Cipla Quality Chemical Industries: Quality Medicines Made in Africa for African Patients

Interview with Nevin Bradford, Executive Director and CEO of Cipla Quality Chemical Industries Limited

What is your assessment of the pharmaceutical sector? What are the latest trends?

It is a very dynamic industry moving forward, particularly in Africa. The African pharmaceutical manufacturing sector will grow and develop at a pace over the next several years that is significantly faster, deeper, and larger than in the past. The concept of manufacturing high quality, affordable pharmaceuticals in Africa for African patients is being increasingly accepted. In many areas and cases, it is becoming the top priority for healthcare providers, for companies and patients and the healthcare provision community in general. We will see an exponential growth of manufacturing of quality associated with those affordable medicines and pharmaceutical products in Africa in the short, medium, and long term. For example, HIV patients in Africa account for almost 60% of the world’s total HIV patients. Yet, less than 5% of the antiretroviral medicines used to treat those patients are manufactured in Africa. We have upwards of 80% of the malaria cases worldwide in Africa but only 5% of the malaria treatments are manufactured here on the continent. That will change in a dynamic fashion and quite quickly. There is no point in having a very high-quality pharmaceutical product, lifesaving in many cases, that is unaffordable. On the other hand, there is no point in having an affordable product that is not of the highest quality. In many cases, this product includes treatments that will improve the quality of life, extend the quality of life, or save lives. It is this combination of affordability and quality that will drive the growth of the African manufacturing sector in the pharmaceutical industry and become a key driver as we go forward.

How competitive is the market? How do you stand out?

In the last year, we manufactured malaria treatments and cures for 35 million patients. We manufacture antiretroviral drugs to treat over 600,000 patients annually, all of these to the highest quality and affordability.

The pharmaceutical industry, both internationally and locally, is intensely competitive. We have competitors here locally in Uganda, regionally in East Africa, and continentally. But our main competition is out of India and to a certain extent China. Our company is a WHO “good manufacturing practice” or GMP approved supplier which means that we are able to supply the major donor organizations in the world. On that basis, we are competing with international companies who have the combination of affordability and quality that we endeavor and are providing but who have significant economies of scale. They are several times larger than us. In the Indian pharmaceutical manufacturing environment, there is a whole pharmaceutical supply substructure which is not currently available to us in Uganda, East Africa, or Africa in general. We have to import all of our active raw materials, called APIs, active pharmaceutical ingredients. The vast majority of our packaging has to be imported from India or elsewhere. This imposes both a time element and a cost barrier as well which our key competitors in India do not face to the same extent. We address that challenge by being affordable, manufacturing medicines of the highest quality, and striving for maximum efficiency. What we can offer to healthcare providers, buyers, patients, doctors, major donor organizations are medicines made in Africa for African patients of the highest quality and affordability. That combination makes us stand out from our peer companies in Africa and East Africa and has been the key to our success and will continue to be so going forward. Our WHO GMP prequalification allows us to bid successfully for business from major donor organizations such as the Global Fund and the President’s Malaria Initiative which is the United States government funded program to provide malaria treatments and care. In the past as well as currently, we have focused on three disease areas. The first is HIV AIDS. We manufacture a range of antiretroviral drugs for the treatment of HIV including the most recent first-line therapy which is a triple combination drug containing three medicines – tenofovir, lamivudine, and dolutegravir. We were one of the first if not the first on the African continent to make that first-line therapy available. We manufacture the WHO first-line therapy and cure for malaria which is a combination of artemether and lumefantrine. We also manufacture drugs for the treatment of Hepatitis B. Moving forward, we want to broaden our focus and enter into the private market in Uganda and elsewhere which includes medicines and drugs that are purchased in retail pharmacies or are prescribed in public clinics and private hospitals. Until now, the majority of our business has been either donor funded or through national governments such as those of Uganda and Zambia who is also a major customer of ours. Moving forward, we want to expand our customer base into the private retail market here in Uganda and elsewhere. This means introducing new products, for example medicines to treat cardiovascular disease, diabetes, and other chronic long-term conditions. In addition, we also want to address an area of currently largely unmet therapeutic need in Uganda, East Africa, and Africa which is the treatment of cancer. We want to manufacture oncology medicines for a range of cancers in Africa. Medicines that are first-line therapy in the rest of the world are not generally available in Uganda or Africa and if they are, they are very highly priced. If they are available, they are certainly not manufactured locally. As part of our intent to make affordable, quality healthcare available, we will embark on a project in the near future to manufacture a range of cancer medicines to treat several of the most common cancers here in Uganda in our new, dedicated facility in Kampala. It will be a greenfield project based on our existing site in the suburb of Kampala. It will be designed from the outset to manufacture to the highest quality standards. We will manufacture a range of cancer medicines for the most common cancers in East Africa such as breast cancer, bowel cancer, prostate cancer. We hope to have this facility up and running in the near future, in the next 18 to 24 months.

