gradually introducing Wegovy in Europe, facing potential reimbursement restrictions based on BMI. Eli Lilly's entry with Zepbound does not exert pricing pressure, with both companies exploring innovative pricing arrangements.

Despite supply challenges, Novo Nordisk is gearing up to launch Wegovy in Japan, marking its entry into the Asian market. However, the industry grapples with the dual challenges of insufficient supplies and the escalating issue of counterfeiting. The future trajectory involves addressing these challenges while striving to make anti-obesity medications more accessible globally. HCMEA NOV/DEC 2023 | HEALTHCARE MIDDLE EAST & AFRICA

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REVITALIZING AFRICA'S PHARMACEUTICAL LANDSCAPE: From dependency to innovation and self-sufficiency Major global pharmaceutical companies are seeking new markets for substantial sales growth, and Africa, with its expected population doubling by 2050, is becoming a key focus. The continent is witnessing a healthcare transformation, with non-communicable diseases projected to be the leading causes of mortality and morbidity by 2030. Policy initiatives are driving efforts towards pharmaceutical self-sufficiency and the creation of commercially viable medicine markets.

The recent pandemic revealed weaknesses in Africa's manufacturing, distribution, and regulatory capacities, prompting a re-evaluation and increased interest in public-private collaborations. Initiatives like the African Centre for Disease Control and Prevention and the proposed African Medicines Agency aim to harmonize regulatory systems. The integration of mobile technologies shows promise in breaking down structural barriers in medicine markets.

As Africa embraces commercial development, it grapples with challenges such as heavy reliance on imports and the dominance of generics.

However, there's a push for increased domestic production, with branded generics playing a significant role. Beyond individual health, the pharmaceutical sector contributes to societal progress through research and development, production, and distribution, driving medical advancements for global health improvement.

devices at an impressive 11%. Factors such as increasing urbanization, expanding healthcare capacity, and a conducive business environment contribute to this growth.

The diversity of the African continent is evident in variations in economic status, GDP, and lifestyles across its countries and regions.

While some nations have thriving economies and high living standards, others face poverty and underdevelopment. Africa is also home to the world's fastest-growing population, expected to contribute 1.3 billion to the projected 2 billion increase in the global population from 2019 to 2050. The demographic landscape, characterized by high fertility rates, decreasing infant mortality, and increased life expectancy, positions Africa for a population surge, with two out of every five children born globally expected to be born on the

By VINCENT MORANGA

A THRIVING INDUSTRY WITH ROOM FOR EXPANSION Africa's pharmaceutical sector holds significant potential for expansion and growth, making it a distinctive market globally. According to McKinsey & Company, various segments of the pharmaceutical market in Africa witnessed substantial compound annual growth rates (CAGRs) between 2013 and 2020. Prescription medications grew at a rate of 6%, generics at 9%, over-the-counter medicines at 6%, and medical HEALTHCAREMEA.COM

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PHARMA FOCUS: Africa's Pharma Landscape

continent by 2050. This sustained growth drives a continuous demand for childhood vaccinations.

However, this demographic transition comes with challenges. Non-communicable diseases (NCDs) are on the rise, projected to contribute to nearly 50% of deaths by 2030, a significant increase from 28% in 2008. Diabetes is a notable example of this shift, with prevalence expected to more than double from 24 million in 2021 to 55 million in 2045. Healthcare systems across the continent are grappling with the transition, facing difficulties in diagnosing and treating chronic conditions like diabetes, with 54% of cases going undiagnosed.

Goldstein Market Intelligence reports remarkable growth in Africa's pharmaceutical industry, increasing from US$5.5 billion a decade ago to a substantial US$28.56 billion in 2017.

Projections suggest that by 2030, this figure will further rise from US$56 billion to a staggering US$70 billion. Leading this growth is South Africa, which boasts the largest pharmaceutical market in Africa, valued at US$3.9 billion in 2021.

TRENDS IN AFRICAN PHARMACEUTICAL MANUFACTURING Africa's pharmaceutical sector is witnessing significant changes with notable investments

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expanding to fill and finish design and packaging.

In February, the World Health Organization announced that six African countries, including Kenya, would receive technologies to produce

MODERNA, WITH SUPPORT FROM THE UNITED STATES GOVERNMENT, WILL INVEST US$500 MILLION TO PRODUCE AROUND 500 MILLION VACCINE DOSES FOR AFRICA.

and strategic collaborations to enhance local drug manufacturing and distribution. In 2020, the European Investment Bank initiated a €50 million (US$ 54 million) program to boost the local production of Active Pharmaceutical Ingredients (APIs). Simultaneously, the Global Fund partnered with local manufacturers and distributors to improve access to essential medicines for HIV, tuberculosis, and malaria.

German biotech pioneer BioNTech is making progress in bringing mRNA-based vaccines closer to African consumers. A cutting-edge modular container solution in Rwanda represents the first step in creating a decentralized manufacturing network. Novo Nordisk has collaborated with Aspen Pharma South Africa to address Africa's insulin demand by local manufacturing. This move aims to reduce dependence on imports and better meet the region's healthcare needs.

Kenya has become the first mRNA hub in Africa, hosting biotech company Moderna.

Moderna, with support from the United States government, will invest US$500 million to produce around 500 million vaccine doses for Africa. The company will initially produce drug substances for various vaccines, including those for HIV, cancer, and COVID-19. Plans include HEALTHCAREMEA.COM

mRNA vaccines like Moderna and Pfizer.

Kenya also plans to establish a local vaccine manufacturing company called Kenya Biovax Limited in Nairobi, addressing inequities in COVID-19 vaccine access. In Cape Town, South Africa, an mRNA technology transfer hub aims to enable commercial production of a COVID-19 vaccine in the next 18 months. Launched by the World Health Organization in July 2021, the hub seeks to transfer knowledge to 15 partner facilities globally. Afrigen, at the hub's center, is developing an mRNA COVID-19 vaccine and transferring knowledge to spokes in Africa, Asia, South America, and Eastern Europe.

Emzor Pharmaceuticals in Nigeria, with a €13.85 million (US$ 15.2 million) EIB loan, is establishing the first Active Pharmaceutical Ingredients (APIs) manufacturing facility in Sub-Saharan Africa. With 60% of project costs covered by EIB, the plant, set to be operational

by February 2024, focuses on producing crucial anti-malaria APIs: artemether, lumefantrine, sulfadoxine, and pyrimethamine.

