Towards National Self-Sufficiency: A Gap Analysis of Afghanistan’s Essential Medicines List and Locally Manufactured Generic Medicines
Keywords: Essential medicines list, generic medicines, production, pharmaceutical self-sufficiency, health system resilience, Afghanistan pharmaceutical sector
Waheed Ullah Hafiz
Abstract
Access to essential medicines is central to health system resilience, yet fragile and conflict-affected countries often struggle to balance industrial growth with public health needs. Afghanistan has developed a modest pharmaceutical base, but its alignment with national priorities remains unclear. This study evaluates the extent to which Afghanistan’s local pharmaceutical production corresponds with its Essential Medicines List (AEML) to identify gaps and inform strategies for self-sufficiency. A comparative cross-sectional analysis was conducted using two official datasets from the Afghanistan Food and Drug Authority: the AEML and the registry of locally manufactured generic medicines. Medicines were matched by active ingredient and therapeutic class, with coverage analyzed by dosage form and therapeutic category. Sixty domestic manufacturers produce 537 generic medicines. However, only 126 (23%) overlap with the AEML, leaving more than three-quarters of essential medicines dependent on imports. Local production is concentrated in low-priority categories such as dermatologicals (57.5%) and musculoskeletal agents (45.5%), while critical areas—including oncology, vaccines, and injectables—show negligible or no local coverage. Dosage form analysis revealed complete absence of locally produced injectables, despite their prominence on the AEML. Afghanistan’s pharmaceutical sector remains largely market-driven rather than needs-driven, favoring profitable but non-essential products. To advance self-reliance, the AEML must be updated, regulatory authority consolidated, and targeted incentives introduced for priority medicines. Strategic investment in infrastructure and public–private partnerships is essential to reduce dependency, improve medicine security, and strengthen resilience of Afghanistan’s health system.
