乌干达本土制药业挑战

在过去十多年时间里，乌干达的制药业逐步增长，投资者们希望继续利用这一增长机遇，扩大其现有的制造规模，升级改造生产设备。
2007年，乌干达建成了两个大型制药厂，即Quality Chemical Industries Limited (QCIL),公司和Abacus Parenterals Drugs Limited (APDL)公司。
虽然乌干达的制药业有了长足的发展，但这个拥有4000万人口的国家每年仍需进口90%的基础药物和医疗用品。按照卫生部的统计，截至2015年，乌干达在医疗和药品方面的进口支出达3.73364亿美元。这些进口药物和卫生用品占乌干达进口总额的5.4%。在这种情形下，乌干达基础药品的价格高昂，生活贫困的百姓根本无力购买。

行业现状
从国家政策上看，这个非洲东部国家的药品制造和销售受国家卫生和药品政策监管。同时，乌干达投资局负责招商和发放投资许可证，国家药品监督管理局则对药品生产进行监管和认证。
乌干达的现代制药业是从用草药治病的传统医学逐渐发展形成的。上世纪40年代，乌干达的一家护肤品公司——Kwefuga公司在经过多年研究后，使用当地技术生产药膏，成为了第一家现代制药企业。
乌干达现在拥有了四家大型制药企业，它们分别是：坎帕拉制药工业有限公司（KPI）、雷内工业有限公司、QCIL公司和APDL公司，但它们所占的当地市场份额尚不到20%。
印度西普拉制药公司拥有的QCIL公司是其中规模最大、经营最成功的企业。2007年，它成为非洲第一家生产用于治疗艾滋病的三联抗逆转录病毒药物（ARV）的公司。2016年，该公司向纳米比亚运送了70吨价值7000万美元的抗逆转录病毒药物。QCIL公司还生产抗疟疾的药物卢马蒿（Lumartem）。

印度掌控乌干达的制药产业
联合国工业发展组织（UNIDO）在2010年发布了一份关于乌干达制药业状况的报告，从中可以看出，乌干达的大多数制药公司都是印度人所拥有。
根据国家药品管理局提供的数据，在乌干达持有执照的280家制药商中，150家归印度所有。
印度还是乌干达最大的药品和医疗设备进口国。根据联合国商品贸易统计数据库中有关国际贸易的数据，截至2017年，乌干达从印度进口的医药产品总额已达到1.474亿美元。
马丁·路德·穆努是位于坎帕拉的马克雷雷大学经济政策研究中心（EPRC）的一位副研究员，他认为乌干达的制药业与其他制造业一样，都遇到产能不足的问题。
穆努说，“乌干达工业生产能力的基础很薄弱，这其中也包括制药业。而且这一领域的创新能力也很差。印度的情况就不是这样，它除了按照世贸组织的法律规定生产仿制药品外，还在技术研发方面加大投资力度。乌干达国内的制药企业太少，无论是数量还是质量都无法满足市场需要，所以不得不对外采购。”

商机无限
中国驻乌干达使馆的一位不愿透露姓名的官员说，虽然中国可以为乌干达的药品生产提供一些原料，但他不了解是否有中国的制药企业愿意来乌干达投资和经营。
乌干达的制药行业以生产仿制药为主。但由于技术落后和缺乏相关的技能培训，乌干达的制药业仍需依赖进口活性药物成分（API）以及几乎所有辅助材料和一些包装材料。
在乌干达，中央政府是药品的最大买家，其次是私营部门。政府药品的采购、贮存和分销均由国家医药商店这一法定机构负责完成。私营部门需从全国各地的批发和零售药店购买药品。按照国家药品管理局的规定，药店则直接从制药厂购买药品。
最近乌干达贸易部部长阿梅利亚·基安巴德女士考察了乌干达的一些制药企业，她一再要求企业扩大其在当地市场的份额。她认为，乌干达要想减少国际收支逆差，制药行业则扮演着至关重要的角色。她甚至期望这些企业能够努力寻求向国际区域市场出口的机会。乌干达生产的药品完全可以出口到其邻近国家，比如坦桑尼亚、南苏丹、卢旺达、布隆迪和刚果民主共和国。
随着乌干达对医疗服务需求的增加，预计在未来十年里制药业的规模会增长一倍。受乌干达在投资方面优惠政策的吸引，许多制药商纷纷表示愿意在乌干达投资建厂。
今年3月，来自印度和乌干达的制药企业齐聚坎帕拉，参加由印度药品出口促进委员会主办的印度-乌干达制药企业会议。这次会议旨在探索加强两国在医药领域合作的途径。离开乌干达前，代表印度一些大型制药企业的印度代表团又与乌干达投资局举行了一次会议，积极探讨在乌干达的各种投资机会。
印度总理纳伦德拉·莫迪去年访问了乌干达，他在访问期间与乌干达总统约韦里·穆塞韦尼签署了若干合作协议，其中一个就是加强双方在医药领域合作的协议。
分析人士认为，这释放出一个信号，乌干达生产仿制药品仍然具有盈利机会，而且投资者对此充满信心。
马丁·路德·穆努说，“直到现在，乌干达的制药业都是由印度在掌控。这充分体现出印度在这一行业，特别是在发展中国家中占据着主导地位。印度的制药企业与乌干达等国家的药品供应商合作，目的是为了促进其自身价值链的发展。此外，印度的投资者们也愿意与其国内企业合作利用这些企业的专业技术、知识产权和经验，共同投资乌干达的制药业，从而在乌干达市场获得机会和收益。”

