The African Medicines Quality Forum (AMQF) is a powerful continental collaborative that helps national quality control laboratories strengthen their capacity for medicines quality testing and supports countries to institute programs that prevent falsified and substandard medicines from reaching consumers. A leading example of the impact of South–South cooperation, AMQF seeks to improve access to quality-assured medicines across Africa by promoting the use of common guidelines, policies, and practices. “By bringing the whole continent together under the platform of medicines quality, the ‘Africa We Want’ is surely within our grasp,” declared Gugu Mahlangu, Director General of the Medicines Control Authority of Zimbabwe, at the AMQF’s most recent annual meeting.
Since its establishment in 2017, AMQF has been managed by the African Union’s (AU) development agency, the New Partnership for Africa’s Development (NEPAD). In this context, the Forum contributes directly to the AU’s African Medicines Regulatory Harmonization (AMRH) program, which works to improve access to quality, safe and efficacious medicines by providing an enabling regulatory environment for pharmaceutical sector development in Africa. AMQF’s activities will be integrated into the African Medicines Agency (AMA), a specialized AU agency seeking to harmonize medicines regulation throughout Africa.
AMQF’s history can be traced back to 2009 when its predecessor, the Network of National Official Medicines Quality Control Laboratories in Sub-Saharan Africa (NOMCoL-SSA) was founded. USAID’s Promoting the Quality of Medicines (PQM) program, which is implemented by the U.S. Pharmacopeial Convention (USP), provided the necessary financial and technical resources to establish NOMCoL-SSA and foster its development. “USAID encourages sustainable health systems within countries and regional mentorship between countries,” says Alison Collins, a Health Systems Advisor in USAID's Bureau for Global Health. “USAID's initial investments in NOMCoL-SSA have paved the way for expansion of AMQF, enabling the network to autonomously support this vision in Africa."
In 2014, USP began contributing technical and financial assistance of its own to NOMCoL-SSA. This marked a critical early step in the process that would culminate in the creation of AMQF by enabling the Network to begin phasing out donor-backed funding and leadership through the PQM program.
USP assumed PQM’s initial NOMCOL-SSA responsibilities in 2016, recognizing this role as a bridge to what would become AMQF. In fact, after setting a short-term goal of recruiting local leadership for NOMCoL-SSA, USP transferred management of the Network to NEPAD in 2017. “Given USP’s proven success administering NOMCoL-SSA, it was very easy to see the benefits of transitioning and expanding the Network under NEPAD,” says Margareth Ndomondo-Sigonda, NEPAD’s Head of Health Programs. She clarified that such expansion was seen not only in the increase of Network membership to 40 countries, but also in the escalation of its mission throughout the region. “Integrating NOMCoL-SSA into the African Union structure through NEPAD made sure that the goal of expanding access to quality-assured medicines would be a lasting part of the African development agenda,” states Ndomondo-Sigonda.
Under new NEPAD leadership, NOMCoL-SSA members agreed at a USP-hosted event in Ghana in 2017 to change their name to African Medicines Quality Forum (AMQF). The AMQF was subsequently established as a technical working group within NEPAD, initiating partial funding through the African Medicines Regulatory Harmonization (AMRH) program while decreasing USP’s financial contribution. Moreover, member countries who committed to hosting the Forum’s upcoming annual meetings also agreed to share related costs with USP.
AMQF’s first annual meeting in Tanzania in 2018 resulted in a preliminary work plan for the Forum. When AMQF gathered in Morocco for its second annual meeting in February 2019, the focus shifted to preparing for the final phase of continental ownership by creating a roadmap for AMQF’s financial independence and redefining the long-term role of USP and other partners as technical assistance providers only. As for developing sustainable financing options over the long term, NEPAD is currently conducting analysis of various sources of potential revenue for national medicines regulatory authorities and national medicines quality control laboratories. The outcome of this exercise will serve as an advocacy tool to guide policymakers, decision-makers, and politicians to invest more in strengthening medicines regulatory systems.
With AMQF’s march toward self-reliance gaining increasing speed, USP and the PQM program are looking to share lessons learned with the other NOMCoLs in the Asia-Pacific, Middle East and North Africa regions. “It’s a long process,” concludes USP Senior Technical Manager, Hariram Ramanathan. “The African experience has shown us that the key is investing the time and effort needed to find the right stakeholder who will take true ownership of a NOMCoL, and then remaining with them as a partner throughout the course of building sustainability.”
What is the impact of this initiative? Margareth Ndomondo-Sigonda offers a persuasive answer. “In the end, we are really talking about improving both public health and economic growth. AMQF’s efforts aimed at eliminating substandard and falsified medical products from the African market will strengthen public confidence in health care delivery systems and attract investment in local pharmaceutical industries.”
The Promoting the Quality of Medicines (PQM) program is funded by the U.S. Agency for International Development (USAID) and implemented by USP. The PQM program supports low- and middle-income countries in strengthening health systems by building capacity for the regulation and manufacture of medical products. This helps increase availability of lifesaving, quality-assured medicines to meet global health priorities, ensuring healthy lives, and promoting well-being for all people of all ages. For more information, visit www.usp-pqm.org.