NAVIGATING CHALLENGES AND UNLOCKING OPPORTUNITIES IN AFRICAN PHARMACEUTICAL INVESTMENTS Investing in Africa's pharmaceutical industry involves overcoming challenges such as infrastructure limitations, regulatory complexities, high financing costs, and concerns about intellectual property protection. Limited local manufacturing capacity and shortages of skilled professionals lead to a heavy reliance on imports for pharmaceutical ingredients and NOV/DEC 2023 | HEALTHCARE MIDDLE EAST & AFRICA

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machinery. The prevalence of substandard or falsified medicines is a significant concern, with an estimated one in 10 medicines falling into this category in low- or middle-income countries.

Regulatory inconsistencies across countries and varying standards among economic PROJECTED communities complicate the regulatory AFRICAN landscape. Efforts to harmonize regulations PHARMACEUTICAL through the African Medicines Regulatory Harmonization Initiative face challenges. The MARKET SIZE BY proposed African Medicines Agency (AMA) 2030. aims to streamline processes such as medicines registration, drawing inspiration from global regulatory agencies to foster a unified approach.

Despite challenges, the pharmaceutical sector in Africa offers investment potential driven by expanding healthcare needs and strategic initiatives like mergers, acquisitions, and investments in generic pharmaceuticals.

Collaborative efforts involving international organizations, foreign investors, and governmental support can create an investmentfriendly environment. Regional integration gains significance, especially with the implementation of the African Continental Free Trade Agreement

IN NUMBERS

US$70B

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(AfCFTA).

Recognizing Africa's genetic diversity, which surpasses that of any other population, the pharmaceutical industry is addressing the disparity in genomics databases. Currently, African samples constitute a mere 1.1% of global genomic studies. Moreover, clinical research in high-income countries disproportionately surpasses Africa's share, accounting for less than 3% of global clinical trials. This lack of diversity hinders the effectiveness of interventions, emphasizing the need for increased representation in research.

In response to challenges such as the development of novel medications, vaccine production, supply chain complexity, and production costs, African pharmaceuticals are adopting advanced technologies. Smart manufacturing, flexible automation, optimized connectivity, and digital intelligence are being implemented to reduce costs, enhance efficiency and productivity, and adapt swiftly to changes.

As the industry embraces these trends, the future of pharmaceutical manufacturing in Africa appears promising, characterized by innovation,

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sustainability, and a commitment to meeting the healthcare needs of the continent.

Stakeholders in the African pharmaceutical sector emphasize innovation and self-sufficiency through intensified Research and Development (R&D) initiatives. Notable investments, like the Bill & Melinda Gates Foundation's US$20 million injection into Quantoom Biosciences, highlight a commitment to improving access to nextgeneration mRNA health tools. Investments in institutions like Senegal's Institut Pasteur de Dakar and South Africa's Biovac aim to strengthen vaccine development capacity. This strategic focus not only fosters the discovery of novel drugs but also positions Africa as a key player in global pharmaceutical innovation.

FUTURE PROSPECTS The future of Africa's pharmaceutical industry depends on strategic initiatives for selfsufficiency and addressing non-communicable diseases (NCDs). Developing local production capacities, expanding essential molecule production, and emphasizing regional integration through initiatives like the African Continental Free Trade Agreement (AfCFTA) are crucial steps. While challenges like high production costs and multinational ownership exist, regional consolidation offers potential cost reduction and HEALTHCAREMEA.COM

THE PHARMACEUTICAL SECTOR IN AFRICA OFFERS INVESTMENT POTENTIAL DRIVEN BY EXPANDING HEALTHCARE NEEDS AND STRATEGIC INITIATIVES LIKE MERGERS, ACQUISITIONS, AND INVESTMENTS IN GENERIC PHARMACEUTICALS. efficiency.

With 80% of critical pharmaceutical companies concentrated in eight countries, there's an opportunity to diversify production beyond basic medicines. To fully realize the potential, Africa must diversify products, improve healthcare access, and enhance health security, moving away from reliance on international supply chains. Integrating logistics, ensuring quality standards, strengthening R&D capacities, harmonizing legislation, and fostering innovation and collaboration are essential for a vibrant and sustainable pharmaceutical industry in Africa's future. HCMEA NOV/DEC 2023 | HEALTHCARE MIDDLE EAST & AFRICA

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Country

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Nigeria's Healthcare System on the mend

By ELLY OKUTOYI

N

igeria, a vibrant nation in West Africa renowned for its contributions to soccer, cinema, and more, stands at the forefront of the continent's socio-economic landscape. Bordered by Niger, Chad, Cameroon, and the Republic of Benin, Nigeria's geographical expanse is matched only by the richness of its cultural diversity. The nation's population, expected to reach 223.8 million by mid-2023, according to the United Nations, underscores its significance on the global stage, constituting 2.78% of the world's total population and ranking it as the seventh most populous country.

Strategically headquartered in Abuja, Nigeria encompasses a vast territory of 923,768 square kilometers, stretching from the Gulf of Guinea in the South to the Sahel, marking the edge of the Sahara Desert. Despite its cultural prominence, Nigeria has grappled with challenges in its healthcare sector for years. The Lancet's 2018 study on global healthcare access and quality positioned Nigeria at 142nd out of 195 countries, reflecting longstanding issues in the nation's healthcare infrastructure.

However, recent endeavors to combat polio have catalyzed positive transformations in Nigeria's healthcare landscape. The implementation of a decentralized disease control network and enhancements in vaccine storage not only position the country on the verge of eradicating polio but also fortify its capabilities in addressing other formidable diseases like measles and Ebola. The impact of these improvements extends across all levels, from national to local, fostering a more resilient and responsive healthcare system.

Statistics from the Nigerian Centre for Disease Control shed light on the prevalent health challenges facing the population. Malaria, affecting a staggering 97% of the populace, emerges as the most widespread disease.

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Following closely are typhoid fever, Lassa fever, tuberculosis (TB), cholera, meningitis, guinea worm diseases, and yellow fever. In contrast, HIV/AIDS, with a prevalence rate of 1.5%, stands as the least pervasive ailment.

Nigeria's commitment to addressing these health challenges marks a transformative phase for its healthcare system, signaling a positive trajectory toward a healthier and more resilient nation. As the population continues to grow, the emphasis on healthcare improvements becomes increasingly crucial for the well-being of the Nigerian people.