兽药制造
为了降低兽药价格和防止假药，乌干达一直鼓励兽药的制造商们在其本土组织生产。
去年乌干达总统约韦里·穆塞韦尼批准成立了阿尔法桑乌干达公司，它是荷兰阿尔法桑国际有限公司的分公司。这家荷兰公司可以生产36种不同的兽类药品，包括维生素、除虫剂、抗生素和除螨剂。
史蒂芬·比朗是阿尔法桑乌干达公司的首席执行官，他最近在接受当地报社采访时说，在乌干达设立制药厂可以大大降低生产成本，这些药品的价格市场也能够接受。该报社援引他的话说，“在本地生产不仅可以降低运输成本，而且在药品供应和包装规格上也可以非常灵活，因此极具吸引力和可行性。许多小农场主不愿使用杀螨剂，只是因为它们的包装规格太大，每包的价格对他们来说太贵了。我估计本土生产的药品会比进口药品便宜40%。”
该公司还与埃拉姆乌干达有限公司展开了合作，因为后者在2015年获得了生产疫苗的许可。

挑战依旧
近年来，乌干达不断修改其投资法律和政策，同时尽量减少办事流程中的繁文缛节和腐败现象，但制药行业的发展仍然面临产业结构和市场的双重挑战。
制药业还需要从国外引进技术、机械设备以及专业培训，但这会极大地增加生产成本，并且使投资者的收益受到影响；同时它也会使本土生产的药品失去与进口药品的竞争能力。
最近在接受当地一家杂志的采访时，坎帕拉制药工业公司首席执行官扎海姆·穆罕默德呼吁乌干达政府考虑对制药行业给予补贴，使其能够更具竞争力。
经济政策研究中心副研究员马丁·路德·穆努认为，乌干达应做到用于药品生产的大多数活性原料都是在当地生产的。
穆努解释说，“我们不应将其视为一个机会，而要作为通过发展医药产业解决全民健康问题必须采取的措施。我们可以像QCIL公司那样，更多关注世贸组织的倾向性。同时我们还需要制定整体方案，比如发展淀粉工业来满足制药产业辅料供应。现在我们进口了太多的淀粉，可实际上我们完全可以在本土生产。而且这类产品不仅在乌干达有需要，在全国各地和非洲大陆也有市场。但这一切必须在工业发展综合规划指导下才能得以实现。”
虽然乌干达的发电量过剩，但由于电力供应经常中断，导致生产企业仍需时常使用备用的发电机生产。此外，工业用户需要缴纳的税收也很高。
在正式生产前，活性药物成分（API）需要贮存在低温、干燥并且获得无菌许可的设备中，可是对许多生产企业来说，这样的设备严重缺乏，甚至根本没有。这是长期困扰该行业的一大问题，而且造成原材料的大量损失。
最严重的情况是，乌干达的药剂师极度匮乏。根据2017-2018年度医药行业的业绩报告，全国注册药剂师只有1010人，相当于每10万人中只有4.77名药剂师，而在公共部门任职的药剂师只占其中的56%。药房技术人员和配药人员在公共部门任职的比例也仅有43%。
乌干达药学协会称，乌干达只有三所大学有资格培养专业药剂师和药学技术人员。而根据乌干达卫生部（MoH）提供的数据，在那些考入药学院的学生中，真正完成学业的学生比率只有53%。
虽然面临着许多挑战，但行业分析师和投资者都越来越相信乌干达的制药产业正在以更强劲的步伐向前迈进。

英文版

Uganda’s pharmaceutical industry makes gains, vast opportunities remain

By Ronald Kato  For China Investment  Journalist of Africa News in Uganda   Photos by Ronald Kato

