The markets for anti-infective drugs in Malawi, Mauritius and Zimbabwe are set to increase from combined a value of US$186.2 million in 2011 to $377.2 million in 2018, according to new forecasts.

The research, from Frost & Sullivan, looks at the potential sales in four key therapeutic segments - antibiotics, anti-tuberculosis drugs, antimalarials and antiretrovirals (ARVs) - and forecasts that the latter group will provide the greatest growth potential in these markets over the next five years.

While the high incidence of infectious diseases in sub-Saharan Africa is expected to sustain the demand for anti-infective drugs, dependence on donor funding for the procurement of essential drugs has resulted in unstable patterns of expenditure,  according to the report. However, it expects that innovative financing mechanisms, such as the AIDS levy, will be effective at reducing this dependency, and that this will result in more stable expenditure patterns.

"The prioritisation of the care and treatment of HIV-positive patients by governments is expected to continue to drive growth of the anti-infectives market," comments Frost & Sullivan health research associate Kudzai Moyo.

"In 2011, ARVs remained the largest therapeutic segment in terms of revenue, accounting for nearly half of the anti-infectives market. This segment provides the greatest growth opportunity over the next five years," she forecasts.

Currently, treatment coverage in sub-Saharan Africa for infectious diseases such as HIV/AIDS is relatively low when compared to developed countries. This creates an opportunity for anti-infective drugs, provided that there is a sustained scaling-up of treatment programmes. 

However, the shortage of skilled personnel and the lack of appropriate healthcare infrastructure in these countries limits patients' access to treatment. Delays are often encountered in the diagnosis and confirmation of a disease, resulting in prolonged time before patients can be started on treatment regimes, says the report.

It also points out that a weak system of disease surveillance in Malawi and Zimbabwe results in deaths that could have been avoided if timely treatment was provided.

The public sector accounts for approximately 69% of the three countries' expenditures on anti-infectives. Financial constraints, and the need to provide wider healthcare coverage, forces governments to favour generic drugs that are less expensive, says the study.

"Availing cheap generics is critical in penetrating the Malawi and Zimbabwean anti-infectives markets. Pricing is a key factor when pharmaceuticals are procured, especially in the public sector, highlighting the need to establish an appropriate pricing structure," Ms Moyo advises.