Zimbabwe is facing a pharmaceutical paradox: local manufacturers say they have the technical capacity to produce 47% of the medicines on the country’s essential medicines list, yet domestic manufacturers supplied less than 1% of public pharmaceutical procurement in recent years, while the country imported medicines worth about US$330 million last year.

The contradiction raises a bigger question than whether Government should simply “buy local”. It is whether Zimbabwe is getting enough value from investments made in its pharmaceutical industry and whether public procurement can be redesigned to build domestic production without making medicines more expensive or leaving hospitals with shortages.

The issue is particularly important because the public health sector is the country's biggest single buyer of medicines, with procurement channelled largely through the National Pharmaceutical Company. Yet Government procurement remains divided between domestic and international suppliers, with some tenders specifically targeting locally manufactured medicines.

The pharmaceutical industry's 47% capacity figure also needs to be understood carefully. It refers to the number of items on the essential medicines list that local producers can manufacture, not 47% of the country's total medicine requirements by value or volume.

That distinction matters because being able to manufacture a medicine does not necessarily mean a factory can produce it at the required volume, price, quality specifications or delivery schedule.

Kudzai Hove of the Pharmaceutical Manufacturers Association argues that Zimbabwe is nevertheless failing to make adequate use of an industrial base that already exists.

“We are practically importing medicines that we manufacture right here at home,” she said.

Her argument is that public procurement is not merely a purchasing decision. A reliable domestic market gives manufacturers the predictable demand needed to invest, increase production runs, spread fixed costs over larger volumes and develop new products.

The experience of Varichem illustrates the other side of the equation. The company has increasingly developed export markets, while the Ministry of Industry and Commerce reported that the manufacturer was operating above 70% capacity utilisation and had invested more than US$3 million in plant and machinery upgrades.

That creates a crucial policy question: if Zimbabwean manufacturers can meet international standards and sell regionally, why is the domestic public market not providing a larger guaranteed customer base?

There is evidence that Government itself recognises the problem.

Industry and Commerce Minister Mangaliso Ndlovu announced that Government had made US$10 million available to NatPharm specifically to procure medicines manufactured in Zimbabwe. He said the decision followed concerns that NatPharm was still importing medicines despite the strength of local manufacturing and the country's regulatory environment.

“Following our plea that our pharmaceutical manufacturing industry is doing very well, aided by the very strong regulatory environment by MCAZ, which was the first regulator in Africa to attain Maturity Level Four, we made a plea to the President because we still saw NatPharm importing more medicines instead of supporting local manufacturers,” Ndlovu said.

He added that the US$10 million facility was intended to operate as a revolving fund rather than a once-off intervention.

“We need a Zimbabwean story, a story where we are supporting people who are doing honest, hard work,” Ndlovu said.

The intervention is significant because it potentially changes the argument from one about protectionism to one about market creation. If Government commits predictable funding to medicines that Zimbabwean companies can competitively manufacture, local firms have an incentive to increase production.

But US$10 million is also small compared with a pharmaceutical import bill of roughly US$330 million cited by industry. Even if the entire US$10 million were spent on locally manufactured medicines, it would represent only about 3% of a US$330 million annual import bill.

That means the fund can be a catalyst, but it cannot by itself transform Zimbabwe's pharmaceutical trade balance.

There is another complication: local procurement cannot mean purchasing locally at any price.

Zimbabwe's public procurement framework requires procurement to be transparent, fair, cost-effective and competitive. This creates the central balancing act. Government can legitimately use procurement to support industrial development, but hospitals still need medicines that are available, affordable, safe and delivered on time.

A policy that automatically awards contracts to domestic manufacturers regardless of price, availability or quality could simply shift the cost to patients and taxpayers.

Conversely, a procurement system that treats every international supplier as automatically preferable on price may ignore the wider economic cost of imports: foreign currency leaving the country, lost manufacturing capacity, weaker local supply chains and reduced incentives for domestic investment.

The regulatory argument also appears less persuasive than it once was.

MCAZ Director-General Richard Rukwata said regulatory cooperation was being strengthened across the region to ensure that only safe, effective and quality-assured medicines reach patients.

“This collaboration marks a significant milestone in regional regulatory convergence,” he said when MCAZ signed a cooperation agreement with Zambia's medicines regulator.

MCAZ has also been tightening traceability requirements across the pharmaceutical supply chain, requiring manufacturers, importers, wholesalers, retailers and health institutions to comply with systems designed to make medicines traceable.

This is important because the argument for buying local cannot be based simply on patriotism. Local medicines still have to meet regulatory requirements and compete on quality, price and reliability.

There is also a supply-chain question.

NatPharm operates a national distribution system and has previously said it gives priority to local manufacturers when sourcing medicines and medical supplies.

Former acting managing director Ivan Gibson Dumba said in 2021:

“NatPharm gives priority to local manufacturers in sourcing all its medicines and medical supplies requirements.”

He added that the organisation was helping manufacturers source active pharmaceutical ingredients to increase production and reduce imports.

So the problem may not be simply that Government has no local-preference policy.

Zimbabwe has had local procurement measures before. The harder question is why those policies have not translated into a much larger share of actual public pharmaceutical purchases.

One explanation is the structure of pharmaceutical financing itself. Zimbabwe's public medicine supply has historically depended heavily on external financing and donor-funded programmes. Earlier industry assessments found that donor-funded procurement channelled substantial volumes of finished medicines through NatPharm, weakening the domestic industry's ability to build a sustainable market.

That history matters as donor financing changes. A system designed around international procurement can be difficult to reorient towards local manufacturing simply by issuing a new preference.