HEALTH REGULATORY BODIES IN NIGERIA In Nigeria, healthcare regulation involves multiple agencies ensuring quality, safety, and accessibility nationwide. The Federal Ministry of Health, led by Minister Muhammad Ali Pate, holds a central role, overseeing key bodies shaping the healthcare landscape. The National Health Insurance Scheme (NHIS) shields families from financial barriers, contributing to universal health coverage by regulating health insurance activities.

The National Institute for Pharmaceutical Research and Development (NIPRD) focuses on research and development to enhance access to safe healthcare. Engaging in capacity building, policymaking, data collation, and strategic partnerships, NIPRD expedites healthcare accessibility. The National Agency for Food and Drug Administration and Control (NAFDAC) ensures product quality and safety, regulating food, drugs, medical devices, chemicals, and water.

The National Primary Health Care Development Agency (NPHCDA) promotes high-quality, sustainable primary healthcare through resource mobilization and communitybased systems. The Nigeria Centre for Disease Control and Prevention (NCDC) plays a crucial

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COUNTRY FOCUS: Nigeria

NIGERIA, IN ISOLATION, FACES AN IMMENSE CHALLENGE, REQUIRING AN ADDITIONAL 386,000 BEDS AND US$82 BILLION IN HEALTHCARE REAL ESTATE INVESTMENTS TO MEET THE GLOBAL BENCHMARK. role in preventing, detecting, and controlling communicable diseases and public health events, safeguarding against health emergencies and outbreaks.

GOVERNMENT BUDGET ALLOCATION AND FINANCIAL SHORTFALLS Nigeria's healthcare financing framework is anchored in diverse sources, including government budgetary allocations, donor funding, National Health Insurance Scheme (NHIS) contributions, and private financing. In the fiscal year 2020, the federal government allocated a commendable Naira 441 billion (US$538 million) to the health sector, reflecting a positive increase from the previous year's Naira 365 billion (US$445.3 million). However,

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despite this apparent boost, healthcare spending constitutes a mere 4.5% of the government's overall budget, falling significantly below the African Union's established benchmark of 15% since 2001 to enhance healthcare delivery continent-wide.

The landscape of healthcare funding in Nigeria remains a critical area requiring transformative strategies. The current underfunding not only impacts the federal level but also reverberates at the state level, where only select states manage to surpass the 12% threshold. This leaves the average state allocation in alignment with federal proportions, highlighting a systemic challenge that demands strategic interventions.

TRANSFORMATIVE INVESTMENTS NEEDED IN NIGERIA’S HEALTHCARE INFRASTRUCTURE While commendable strides have been made in refurbishing health facilities, such as the University College of Ibadan Hospital, a prevailing narrative underscores a significant unmet need for broader healthcare infrastructure improvements. A sobering 2020 report by Frank Night illuminates this concern, revealing a stark reality: excluding South Africa, all African countries, including Nigeria, fall below the global average of 2.7 hospital beds per 1,000 people.

Nigeria, in isolation, faces an immense HEALTHCAREMEA.COM

challenge, requiring an additional 386,000 beds and US$82 billion in healthcare real estate investments to meet the global benchmark. This not only emphasizes the urgency for expansion but also highlights the magnitude of investment needed to bridge the existing gap. Similar challenges echo across the African continent, with countries like Egypt, Uganda, and Kenya requiring investments of US$23 billion, US$11 billion, and US$6 billion, respectively, to reach the global average.

This glaring deficit in hospital bed capacity reflects a critical need for transformative investments in healthcare infrastructure. It transcends national borders and demands collective attention to fortify healthcare systems across the continent. The repercussions of this infrastructure gap are felt in compromised healthcare delivery, particularly in times of crises such as pandemics, where the strain on limited resources becomes even more apparent.

To address this monumental challenge, it is imperative for Nigeria to prioritize healthcare infrastructure in its development agendas.

Collaborative efforts, both domestically and through international partnerships, should be fostered to secure the necessary investments.

Mobilizing public and private sectors, along with international organizations, becomes paramount

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in ensuring the realization of robust healthcare infrastructure that can meet the needs of growing populations.

Moreover, the impact of improved healthcare infrastructure extends beyond crisis response.

It forms the backbone of sustained healthcare delivery, preventive measures, and the overall well-being of the population. As Nigeria grapples with the evolving landscape of global health, strategic investments in infrastructure emerge as a linchpin for resilience and preparedness.

NAVIGATING CHALLENGES THROUGH COLLABORATIVE REFORM The intricate landscape of Nigeria's healthcare is illuminated by the 2019 Nigerian health facility register, revealing a staggering 40,821 health facilities. Among these, 34,675 are primary, 5,780 secondary, and 166 tertiary care facilities.

In a scenario where government funding faces constraints, the private sector emerges as a crucial force, significantly bolstering the country's healthcare capacities.

The strategic adoption of Public-Private Partnerships (PPP) stands out as a transformative model, serving as a catalyst in addressing healthcare challenges and fostering job creation.

This approach signifies a pivotal step toward achieving Universal Health Coverage (UHC) and

AN AERIAL VIEW OF UNIVERSITY COLLEGE HOSPITALIBADAN, A TERTIARY HEALTHCARE INSTITUTION IN NIGERIA

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PROFESSOR ALI MUHAMMAD PATE, NIGERIA'S MINISTER OF HEALTH.

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transforming healthcare coverage in Nigeria One transformative model that stands out is the strategic adoption of Public-Private Partnerships (PPPs). This approach becomes a catalyst in addressing healthcare challenges and fostering job creation, marking a pivotal step toward achieving Universal Health Coverage (UHC) and transforming healthcare coverage in Nigeria.

An illustrative example of a successful PPP is the initiative by Christian Aid (CA) in Nasarawa, where premiums for 400 individuals across five wards in the Lafia Local Government Area were funded. Collaborating with the Development Government International Foundation (DGIF), CA navigated community engagement to identify vulnerable individuals, showcasing the potential impact of targeted PPPs. A novel initiative gaining traction is the "Adopt A PHC" program in Nigeria. This PPP model involves private sector entities investing in Primary Healthcare Centers (PHCs) to revitalize and make health services accessible to local populations, offering a promising approach to

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increase healthcare access across the continent.

Additionally, Bloom Public Health, as an indigenous African company, is making significant strides in supporting health-related innovations in Africa. Partnering with African governments and agencies, Bloom Public Health is at the forefront of providing exemplary partnership models for future public health interventions. For instance, in collaboration with Nigeria’s National Institute for Pharmaceutical Research and Development (NIPRD), Bloom Public Health is leading a World Bank-funded initiative to support local pharmaceutical manufacturing companies in attaining Good Manufacturing Practices (GMP) and WHO Prequalification (WHO PQ), positioning Nigeria on the global pharmaceutical stage.

