Complex norm localization: from price competitiveness to local production in East African Community pharmaceutical policy
| Author | Peg Murray-Evans,Peter O’Reilly |
| DOI | http://doi.org/10.1177/13540661221123504 |
| Published date | 01 December 2022 |
| Date | 01 December 2022 |
https://doi.org/10.1177/13540661221123504
European Journal of
International Relations
2022, Vol. 28(4) 885 –909
© The Author(s) 2022
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DOI: 10.1177/13540661221123504
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JR
I
Complex norm localization:
from price competitiveness to
local production in East African
Community pharmaceutical
policy
Peg Murray-Evans
University of York, UK
Peter O’Reilly
Liverpool John Moores University, UK
Abstract
This article offers a critical contribution to debates around access to medicines and
the global politics of pharmaceutical production in Africa. Specifically, we seek to
account for a normative shift within these debates whereby the promotion of local
pharmaceutical production in Africa has once again come to be viewed as a central
modality for achieving access to health across the continent. While the onset of this
normative shift has been highlighted by the global Covid-19 pandemic, in this article we
argue that its antecedents can be traced to a more incremental process of global and
regional normative change that has been in motion since the late 1990s. To illustrate
this, we narrow our empirical focus onto the East African Community (EAC) and
the regional initiatives its members have pursued to promote local pharmaceutical
production capacities since 2012. We draw and build upon the literature on norm
localization to emphasize how the emergence and distinctiveness of this policy reflected
the complex way in which policy actors within the EAC sought to localize and combine
separate (and somewhat competing) changing global norms around access to health and
industrial policy. The article also points to the tensions and unintended consequences
which emerged from this complex process of norm localization and the challenges of
implementing this strategy within the institutional landscape of the EAC.
Corresponding author:
Peter O’Reilly, School of Humanities and Social Sciences, Liverpool John Moores University, John Foster
Building, 80-98 Mount Pleasant, Liverpool L3 5UZ, UK.
Email: P.J.OReilly1@ljmu.ac.uk
1123504EJT0010.1177/13540661221123504European Journal of International RelationsMurray-Evans and O’Reilly
research-article2022
Article
886 European Journal of International Relations 28(4)
Keywords
Regionalism, East African Community, access to health, industrialization,
pharmaceuticals, norm localization
Introduction
Africa should not be begging for vaccines. Africa should be producing vaccines.
Dr Akinwumi A. Adesina, President of the African Development Bank (AfDB),
speech at AfDB’s annual meeting in June 2021
Since the outbreak of the global Covid-19 pandemic in 2020, inequities around
Africa’s access to medicines have been starkly illustrated by the administration of Covid-
19 vaccinations across the world. At the time of writing, only 6.8 vaccination doses per
100 people have been administered across Africa, while in Europe and North America
this figure stands at 97 and 92 doses per 100 people, respectively (The New York Times,
2021). As the above quote by the President of the African Development Bank (AfDB)
shows, this has reignited calls for the African continent to develop its own regional phar-
maceutical production capacities and secure its own access to vaccines and other medi-
cines, rather than relying on foreign imports. This call has been echoed by several
western donors who have reaffirmed their commitment to support vaccine production in
Africa (The Financial Times, 2021). Pharmaceutical production in Africa, therefore, has
come under the spotlight during the Covid-19 pandemic, but was also high on the agenda
in previous years (African Union (AU), 2007). Significantly, however, the perceived
links between the establishment of local pharmaceutical production capacities and access
to medicines in Africa has not always been clear cut. During the 1990s and early 2000s,
the prevailing consensus was that access to medicines in Africa would be better served
by multinational pharmaceutical firms who were seen to have both the scale and capacity
to produce medicines more efficiently and cheaply (see Kaplan and Laing, 2005).
Existing research on the global politics of pharmaceutical production has tended to
focus on the origins and impact of major shifts in the global patent regime (see, for exam-
ple, Muzaka, 2011; Shadlen et al., 2011) as well as the opposition mobilized to this
regime by civil society and developing countries (Kapstein and Busby, 2013; ’t Hoen
et al., 2011) and, more recently, varying policy responses to this regime by developing
countries (Chorev, 2020; Chorev and Shadlen, 2015; Löfgren and Williams, 2013;
Shadlen, 2009, 2020; Shadlen and Fonseca, 2013). Here, we seek to extend this literature
by charting the normative shifts at global and regional levels that saw local production
return to the fore as a central modality for achieving access to medicines. More specifi-
cally, we ask how local production came to be accepted as a legitimate and viable solu-
tion to promoting access to health in Africa.
We do so by narrowing our focus onto the East African Community (EAC) and its
agenda since 2012 to promote access to health through local pharmaceutical production.
Like many other governments across Africa during the 2000s, EAC members (Burundi,
Kenya, Rwanda, Tanzania and Uganda) had sought to procure medicines based on price
competitiveness, as opposed to prioritizing local producers. Indeed, as late as 2009, the
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