What is one of your success stories?

Currently, we manufacture a range of antiretroviral and malaria medicines. In the last year, we manufactured malaria treatments and cures for 35 million patients. We manufacture antiretroviral drugs to treat over 600,000 patients annually, all of these to the highest quality and affordability. In addition, we are the only African supplier and manufacturer of quality, affordable pharmaceuticals to major donor organizations currently such as the Global Fund and the President’s Malaria Initiative. In the last year, we exported malaria treatments to over 15 countries in Africa sponsored or bought by donor organizations. We intend to hold the emergency stockpile of malaria treatments for the President’s Malaria Initiative. This means that if there is an emergency anywhere in Africa, we will deliver medicines from the stockpile within one week. We have handled the Global Fund’s emergency stockpile of malaria treatments for Africa for the past five years. During that time period, every emergency order that we have received from the Global Fund has been manufactured, packed, and delivered within seven days. This means that when we add the President’s Malaria Initiative stockpile to the existing Global Fund stockpile, we will hold here emergency malaria treatments for over 2 million adults and 4 million children which we will be able to pack off and deliver within the timeframe of seven to ten days maximum. If there was a healthcare crisis in malaria, an epidemic, or another healthcare emergency – for example, when the entire West African country medical stores burned down three years ago – the provision of essential lifesaving malaria medicines should not be a critical issue because we will be called upon and meet our commitment to deliver within a week to ten days maximum. This gives security of supply of malaria treatments throughout the continent from an African based manufacturer.

What are your CSR activities?

We have an active CSR program. Over the last several years, we have sponsored HIV orphans through education from primary to secondary and to university. We currently have an internship program for pharmacy students which involves us taking between 100 to 120 pharmacy undergraduates into our facility for a 4 to 6-week internship. This internship extends across Uganda and regionally to Kenya, Namibia, and Rwanda. It will soon be extended to Zambia and Malawi. The program is offered free of charge. There have been over 1,200 students involved in the program since its beginning. We give them exposure and experience in world class quality pharmaceutical manufacturing. In addition, we have ongoing events in Uganda. We have medical camps testing for HIV AIDS, malaria, Hepatitis B. These are ongoing programs that we have conducted for several years and plan to continue to offer into the future.

What is your vision for the company in the next two to three years, the medium term?

We want to develop and grow our company. 18 months ago, we floated on the Uganda Securities Exchange. Currently, we are the only publicly quoted pharmaceutical manufacturer in East Africa. We want to build on that to provide success for our stakeholders in terms of the patient community and our shareholders. We want to grow and develop the existing therapeutic categories we produce and manufacture as well as entering new areas of business such as the private retail market in Uganda and elsewhere. We also plan to establish a new manufacturing facility for oncology here in Uganda. It is possible that we will establish additional manufacturing facilities outside of Uganda to provide access to the affordable quality healthcare that we have been able to offer to patients in Uganda for the past 12 years. We want to make access to our affordable quality medicine available to more patients in Africa. That is what drives our company forward.

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