Uganda’s
pharmaceutical industry has developed significantly over the last 10
years with investors looking to expand current manufacturing facilities
to take advantage of growth in Uganda’s medical sector.
2007 saw the
establishment of two new large pharmaceutical manufacturers  Quality
Chemical Industries Limited (QCIL), and Abacus Parenterals Drugs Limited
(APDL).
Even with this growth, Uganda, whose population is
estimated at 40 million people, still imports 90% of its essential
medicines and health supplies. As of 2015, Uganda’s Medical and
Pharmaceutical product imports cost $373.364m according to the Ministry
of Health.
The imported medicines and health supplies account for 5.4
per cent of Uganda’s total imports.As a result, essential medicines in
Uganda remain expensive, unaffordable by the country’s poor.

Overview of the sector
At
policy level, pharmaceuticals in the east African country are overseen
by the National Health Policy and the National Drug Policy. The Uganda
Investment Authority, mandated to attract investors issues investment
licenses while the National Drug Authority conducts regulation and
certification.
Modern Ugandan pharmaceutical industry evolved from
traditional medicine men and women who treated diseases using herbs. In
the 1940’s, Uganda Kwefuga African Industries, makers of a skin cream,
was founded as a modern day pharmaceutical, after years of making
ointments using local technology.
The four major players in Uganda’s
pharmaceutical industry are Kampala Pharmaceutical Industrial Ltd
(KPI), Rene Industries Ltd, Quality Chemicals Industries Ltd and Abacus
Drugs Limited have only managed to capture less than 20 percent of the
local market.
Quality chemicals, owned by India’s Cipla remains the
biggest and most successful. In 2007, it became the first pharmaceutical
maker in Africa to produce triple-combination antiretroviral (ARV)
drugs which are used to treat HIV/AIDS.
In 2016, the company shipped
70 tonnes of antiretroviral medicines to Namibia worth $70m. Quality
Chemicals also makes anti-malarial, Lumartem.

Indian dominated sector
According
to a 2010 report on the state of Uganda’s pharmaceutical industry by
the United Nations Development Organisation (UNIDO), most pharmaceutical
companies in Uganda are owned by Indians.
According to the National Drug Authority, Uganda has 280 licensed pharmaceutical makers. 150 of those are Indian owned.
India
is also the biggest exporter of drugs and pharmaceutical equipment to
Uganda. Uganda’s pharmaceutical products imports from India as of 2017,
totaled $140.74m, according to the United Nations COMTRADE database on
international trade.
Martin Luther Munu, a researcher with the
Economic Policy Research Centre (EPRC) at Makerere University in Kampala
says Uganda’s pharmaceutical sector, as the rest of manufacturing, has
been held back by low capacity.
“Uganda has a low industrial capacity
base and this is inclusive of the pharmaceutical industry. Besides, our
level of innovations in medicine is low unlike India which has invested
a lot in R&D in addition to utilising provisions in WTO laws to
manufacture generic drugs. In addition, the few domestic pharmaceutical
industries cannot meet demand (both in terms of quality and quantity)
and so the need to import”, said Munu.

Boundless opportunities
Although
China supplies some active industry ingredients to pharmaceuticals in
Uganda, an official at the Chinese embassy in Kampala, who did not want
to be named as he wasn’t authorized to talk about the issue, said he did
not know any Chinese pharma companies setting up shop in Uganda
presently.
The sector mostly does generic pharmaceutical
manufacturing. Due to inferior technology and the absence of associated
highly skilled expertise, Uganda’s pharmaceutical sector depends on
importing active pharmaceutical ingredients (APIs) and almost all
excipients and some packaging materials.
In Uganda, the central
government is the biggest buyer of drugs followed by the private sector.
Procurement, storage and distribution of government drugs is done by
the National medical Stores, a statutory body. The private sector buys
its medicines from wholesale and retail pharmacies and drug shops spread
all over the country. The pharmacies, under regulation by the National
Drug Authority, buy from pharmaceutical manufacturers.
While on a
tour of pharmaceutical manufacturers recently, Uganda’s Trade minister
Ms Amelia Kyambadde urged pharmaceutical firms in Uganda to work towards
increasing the size of the local market they serve.She said that
pharmaceutical industries were critical in Uganda’s drive towards
reducing its balance of payment deficit. She challenged them to explore
opportunities of exporting to regional markets.
Uganda’s
pharmaceutical products are exported to neighboring Tanzania, South
Sudan, Rwanda, Burundi and the Democratic Republic of Congo (DRC).
As
demand for medical services grows in Uganda, the sector is projected to
double in size in the next decade. Attracted by Uganda’s favourable
investment policies, many drug makers have expressed willingness to set
up shop in Uganda.
In March, pharmaceutical industry players from
India and Uganda converged in Kampala for the India-Uganda Pharma
business meeting.
The meeting organized by the Pharmaceuticals Export
Promotions Council of India, was meant to explore ways of strengthening
cooperation between the pharmaceutical sectors in the two countries.
Before
leaving the country, the Indian delegation representing some of the
biggest pharmaceutical industries in India held a meeting with Uganda’s
Investment Authority to study the different investment opportunities in
the country.
During his visit to Uganda last year, Indian prime
minister Narendra Modi signed several cooperation agreements with
Uganda’s president Yoweri Museveni. One of them was to strengthen
cooperation in the area of pharmaceuticals.
 Analysts argue that
this is a signal that investors have confidence that manufacturing
generic pharmaceuticals in Uganda remains a profitable opportunity.
“Even
more recently the sector is dominated by India. This is characteristic
of Indian dominance in the pharmaceutical industries, especially in
developing countries. Indian producers link up with suppliers in
countries like Uganda in order to facilitate their value chain
development. Besides, it is easier for Indian investors to collaborate
with their fellow nationals (in terms of expertise, Intellectual
Property and experience) to invest in Uganda. They also collaborate more
amongst themselves in order to benefit more from the market
opportunities in Uganda”, said Martin Luther Munu, a researcher.