The Health Supply Chain Transformation project, spearheaded by a Bloom Public Healthled consortium, is another noteworthy example.

This initiative partners with several Nigerian states to ensure the availability of medicines at health facilities, addressing a crucial aspect of healthcare delivery.

The proposed "One Nation, One Health" policy emerges as a potential catalyst for prioritizing and expediting UHC, leveraging health as a political force. A recommended reform to ensure a locally delivered healthcare system includes providing health insurance coverage for the 113 million Nigerians identified by the 2022 Multidimensional Poverty Index. Innovative financing mechanisms and efficient resource utilization are identified as pivotal components of this reform.

Adequate funding is indispensable for fostering a robust health system. The enactment of the National Health Insurance Authority (NHIA) Act in May 2022, mandating health insurance for all Nigerians, represents a significant stride toward achieving universal health coverage. The 'Vulnerable Group Fund' (VGF) incorporated into this act, specifically designed for over 83 million citizens unable to afford premiums, requires urgent establishment. Equally crucial is public education on health insurance, recognizing the pivotal role of demand generation in effective implementation.

In alignment with SDG 3, a call for social health protection schemes targeting the poor and vulnerable emphasizes the need for governments to prioritize reducing out-of-pocket payments through the adoption of a tax-financed, noncontributory UHC scheme.

Despite commendable progress, Nigeria HEALTHCAREMEA.COM

grapples with multifaceted challenges within its healthcare sector. These challenges encompass corruption, inadequate infrastructure, poor governance, brain drain, and consistent underfunding by the Federal Government. A recent report from the Nigeria Lancet Commission advocates for a new social contract on health, emphasizing the need to redefine the citizen-state relationship. As Nigeria navigates these challenges, a comprehensive approach encompassing infrastructure development, public-private collaborations, and targeted reforms emerges as pivotal for building a resilient and inclusive healthcare system.

OPPORTUNITIES IN PHARMACEUTICAL MANUFACTURING Nigeria, with 132 licensed pharmaceutical manufacturers, holds a significant opportunity to bolster its healthcare selfsufficiency, foster economic growth, and create jobs by reducing its reliance on drug imports. However, despite this promising landscape, the country grapples with challenges, including dependence on external supplies, currency fluctuations, and a lack of emphasis on local production.

Despite having over 130 registered pharmaceutical manufacturers, Nigeria still heavily depends on external sources for crucial active pharmaceutical ingredients and excipients. This reliance, coupled with currency fluctuations, poses risks for local manufacturers. Even with an investment of over NGN400 billion (US$969 million) in infrastructure to meet global standards, challenges persist. The absence of domestic production for key inputs forces reliance on countries like India and China, contributing to price hikes and foreign exchange difficulties.

The fall in the value of the naira since 2015 has led to a

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substantial increase in the cost of imported drugs, reaching up to 200%, according to the Pharmaceutical Society of Nigeria (PSN). The lack of emphasis on local production of raw materials, pharmaceutical dosage formulations, and processing equipment has hindered the sector's growth.

Emphasizing the urgent need for increased local production, the COVID-19 pandemic exposed vulnerabilities in Nigeria's pharmaceutical manufacturing capacity. Recent data from the National Bureau of Statistics (NBS) indicates that Nigeria's pharmaceutical manufacturing sector was worth US$777 million in 2018, accounting for less than 0.25% of GDP. However, amidst challenges, there are promising initiatives.

Supported by a €13.85 million (US$15.11 million) loan from the European Investment Bank (EIB), Emzor Pharmaceutical Industries Limited is nearing completion of a US$23 million plant. This private-sector investment aims to position Nigeria as a hub for active pharmaceutical ingredients (API) manufacturing by the first quarter of 2024.

While the pharmaceutical market in Africa is valued at approximately US$30 billion, Nigeria covers only 1.5% of this market size. The majority of drugs are sourced internationally, emphasizing the need for backward integration to enhance self-sufficiency and address health challenges. Despite European multinationals dominating the market with branded drugs, Indian pharmaceutical companies are expanding locally, manufacturing generic products through cost-effective partnerships.

Introduced in 2015, the ECOWAS Common External Tariff (CET) initially granted imported drugs tariff exemptions, impacting the costs of locally made medicines. Despite a policy reversal in 2016, imposing a 20% import tax on specific drugs, the sector faced challenges. HCMEA

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SIGNIFICANT MILESTONES IN HIV/ AIDS CARE REACHED, AS SEARCH FOR ELUSIVE CURE REMAINS

A

lmost 40 years after the Pasteur Institute discovered the first case of what became known as Acquired Immuno-Deficiency Syndrome (AIDS), key statistics reveal what progress has or has not been made in the collective fight against HIV (Human Immunodeficiency Virus).

Over the years, HIV has slowly spread not only on the African continent but also across other parts of the world. In 2022, the Joint United Nations Programme on HIV/AIDS announced that there were about 39 million people worldwide living with HIV. “At the end of December 2022, 29.8 million people of all people living with HIV had access to antiretroviral therapy, up from 7.7 million in 2010,” UNAIDS confirmed.

The UN body also reported that only five African countries, including Botswana, Eswatini, Rwanda, the United Republic of Tanzania, and Zimbabwe, had achieved the 95-95-95 targets by 2022.

UNAIDS has set in motion the “FastTrack” targets strategy in an effort to scale up HIV prevention and treatment programs. By implementing this strategy, the UN body seeks to avert 28 million new HIV infections and end the epidemic as a public health issue by 2030.

LATEST ON HIV TREATMENT EFFORTS Each step in the HIV care continuum is marked by an assessment of the number of people who have reached the stage of an undetectable viral load.

Thanks to the tireless efforts of key players in the healthcare industry, treatments for HIV have come a long way since the release of the first antiretroviral therapy (ART), zidovudine in 1987. There are now seven distinct mechanisms of action for HIV medicines that have been approved for the market by the Food and Drug Administration.

Ninety-five percent of HIV-positive people live in developing countries, where combination

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therapy with the new antiretroviral drugs is practically unattainable, and for many, even basic treatments for opportunistic infections and symptoms of AIDS are hard to find.

In Uganda, where two million people are estimated to be infected, UNAIDS officials believe that no more than 1,000 people have access to antiretrovirals. In South Africa, where some three million people are infected, no more than 2,000 people are thought to be receiving ARVs. The officials concluded that the countries with the greatest need for HIV medicines are also those least likely to have them.

