The tree lives continuously for centuries, sustaining entire communities through its nutritious fruit and the ecosystems it supports.

Large companies that have emerged in Africa’s transformational economic boom, are regarded as playing a similar role in their local economies, contributing disproportionately to their nations’ employment, productivity, innovation, and tax revenues.

Just as the baobab tree creates conditions for smaller plants to thrive, large companies have created new networks of suppliers, distributors, and service providers that are driving broad-based economic development across the continent.

Africa now has around 400 companies with annual revenues north of $1billion, but it needs more. In sectors like medical technology, biotech and pharmaceuticals, the gap between what exists and what is needed is particularly acute.

Opportunities to do business there have never been greater but for many Western companies, misperceptions about its size and an enduring perception of the continent as a charity case contribute to a costly reluctance.

Companies that fail to recognise this transformation risk not only missing one of the 21st century’s great growth opportunities but also ceding the field to more agile competitors.

The demographic and epidemiological shift

Africa’s population has surpassed 1.5billion and is projected to reach 2.5billion by 2050, increasing the continent’s share of the global population from 10% in 1960 to nearly 28% by mid-century.

By 2030, half of the continent’s population will live in urban areas. This urban concentration creates attractive markets for sophisticated goods and services, including advanced healthcare.

By 2030, the continent’s healthcare market alone is estimated to reach $259billion – a figure that should command the attention of any global health company. Yet Western executives consistently underestimate this potential.

Arguably, the most significant transformation affecting African healthcare is the dramatic epidemiological shift toward non-communicable diseases (NCDs).

Diabetes, cardiovascular disease, cancer, and chronic respiratory conditions are rapidly rising, driven by urbanisation, changing diets, and increased life expectancy.

The productivity losses from NCDs in Africa now exceed $1trillion, creating an urgent mandate for both governments and the private sector to invest in long-term management rather than emergency interventions.

Consider diabetes alone, the International Diabetes Federation estimates that the number of Africans living with diabetes will rise from 19million in 2019, to 47million by 2045, a 150% increase.

Managing this epidemic requires insulin, glucose monitoring systems, diagnostic equipment, patient education platforms, and specialised healthcare providers.

These are not ‘charity’ products, they are sophisticated medical technologies for which millions of Africans are willing and increasingly able to pay.

Diagnostics will play a central role in this transition. Managing chronic diseases such as diabetes, cardiovascular disease and cancer requires large-scale deployment of laboratory testing, point-of-care diagnostics and digital monitoring systems. For medical technology companies, this represents not only a clinical necessity but a major commercial opportunity.

The response from Western companies has been lukewarm at best. As the United Nations Industrial Development Organisation (UNIDO) pointed out in its comprehensive guidelines on pharmaceutical manufacturing in Africa, the continent currently imports approximately 95% of its pharmaceutical products.

This dependency persists despite 10 countries alone, Egypt, Ghana, Kenya, Morocco, Nigeria, Rwanda, Senegal, South Africa, Tanzania, and Tunisia, representing an estimated 75% of the total African pharmaceutical market.

The manufacturing paradox

The Covid pandemic laid bare the dangers of Africa’s pharmaceutical dependency. As wealthy nations hoarded vaccines and restricted exports of essential medicines, African countries found themselves vulnerable in ways that were both medically dangerous and politically untenable.

The response has been a continent-wide push for local pharmaceutical manufacturing, supported by initiatives like the African Vaccine Manufacturing Accelerator (AVMA), launched by Gavi, which is incentivising private investment in local production capacity.

The targets are ambitious. The Partnership for African Vaccine Manufacturing aims for 60% of local demand to be produced on the continent by 2040 – up from less than 1% today.

The African pharmaceutical market is projected to grow at compound annual growth rate (CAGR) of between six and eight per cent by 2029.

Biotech startups raised over $500million in 2023 alone, signalling that the sector is shifting from a niche to an investment frontier.

Several countries are emerging as manufacturing hubs. Senegal, under its ‘Emerging Senegal Plan’, aims to domestically manufacture 50% of its pharmaceutical products by 2035.

 It is one of six African Union member states (along with Egypt, Kenya, Nigeria, South Africa, and Tunisia) receiving mRNA technology for local vaccine production through the WHO technology transfer hub programme.

The Institut Pasteur de Dakar, in partnership with the Mastercard Foundation and with €75million in financing from the European Investment Bank, is constructing a vaccine manufacturing facility expected to produce up to 300million doses annually.

