Africa’s struggle to make essential medicines affordable is not simply a problem of inadequate pharmaceutical production, as a new report suggests that fragmented markets, weak procurement systems, unpredictable demand and differing regulatory requirements are making it difficult for drug manufacturers to scale supply and bring medicines to more patients.

The findings of the report by the Access to Medicine Foundation, are significant for Africa’s growing pharmaceutical market, where demand for medicines is rising at the same time as governments and investors push for greater local production.

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The report examined eight multinational and regional generic medicine manufacturers: Aspen Pharmacare, Cipla, Emzor Pharmaceutical Industries, EVA Pharma, Hikma Pharmaceuticals, Sothema, Universal Corporation and Viatris — and found that companies are already adapting their businesses to Africa’s changing healthcare needs.

However, the report suggests that manufacturers cannot solve the continent’s medicine access problem on their own.