Due to the fact that the new treatments are essentially out of reach for people living in developing nations, governments, UNAIDS, and pharmaceutical companies have teamed up in a calculated attempt to overcome the challenges posed by cost, inadequate health services, and an unreliable local supply of medicines.

Moreover, single-pill regimens were once a major unmet medical need; now multiple single-tablet regimens are readily available in the market.

By LORRAINE ABWAO

NEW HIV MEDICINES IN THE MARKET More than 30 antiretroviral drugs are currently available on the market, including several fixed-

ONLY FIVE AFRICAN COUNTRIES, INCLUDING BOTSWANA, ESWATINI, RWANDA, THE UNITED REPUBLIC OF TANZANIA, AND ZIMBABWE, HAD ACHIEVED THE 95-95-95 TARGETS BY 2022.

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DISEASE FOCUS: HIV/AIDS

dose combinations, which contain two or more medications from one or more drug classes in a single tablet.

The latest report released by ResearchAndMarkets.com highlighted that the global HIV treatment market in 2022 stood at US$22.38 billion and is likely to reach US$25.5 billion by 2030.

Gilead Sciences, Inc., GlaxoSmithKline Plc (ViiV Healthcare), and Merck & Co. are the pharma companies leading the global HIV treatment market with their comprehensive drug portfolios. Other key players in the HIV treatment market are Abbott Laboratories, AbbVie Inc., TEVA Pharmaceutical Industries Limited, Johnson & Johnson (Janssen Pharmaceuticals), Boehringer Ingelheim, Cipla Limited, Viatris Inc., Bristol-Myers Squibb Company, and Hetero Drugs Limited.

Notably, the first long-acting cART regimen

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for HIV – Janssen’s Rekambys (rilpivirine) and ViiV’s Vocabria injection (cabotegravir) – was approved for once-monthly dosing in the US in January 2021 and in the EU in December 2020, the EU has also approved the two-month dosing regimen.

Reports show that the surge in demand for HIV treatment continues amid heightened public awareness and healthcare initiatives. For instance, ViiV Healthcare makes 17 prescription HIV medicines, including the long-acting treatment cabotegravir, which was first approved in the United States in January 2021.

An NIH-supported clinical study demonstrates that long-acting injectable antiretroviral therapy may improve viral suppression outcomes for people experiencing challenges taking a daily HIV treatment pill.

Sold as Cabenuva, the injectable medication contains two different types of HIV drugs, cabotegravir and rilpivirine. This medication is designated only for persons who have achieved undetectable virus status on existing therapies.

ViiV Healthcare also makes dolutegravir, a tablet known as Tivicay that is taken once a day and was first approved in Europe in 2014.

Comparably, Gilead’s lenacapavir (Sunlenca) received FDA approval in late 2022 as the second injectable HIV medication, exemplifying the company’s commitment to innovation.

Lenacapavir is in a new class of drugs called capsid inhibitors, meaning that it affects the shell that protects the virus, preventing it from multiplying. With a huge potential to cut doctor visits down to twice a year, lenacapavir received FDA approval for the treatment of adult patients with multidrug-resistant (MDR) HIV. In the coming years, pharma companies are expected to debut several groundbreaking products like Sunlenca, VH184, Capsid, bNAbs, and Islatravir, a weekly pill that blocks a protein that helps the virus multiply.

Concurrently, the patents of numerous existing drugs such as Descovy, Tivicay, Triumeq, Juluca, and Dovato are anticipated to expire, thereby facilitating the introduction of generic substitutes in the market.

ViiV’s Cabenuva has been available on the NHS as a combination treatment with another drug and is now injected into the patient’s buttocks via syringes in the hospital every two months. Drug administration by self-injection provides an alternative option to taking a daily tablet to stop the HIV virus from attacking the immune system.

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INNOVATIONS IN DELIVERY SYSTEMS AND DOSAGE FORMS After years in the making, the National Library of Medicine (NLM) confirmed that better drug delivery systems and the development of new drug molecules with high anti-viral potency and a longer half-life could enhance the success of HIV treatment.

To ensure a longer period between drug administrations, and fewer clinic visits, ViiV Healthcare is also developing a new formulation with an autoinjector device that makes it easy and safe for patients to self-inject the drug themselves at home every two to three months.

In a news story published by European Pharmaceutical Review, ViiV Healthcare’s Head of Research and Development, Kimberly Smith, disclosed that the company is expected to start clinical trials for its new formulation with an autoinjector device in 2026 and to launch the treatment by 2030.

Smith confirmed that ViiV has several products in its portfolio that it is evaluating for potential options for self-administration.

Commenting on the long-acting therapy pipeline, Kimberly Smith explained: “ViiV is developing a version of cabotegravir as an ultra-long-acting

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treatment and prevention that could be injected every four months and ultimately every six months by the end of the decade. This is double the concentration of the current drug.”

Some of the products in ViiV’s pipeline include new long-acting maturation inhibitors, long-acting capsid inhibitors, a neutralising antibody targeting the CD4 binding site, and Non-nucleoside reverse transcriptase inhibitors (NNRTIs). Smith revealed that the company expects the four-monthly injection to be available in 2026 for HIV prevention, with a targeted focus on people who don’t have HIV but are at high risk because of exposure to the virus.

In addition to being used for the treatment of HIV, ViiV’s long-acting cabotegravir regimen is also being developed for HIV prevention, and is currently under evaluation as a PrEP in two trials.

Smith further mentioned that the vaccine regimen, which showed promise in Phase I/II studies, is currently being evaluated in the Phase III Mosaico trial. According to Smith, a favourable safety profile with no serious adverse events will be achieved not only through the development of these new classes of drugs but also through other collaborations, such as ViiV’s partnership with Halozyme.

IN NUMBERS

US$25.5B PROJECTED GLOBAL HIV TREATMENT MARKET SIZE BY 2030.

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DISEASE FOCUS: HIV/AIDS

In this context, clinical trials have limited scope to discover rare but important adverse side effects experienced by drug users; thus, enhanced pharmacovigilance is a critical component to ensuring patient safety. Halozyme makes a recombinant human hyaluronidase (recombinant PPH21) used to increase the volume of a subcutaneous injection that can be administered, expanding the current maximum of 2 ml to 20 ml. That flexibility allows ViiV’s development teams to increase the dose and therefore increase the interval between treatments.