South Africa, Egypt, Kenya, Nigeria, and Morocco are similarly positioning themselves as regional pharmaceutical hubs, with Saudi Arabia and the UAE in the broader region showing significant investment through initiatives like Vision 2030.

Fifty-Four Markets, Not One

One of the biggest mistakes Western companies make is to treat Africa as a single market. The continent comprises 54 countries with vastly different regulatory regimes, income levels, disease profiles, and healthcare infrastructures.

A strategy that works in South Africa, with its sophisticated private healthcare system and regulatory authority, would not work in Nigeria, where the market is larger but infrastructure more challenging and distribution more complex.

Western companies seeking investment opportunities must be prepared to navigate an array of different national regulatory authorities, each with its own requirements, timelines, and standards.

As of December 2024, only eight African national regulatory authorities, Egypt, Ghana, Nigeria, Rwanda, Senegal, South Africa, Tanzania, and Zimbabwe, achieved WHO maturity level 3, indicating a stable, well-functioning regulatory system. The remainder are at earlier stages of development, with varying capacity and resources.

This complexity is not a reason to avoid Africa, but rather to approach it strategically. The most successful companies will be those that identify priority markets based on clear criteria, regulatory maturity, market size, infrastructure quality, and strategic position within regional economic communities.

The business case

Another significant barrier to Western pharmaceutical investment in Africa is what might be called the ‘charity mindset’ – an assumption that African healthcare is primarily a matter of humanitarian aid rather than commercial opportunity.

This manifests in product strategies focused on ‘essential’ medicines, rather than innovative therapies, in pricing models based on ability to pay rather than value delivered, and in distribution approaches that rely on donor programmes rather than commercial channels.

Such an approach does a disservice to both African patients and Western companies. African patients deserve access to the same innovative medicines and technologies available elsewhere; they are not well-served by a system that treats them as second-class consumers.

The companies that succeed in Africa over the next two decades will not be those that treat the continent as a philanthropic afterthought but rather firms that approach it as one of the last major growth frontiers in global healthcare.

As African life-science sectors expand, one constraint increasingly cited by investors is access to experienced leadership teams capable of scaling manufacturing, navigating regulatory frameworks and building international commercial partnerships.

The choice for Western life sciences companies is straightforward – engage seriously with Africa’s emerging markets today, or watch others build the relationships, manufacturing capacity and regulatory expertise that will define the industry tomorrow.

*Ivor Campbell is chief executive of Snedden Campbell, a specialist recruitment consultant for the global medical technology industry.

Public outrage and legal challenges, including from Oxfam, met the Trump administration’s immediate closure of the United States Agency for International Development (USAID) last year, which had been critical to global humanitarian and development assistance since 1961.

While these cuts represented less than one percent of the federal budget, they have potentially denied education to 23million children, depriving 95million people of basic healthcare, and causing over 3million preventable deaths annually, by dismantling programmes that provided lifesaving aid, food, clean water, and economic support worldwide.

There is also the loss to US companies of the less acknowledged ‘aid dividend’ – the commercial goodwill that often results from government altruism.

The withdrawal of traditional aid, such as from the US, is often framed as a risk. In practice, it may simply create a vacuum for others to fill. The hard currency from aid is helpful, but the underlying demand for better health does not vanish.

This is where Europe, with its historical ties, and China, with its aggressive, long-term strategy, are actively positioning themselves.

Chinese universities are educating Africa’s next generation of professionals, creating deep, lasting ties. For Western companies to cede this ground is not just a commercial mistake; it is a forfeiture of strategic influence in the continents of tomorrow.

The investment landscape for African MedTech, biotech, and pharma is maturing rapidly. The sector is now seen as a high-growth opportunity, defined by demographic inevitability, digital innovation, and a new generation of entrepreneurs who are creating profitable solutions to profound challenges.

Of all the territories of the world, Africa has arguably suffered most from the damaging power of cliché. Lack of knowledge and curiosity about the continent and its people, has contributed to the persistence of stereotypes that have encouraged racist profiling, facilitated exploitation of its people and resources and hampered economic growth.

For decades, the narrative surrounding Africa in the MedTech, biotech, and pharmaceutical sectors was dominated by a charitable, aid-based paradigm – a one-way flow of donated goods and paternalistic programmes.

For companies in the west, the only reason to invest in Africa was through mass vaccination programmes funded by governments and NCOs. But times they are a changing.

