Expanding Africa’s ARV reach: Why export promotion matters

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OPINION

By Emmanuel Katongole

World AIDS Day was commemorated on Monday, December 1, 2025. As we commemorated this day, the story of HIV treatment in Africa has changed profoundly, from misery to reliable, lifelong therapy.

We have moved from a time when many people died from HIV/AIDS-related illnesses like Kaposi’s sarcoma, to a time when most people on treatment can keep the virus under control and live healthy, long lives.

That transformation has been powered by science, partnership, and, critically, access to the latest technology to manufacture affordable antiretroviral (ARV) medicines.

At Quality Chemical Industries Limited (Qcil), that mission is deeply personal. When my partners and I first stood up and said we would manufacture ARVs in Uganda, few believed it was possible. Even some of our closest friends warned that the molecules were too complex to produce in Africa. But we had seen evidence to the contrary, that countries with large populations, shared vulnerabilities and the right environment could produce generics at a world-class standard. We believed Uganda could be that proof point.

The urgency became real between 2002 and 2005 when India and China ratified the Trade-Related Aspects of Intellectual Property Rights (TRIPS) agreement. This meant that generic versions of patented drugs could no longer be produced there without special legal flexibilities.

For Africa, where affordable treatment had been mainly sourced from these countries, the news was devastating. However, TRIPS had a lifeline clause that allowed least developed countries to manufacture patented medicines, if technology was transferred to them.

That clause became Uganda’s strategic window. Dr Yusuf Hamied, then chairperson of Cipla, a multinational pharmaceutical company based in India, had already pledged to offer medical technology to any African country willing to produce it. And we took that opportunity.

When we approached Dr Hamied, I said this to him: “We have seen India, where the rich and poor live side by side, much like in Africa. If they can produce affordable medicines at scale, why can’t we do the same here in Uganda?” This was the beginning of Qcil’s journey to complete technology transfer for ARV manufacturing from Cipla, turning a possibility into reality and giving birth to Qcil, Sub-Saharan Africa’s leading ARV manufacturer.

Uganda became the first and remains the only African country to receive complete technology transfer for manufacturing WHO-prequalified HIV and malaria medicines in the region. Thanks to President Yoweri Museveni’s confidence in support for local manufacturing. Uganda already had a foundation, having collaborated with Dr Hamied during the Joint Clinical Research Centre (JCRC) trials. That meant the first offer came to us.

Fast-forward to 2025, and Qcil now supplies ARVs to 14 African countries, which proves that Uganda can lead on regional medicine security, not just national demand. This is impact at scale, anchored in Ugandan innovation, scientific capability, and industrial resilience. Last year alone, we produced and supplied more than 200 million ARV tablets locally, enough to support over 550,000 people living with HIV in Uganda. Put simply, four in every 10 Ugandans on HIV therapy depend on ARVs made by Qcil.

ARVs are more affordable today because we manufacture them locally in Uganda, reducing the high import costs and ensuring treatment is always available. This means more people can stay on treatment without interruption, which allows them to live long, healthy lives while keeping costs manageable for families and the health system.

However, we must face a critical reality: Producing ARVs locally is only one part of the solution. If deliberate policies, such as favourable export promotion, are not implemented to expand sustainable access beyond Uganda’s borders, the full potential of local manufacturing will remain unrealised.

Despite the progress we have made, many African countries still struggle with inconsistent supply, high costs and limited availability of quality ARVs.

To transform local production into regional impact, Uganda must adopt robust export-promotion policies that allow locally manufactured ARVs to reach more African markets efficiently. This includes measures, such as streamlined regulatory approvals, tax incentives, trade facilitation and harmonised cross-border standards. By enabling Ugandan-made medicines to compete fairly across the continent, we can achieve economies of scale, lower production costs, and expand access to lifesaving treatment.

Export promotion is not just an economic strategy, it is a public-health imperative. Greater regional distribution of locally produced ARVs means more patients can receive uninterrupted therapy, viral suppression becomes more achievable, and the continent moves closer to ending HIV/AIDS as a public health threat. Thus, export-focused policies can turn Uganda’s manufacturing success into a lifeline for millions across Sub-Saharan Africa.

Uganda treats over 1.3 million people living with HIV, but still largely depends on imported ARVs for some specialised or patented medicines. This puts patients at risk of delays, price changes and shortages caused by various global market dynamics.

Donors often favour cheaper foreign manufactured ARVs, limiting opportunities for local manufacturers like Qcil, who face high production costs, expensive financing, and fragmented regulations. At the same time, global suppliers benefit from scale and preferential export policies.

To unlock regional impact, Uganda must expand export-promotion policies, harmonise regulations and support local consumption to sustain treatment continuity. Affordable long-term financing and increased production capacity will reduce costs and boost competitiveness.

Local manufacturing is both a public-health necessity and an economic growth driver, saving lives in Uganda and across Africa.

The writer is the Board Chairperson and Co-Founder of Quality Chemical Industries Limited