Globally, treatment outcomes are improved through the accessibility and affordability of HIV medications made possible by smaller players and generic manufacturers. Case in point: the strategic partnership between the Medicines Patent Pool (MPP) and ViiV that facilitated the production of affordable generic versions of HIV medications.

GSK’s US rival Gilead is also developing a long-acting injectable HIV treatment that can be given every six months, with positive clinical trial data already reported in July 2023.

The National Institute of Allergy and Infectious Diseases (NIAID) continues to fund research to develop new antiretroviral drugs and new tools to enhance HIV treatment, since only a significant portion of the global population can benefit from daily antiretroviral therapy.

NIAID shed light on the complexity that made it difficult for people to adhere to the regimens long-term. However, with the latest advances, a person living with HIV on effective treatment can enjoy a healthy and long life, comparable to a person living

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Although there is still insufficient data about PrEP’s effectiveness in preventing HIV infections from nonsterile injection drug use, the CDC disclosed that increasing PrEP coverage is one of the key prevention strategies outlined in the Ending the HIV Epidemic in the U.S. (EHE) initiative.

KENYAN E-PHARMACY STARTUP MYDAWA LAUNCHED A TELEHEALTH SOLUTION TAILORED TO HIV PREVENTION WITH A US$1.2 MILLION GRANT FROM THE BILL & MELINDA GATES FOUNDATION.

without HIV. PREVENTIVE SERVICES TOWARDS AN AIDS-FREE GENERATION Looking at preventive interventions, a multitude of research-backed data further suggests that an improved therapeutic and safety profile supports the current policy to treat all individuals with HIV as soon as diagnosis is confirmed (Treat-All).

It is projected to reduce mortality and improve life expectancy and quality of care for patients with HIV on antiretroviral therapy, even in lowincome settings.

With an emphasis on targeting key populations as a crucial consideration, antiretroviral drugs have shown promise for prevention in HIV preexposure prophylaxis and treatment.

A long-acting injectable form of PrEP, Apretude, has also been approved by the FDA, specifically designed to be administered by a healthcare provider every two months instead of daily oral pills. On top of this, healthcare providers can offer to facilitate the conversations or identify providers who may be able to offer PrEP and post-exposure prophylaxis (PEP) to partners.

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Zeroing in on the horn of Africa, Kenyan e-pharmacy startup MYDAWA launched a telehealth solution tailored to HIV prevention with a US$1.2 million grant from the Bill & Melinda Gates Foundation. MYDAWA, in partnership with the University of Washington, Jomo Kenyatta University of Agriculture and Technology, Fred Hutch Cancer Research Centre, Jhpiego, and Audere, has also developed an end-to-end virtual healthcare solution for customers who wish to access PrEP and PEP online.

The start-up’s virtual, discreet, and convenient service delivery can expand the reach of PrEP, which has been limited by the stigma associated with HIV and the public nature of the current onboarding system. Over the past decade, drug developers have worked to improve a wide array of regimens as well as the properties of individual therapies.

To meet children's individual needs, Gilead Sciences has teamed up with the Clinton Health Access Initiative (CHAI) and the Penta ID network to accelerate the development and marketing of dispersible HIV treatments for the paediatric population. The focal point of privatepublic collaborations is to develop medicine formulations that meet the needs of children, improve palatability, and, in turn, potentially increase adherence rates in children.

Long-acting treatment regimens are reportedly preferable for paediatric populations, which is a group with unmet need in the HIV NOV/DEC 2023 | HEALTHCARE MIDDLE EAST & AFRICA

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DISEASE FOCUS: HIV/AIDS

market, due to the poor availability of age-adjusted and optimised paediatric formulations of ART. Despite significant progress in scaling up HIV services for children living with HIV, the treatment gap persists, with children continuing to present lower rates of viral suppression than adults. A recent UNICEF report shows that of the estimated 39 million people living with HIV worldwide in 2022, 2.58 million were children under 19 years old.

UNICEF warns that each day in 2022, approximately 740 children became infected with HIV, and approximately 274 children died from AIDS-related causes, mostly because of inadequate access to HIV prevention, care, and treatment services.

THE PROMISE OF GENE THERAPY Despite the massive expansion of HIV treatment in recent years, there has been uneven progress in reducing new HIV infections, improving access to treatment, and ending AIDSrelated deaths as Africa bears the brunt of this inequality.

Promising candidates in clinical development show great market and growth opportunities, with the potential to change the treatment landscape and improve the quality of life for HIV-positive individuals.

An NIH-supported trial of a preventive HIV vaccine candidate is enrolling participants at six locations in the US and South Africa in an effort to create a new therapeutic option. The Phase 1 trial will evaluate a novel vaccine known as VIR-1388 for its safety and ability to induce an HIV-specific immune response in people.

NIAID continues to push for the development of antiretroviral therapies, supports the largest networks of HIV therapeutic clinical trial units in the world, and helps advance clinical drug development in different parts of the world.

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NIAID points out, “Some of the largest networks of HIV therapeutic clinical trial units in the world include the AIDS Clinical Trials Group (ACTG), the International Network for Strategic Initiatives in Global HIV Trials (INSIGHT), and the International Maternal Pediatric Adolescent AIDS Clinical Trials (IMPAACT) network.”

On top of the ongoing clinical trials, international organizations, educational institutions, pharmaceutical companies, and other stakeholders have worked together to expand treatment options and develop new drug formulations for adults living with HIV. NIAID highlights that numerous initiatives to support ARV drug optimization have been made possible by these extensive efforts. This involves at least three major international conferences on Antiretroviral Drug Optimization (CADO), as well as a number of think tank meetings and technical working group activities aimed at proactively shaping the global research and policy agenda.

Researchers found that combining mechanisms of action for HIV medicines, specifically two NRTIs and a Protease inhibitor (PI) or NNRTI, in highly active antiretroviral therapy (HAART) regimens was more effective at reducing viral load to undetectable levels than using the treatments as monotherapies.

In light of growing scientific evidence, companies are taking a keen interest in safety and efficacy across a range of patient populations, as well as the mode of administration in the context of lifelong therapy.

It is quite evident that building a critical mass of expertise, strengthened through external collaboration and knowledge exchange, should be the ultimate goal of stemming the rising number of new HIV infections. HCMEA HEALTHCAREMEA.COM

MEDICAL DEVICES & INNOVATIONS

BD launches SiteRite 9, an advanced vascular access ultrasound system, elevating clinician efficiency USA — Becton, Dickinson and Company (BD) has launched SiteRite 9, a cuttingedge vascular access ultrasound system designed to optimize clinician efficiency during the insertion of various vascular access devices.