Veterinary pharmaceutical manufacturers
In
a race to bring down prices of veterinary medicines and to prevent
counterfeits, Uganda has been encouraging manufacturers of animal drugs
to set up shop.
Last year, uganda’s president Yoweri Museveni opened
Alfasan Uganda, a subsidiary of Alfasan Netherlands International BV, a
Dutch company to produce 36 different kinds of veterinary medicines
including vitamins, de-wormers, antibiotics and acaricides.
In a
recent interview with a local daily, Stephen Birungi, the CEO of Alfasan
Uganda said setting up in the country allowed them to produce drugs at
affordable costs.
“The rationale of local production is to reduce
shipping costs, create flexibility in terms of product supply and pack
size. Many small farmers do not use acaricides as the pack sizes are too
large and expensive. I estimate that the product will be 40% cheaper
than imported products,” Birungi was quoted as saying by the New Vision.
The company joined Eram Uganda Limited which was licensed to manufacture vaccines in 2015.

Challenges remain
While
Uganda has worked in recent years to reform its investment laws and
policies and  to reduce red tape and corruption, the development of the
pharmaceutical industry is still weighed down by a combination of
structural and physical challenges.
The sector still sources
technology, machinery and associated highly skilled expertise from
abroad. This increases production expenses costs sharply and affects
investors’ profit margins. It also makes their competition against
imported medicines virtually impossible.
In a recent interview with a
local magazine, Zaheem Mohammed, the CEO of Kampala Pharmaceutical
Industries, appealed to Uganda’s government to consider subsidizing the
sector to make it more competitive.
Martin Luther Munu, an associate
fellow at the Economic Policy Research Centre says Uganda should ensure
that most of the active ingredients used in the production of medicines
are produced locally.
“We should not look at this entirely as an
opportunity but rather measures to address the health problems by
developing the pharmaceutical industry. The use of WTO preferences like
for the case of Quality chemicals is one area we should look at more. We
need a holistic approach for instance to even develop the starch
industry to supply pharmaceutical industries. Currently we import a lot
of starch yet we can produce it locally. Market opportunities for these
products are not only in Uganda but also regional and continental
markets. This can only be harnessed through a comprehensive industrial
development strategy”, argues Munu.
Although Uganda generates surplus
electricity, manufacturers still have to revert to backup generators
from time to time due to power supply interruptions. Tariffs also remain
high for industrial users.
The shortage and sometimes absence of
licensed cold and dry storage facilities to hold Active Pharmaceutical
Ingredients (APIs) prior to final production still haunts the industry.
It has led to raw materials losses.
But most importantly, Uganda has
a shocking shortage of pharmacists. According to the Annual
Pharmaceutical Sector Performance Report of 2017-2018, the number of
registered pharmacists was 1010, putting the ratio of pharmacy staff to
the population to 4.77 per 100,000 people. Only 56% of pharmacist and
43% of the pharmacy technician and dispenser posts are filled in the
public sector.
According to the Pharmaceutical Society of Uganda,
only three universities are licensed to teach pharmacists and pharmacy
technicians. The completion rate for those that enroll in pharmacy
school stands at 53% according to Uganda’s Ministry of Health (MoH).
Despite
the challenges, there is increased confidence from industry analysts
and investors alike that Uganda’s pharmaceutical industry is headed for
stronger growth.