African governments and pharmaceutical manufacturers are investing heavily in local medicine production to reduce the continent's dependence on imports, with roughly 70–80% of medicines and nearly all vaccines currently sourced from overseas — a vulnerability laid bare during the Covid-19 pandemic. However, a new report by the Access to Medicine Foundation warns that the central challenge is no longer factory construction but securing predictable purchasing commitments from governments and donors to keep plants financially viable. Fragmented national markets, country-by-country drug registration requirements, and inconsistent procurement systems continue to undermine manufacturers' ability to achieve the production volumes needed to compete on price, with experts calling for greater regional regulatory cooperation and pooled procurement under frameworks such as the African Continental Free Trade Area.