The system features an industryleading 15.6-inch touchscreen with enhanced image quality, supporting the insertion of IV lines, central venous catheters, and peripherally inserted central catheters (PICCs). SiteRite 9 integrates advanced visualization tools such as the Cue Needle monitoring system and the Sherlock 3CG+ Tip Confirmation System for real-time needle monitoring and precise catheter tip navigation.

The intelligent, networked technologies automatically detect vessels and assist in catheter selection, improving accuracy and streamlining the insertion process. Aligned with BD's "One-Stick Hospital Stay" initiative, SiteRite 9 aims to minimize repeated needlesticks and enhance insertion

success rates on the first attempt. The system, cleared by the FDA in September 2023, is now available in the United States, contributing to BD's commitment to advancing patient care and clinical efficiency.

Smith+Nephew to acquire CartiHeal for up to US$330M, enhancing sports medicine portfolio

UNITED KINGDOM — British medical technology firm Smith+Nephew is set to acquire Israeli medical equipment manufacturer CartiHeal for an initial payment of US$180 million, along with potential contingent payments of up to HEALTHCAREMEA.COM

South African company to produce HIV-preventing vaginal rings, promising increased accessibility SOUTH AFRICA — Kiara Health, based in Johannesburg, will manufacture vaginal rings designed to protect against HIV, according to the Population Council.

With an estimated annual production of one million rings, the move aims to enhance accessibility and affordability.

Currently produced by a Swedish company, the rings release dapivirine, an HIV-preventing drug, over a month.

The discreet nature of the ring provides women an option for prevention without their partner's knowledge or consent, addressing challenges faced by women in HIV-prone regions.

HIV remains a significant cause of death among women in Africa, prompting efforts to expand preventive measures. With regulatory approval in multiple African countries, including South Africa and Uganda, the initiative aims to combat the high infection rates affecting women in the region and contributes to the global fight against HIV/AIDS.

US$150 million.

The acquisition includes CartiHeal's Agili-C, a cell-free implant designed for cartilage and osteochondral defect treatment in traumatic and osteoarthritic joints. Agili-C, which received FDA Breakthrough Device designation and Premarket Approval in 2021, is a porous, resorbable scaffold promoting natural cartilage regeneration.

The acquisition aligns with Smith+Nephew's strategy to bolster its Sports Medicine business and leverage its commercial expertise in biologics.

The transaction is expected to close in Q1 2024, with CartiHeal employees moving to Smith+Nephew upon completion.

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MEDICAL DEVICES & INNOVATIONS

GE Healthcare launches MyBreastAI Suite to enhance breast cancer detection with AI USA — GE Healthcare has rolled out the MyBreastAI Suite, an all-in-one artificial intelligence (AI) platform for mammography, aimed at expediting breast cancer detection and improving workflow productivity.

The suite integrates three AI applications from iCAD—ProFound AI for DBT, SecondLook for 2D Mammography, and PowerLook Density Assessment AI. ProFound AI for DBT offers lesion certainty data, supporting caseload prioritization and clinical decision-making.

SecondLook for 2D Mammography is a computer-aided detection system highlighting regions of interest, while PowerLook Density Assessment facilitates consistent breast density assessments. The platform, part of GE Healthcare's commitment to leveraging AI in mammography, enhances early detection and patient outcomes while addressing evolving screening guidelines and personal risk factors.

The MyBreastAI Suite is initially available in the United States and will be distributed as part of the Senographe Pristina mammography portfolio.

Argon Medical unveils Kodiak Kit for precision in complex vascular access

USA — Argon Medical Devices introduces the Kodiak Dual Port Coaxial Introducer Kit, catering to interventional radiology, vascular surgery, and cardiology. Engineered for versatility, Kodiak facilitates the simultaneous introduction of diagnostic and therapeutic devices through a single access site, streamlining complex vascular procedures.

With a robust, large-bore sheath and a Y-shaped adapter, the system provides reinforced support, particularly beneficial in procedures like

Canon Medical unveils AI-powered CT workflow automation for enhanced patient care USA — Canon Medical Systems USA introduces the End-to-End CT Workflow Automation suite, leveraging artificial intelligence (AI) technology to streamline operations from referral through reporting.

The suite aims to enhance patient care and operational efficiencies, featuring the INSTINX CT workflow experience tool for quick scan planning and safe patient positioning. The Remote Assist tool enables remote scanning assistance, providing direct virtual access from the scanner to in-house experts.

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complex IVC filter retrievals. Dr. Julie Bulman notes its stability and reliability in accommodating various retrieval methods.

Argon's President & CEO, George Leondis, emphasizes the Kodiak's contribution to improved procedural outcomes, addressing the anatomical diversity encountered in vascular procedures. The Kodiak Kit enhances Argon's commitment to providing differentiated solutions for efficient and successful complex vascular interventions.

NOV/DEC 2023 | HEALTHCARE MIDDLE EAST & AFRICA

The Automation Platform utilizes AIpowered zero-click solutions to reduce manual intervention, while the Vina Analytics CT Protocol Management solution streamlines and standardizes protocol management for Canon CT scanners.

This innovation supports healthcare providers in delivering exceptional patient care by automating various aspects of the CT scanning process, empowering professionals in the current landscape of limited access to skilled labor.

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BD launches PIVO Pro Needle-free blood collection device compatible with integrated catheters

USA — Becton, Dickinson and Company (BD) has introduced the PIVO Pro Needle-free Blood Collection Device in the US, securing 510(k) clearance from

the FDA. The device is designed for compatibility with integrated and extended peripheral IV catheters,

making it the first option for such use.

The compatibility extends to the new Nexiva Closed IV Catheter System with NearPort IV Access, expanding on PIVO's established compatibility with traditional short peripheral IV catheters since 2017.

PIVO Pro enables high-quality blood sample collection directly from a patient’s peripheral IV line, reducing the need for additional needle insertions.

The device aligns with BD's vision of a 'One-Stick Hospital Stay,' aiming to improve workflow, clinical outcomes, and the overall experience for both clinicians and patients.

Siemens Healthineers Receives FDA Clearance for Biograph Vision.X PET/CT Scanner USA — Siemens Healthineers has gained FDA clearance for the Biograph Vision.X PET/CT scanner, featuring a groundbreaking time of flight (TOF) of 178 picoseconds for improved lesion detection and anatomical detail.

The next-gen system builds upon the Biograph Vision scanner's established performance, offering an upgrade option for current users.