A new and more compelling story is emerging around the booming economies of Egypt, Algeria and Nigeria, and the continued emergence of an affluent ‘middle-class’ in these countries.

From my recent immersion in recruiting for the diagnostics space across sub-Saharan Africa, a clear perspective has crystallised: engaging with Africa is no longer an act of charity; it is a critical business and moral imperative for any company with ambitions for the future.

The catalyst for this shift is the confluence of three powerful forces, leapfrog technology adoption, the rise of a capable and dynamic local workforce, and the undeniable demographic and economic trajectory of the continent.

My conversations with professionals from Nairobi to Lagos have fundamentally altered my understanding of the opportunity.

The leapfrog effect

The core of the new opportunity lies in Africa’s ability to bypass legacy systems, particularly with AI in medical imaging.

In the West, the integration of AI into radiology is often seen as a disruptive threat to established professions and workflows.

The resistance is understandable; it’s about managing displacement within a complex, existing structure.

In Africa, the calculus is different because, until now, it has had no radiography function to speak of outside of major urban centres, at scale or relative to populations. This is the leapfrog effect in action as there is no entrenched, human-intensive system to disrupt.

Instead, AI-powered point-of-care diagnostics and imaging can be deployed from scratch, creating capability where little or none existed before. The result isn’t job losses, but rather a dramatic amplification of public health capacity.

A nurse with a robust, AI-enabled device can provide screening services that were previously the sole preserve of a specialist in a central hospital hundreds of miles away.

This mirrors the mobile banking revolution. Africa didn’t need to lay billions of miles of copper telephone lines; it went straight to cellular networks, unlocking financial inclusion at a staggering pace.

The same pattern is repeating in health tech. Companies that offer durable, affordable, and smart diagnostic solutions are not just selling a product; they are providing the foundational infrastructure for 21st-century healthcare.

The benefit is twofold: companies access a vast, growing market, while African nations achieve quantum leaps in health outcomes, turning the tide on maternal mortality, infectious diseases, and the rising burden of cancers.

Enthusiasm, expertise, and equity

Perhaps the most profound misconception we in the west held was about the African workforce, assuming that roles would be locally based, with salary structures significantly lower than in Europe. This is not necessarily the case.

As we have discovered, wages for people doing what we would regards as Western jobs for Western companies, are frequently the same as you’d find in Europe.

This isn’t exploitation, but rather a recognition of value. The individuals managing these complex markets, navigating health ministries, NGO partnerships, and local distributors, possess a rare and critical skillset, and they are imbued with a ‘can-do attitude’ more reminiscent of American commercial culture than European caution. They are highly educated, often globally, and incredibly responsive.

While researching candidates, our standard rule of thumb was upended. We researched 28 people for a position and came up with 12 shortlisted candidates in a short space of time.

As a guide, we would normally expect to engage with one in every ten people contact. The talent pool is not just deep, it is also engaged and entrepreneurial.

For many mature life sciences businesses in Europe, North America, South-east Asia and the Pacific, this has the potential to change their entire strategic equation.

Building a business in Africa is not about finding cheap labour, it’s about partnering with high-value, locally knowledgeable experts who are essential for market entry. The long-term implication is even more significant.

Beyond the anecdotes and rhetoric

As these professionals gain experience with global companies, a pipeline of future regional and global leaders is being created.

The question for multinational boardrooms should be ‘do we have African senior management on our global team?’ Failing to cultivate this talent is a strategic oversight, especially as these individuals understand growth markets in a way few others can.

The political rhetoric emanating from Donald Trump may dismiss Africa, but the commercial reality tells a starkly different story. One anecdote stood out – a diagnostic product generating $600,000 a year in gross sales in Eritrea, a country often depicted as isolated and impoverished. This is not anomalous, rather it signals a fundamental truth that need creates market demand, and where there is demand, funding follows, through governments, NGOs, and a burgeoning private healthcare sector.

The market is complex and fragmented, comprising more than 50 distinct healthcare systems, from NHS-style models to purely commercial ones. Success requires nuance and local partnership, not a one-size-fits-all approach.

Corruption remains a concern, as it is in many emerging markets, but reputable global companies have strict compliance frameworks.

The real business is done by building relationships and demonstrating value, not by backhanders. As we surmised, for most people in Africa as elsewhere, ‘business is business’.

Ivor Campbell is chief executive of Snedden Campbell, a specialist recruitment consultant for the global medical technology industry.