The Optiso Ultra Dynamic Range detector technology incorporates silicon photomultipliers and small lutetium oxyorthosilicate crystals, achieving

superior spatial and temporal resolution.

With a 20% performance improvement, the Biograph Vision.X enhances patient throughput, reduces radiation exposure, and minimizes radiotracer costs.

Equipped with the AIDAN intelligent imaging platform, leveraging AI, the scanner incorporates features like FlowMotion AI for seamless and personalized image acquisitions. The 78cm bore ensures patient comfort and facilitates positioning for various needs, making it a versatile addition to PET/CT facilities.

Medtronic's Symplicity Spyral gains FDA approval for hypertension USA — Medtronic has received FDA approval for its Symplicity Spyral Renal Denervation (RDN) System, an advanced, minimally invasive treatment for hypertension.

The Symplicity Spyral, also known as the Symplicity blood pressure procedure, employs radiofrequency energy to target HEALTHCAREMEA.COM

overactive nerves surrounding the kidneys, a common cause of high blood pressure. The FDA's approval allows Medtronic to immediately commence commercialization of the device.

Hypertension, a significant modifiable risk factor for heart-related issues, is a global health concern. The

approval follows a comprehensive global clinical program, SPYRAL HTN, involving over 25,000 patients and evaluating the RDN system's effectiveness with and without medication and in high-risk cardiovascular patients.

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MEDICAL DEVICES & INNOVATIONS

GE HealthCare secures FDA 510(k) approval for Critical Care Suite 2.1 with PTX algorithm

USA — GE HealthCare has secured FDA 510(k) approval for its Critical Care Suite

2.1, featuring a Pneumothorax (PTX) algorithm. The PTX algorithm expands

the on-device triage capabilities of the Critical Care Suite, enabling immediate detection, notification, triage, and diagnosis of PTX. The system displays on-device and PACS overlays upon PTX detection, enhancing PTX localization and diagnosis. Operating with high accuracy, the algorithm significantly reduces reporting times for actionable PTXs and improves clinician detection of small PTXs. Co-developed by GE HealthCare and UCSF’s Centre for Digital Health Innovation, the advanced AI algorithm was trained using a diverse data set of over 30,000 images. GE HealthCare's Critical Care Suite aims to enhance clinical outcomes by empowering clinicians with timely and efficient AIdriven insights in critical care situations.

Medtronic launches Penditure LAA Exclusion System for enhanced cardiac surgery control Post-Market Study in 2024 to further evaluate the system's clinical outcomes in concomitant cardiac surgery, reinforcing the company's commitment to advancing cardiac care through innovative solutions.

USA — Medtronic, a global healthcare technology leader has launched its Penditure Left Atrial Appendage (LAA) Exclusion System, an implantable clip designed for left atrial appendage management (LAAM) during cardiac surgery in the U.S. The Penditure clip, acquired from Syntheon LLC, is preloaded on a single-use delivery system and uniquely curved to match atrial anatomy.

Notably, it is the only recapturable 62

and redeployable LAA clip, providing surgeons greater control during procedures. The clip's atraumatic closure and reduced inflammation, along with its low profile, contribute to improved visibility and safety.

Dr. Gorav Ailawadi at the University of Michigan and Dr. Basel Ramlawi at Lankenau Heart Institute commend the innovation, emphasizing its efficacy and repositioning capabilities.

Medtronic plans to initiate the CLIP-IT

NOV/DEC 2023 | HEALTHCARE MIDDLE EAST & AFRICA

LEFT ATRIAL APPENDAGE EXCLUSION SYSTEM IS THE ONLY RECAPTURABLE AND REDEPLOYABLE LAA CLIP, PROVIDING SURGEONS GREATER CONTROL DURING PROCEDURES.

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MEDICAL DEVICES & INNOVATIONS

Roche launches LightCycler PRO System, advancing PCR technology for research and diagnostics SWITZERLAND — Roche introduces the LightCycler PRO System, a cuttingedge PCR technology that bridges the gap between translational research and in vitro diagnostics.

The system, building on the heritage of Roche's LightCycler real-time PCR systems, sets a new standard for performance and usability. Addressing the evolving dynamics of healthcare post-pandemic, the LightCycler PRO System allows seamless transitions between research and clinical applications, providing flexibility and reliability.

Users can develop custom tests, and the system supports a portfolio of over 200 LightMix Modular research assays and 60 LightMix CE-IVD assays.

Launching initially in select countries by

the end of 2023, the system will be CEmarked and have FDA 510(k) exempt status.

Roche introduces Elecsys HBeAg Quant Test for Hepatitis B monitoring

SWITZERLAND —Roche has introduced Elecsys HBeAg quant, a new immunoassay for qualitatively and quantitatively determining hepatitis B e antigen (HBeAg) in human serum and plasma.

The test, intended for use on Roche’s cobas e analysers, aids in the diagnosis and monitoring of patients with hepatitis B viral infection. Providing information on the presence and quantity of HBeAg, the test assists clinicians in deciding on 64

treatment regimens.

Roche emphasizes the critical need for accurate diagnosis in addressing the global health burden of hepatitis B, which can lead to chronic infections and increase the risk of cirrhosis and liver cancer. The Elecsys HBeAg quant assay complements Roche’s existing HBV testing markers, offering improved operational efficiency and reducing complexity for laboratory personnel.

NOV/DEC 2023 | HEALTHCARE MIDDLE EAST & AFRICA

Johnson & Johnson MedTech invests US$400M in Laminar for heart device

USA — Johnson & Johnson MedTech has made a significant upfront investment of US$400 million to acquire Laminar, the developer of a pioneering device designed to address complications related to the left atrial appendage in individuals with irregular heartbeats.

This acquisition places Johnson & Johnson MedTech at the forefront of the rapidly evolving market for heartrelated interventions, competing with major players like Medtronic. Laminar's device, termed "left atrial appendage elimination," unfolds into a small ball, uniquely twisted around in a circle to gather tissue and securely closed with a patch, minimizing metal exposure and reducing the risk of blood clots.

The deal includes additional clinical and regulatory milestone payments, reflecting a commitment to ongoing development. Despite the promising potential, the acquisition's cost and future research plans will impact J&J's profit projections for the fiscal year 2023, influencing adjusted earnings per share for the next fiscal year.

A pivotal human study for Laminar's device, with FDA approval, is set to begin enrollment in early 2024, addressing the needs of the approximately 38 million individuals worldwide suffering from atrial fibrillation.

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