Why radical action for smarter medicine access is a wake-up call

For decades, global health procurement – on which over six billion people depend - has mostly relied on one system: centralized multilateral institutions pooling donor funding to purchase and distribute medicines across low- and middle-income countries. While this model has delivered significant successes in certain regions and therapeutic areas, it has simultaneously perpetuated inefficiencies, including bureaucratic hurdles, misaligned priorities, inflexible procurement processes, and an unsustainable reliance on external philanthropic funding.

Now, this system is unravelling,

The recent dramatic pullback in funding from major donors, such as USAID and the UK Government, has dealt a severe blow to global health initiatives, forcing deep budget cuts across multilateral organizations. The consequences are not abstract – they will be measured in lost lives. In Kenya, 1.4 million people living with HIV are at risk as $34 million worth of antiretroviral medicine shipments remain stranded in warehouses. In Ethiopia’s Tigray region, over 2.4 million people who relied on USAID for food now face critical shortages, with hunger accelerating the spread of preventable diseases. In Uganda, malaria deaths, already a leading cause of child mortality, are set to rise as mosquito control and treatment programs collapse. Across multiple countries, the withdrawal of the

U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) has left millions without access to HIV testing, treatment, or even basic prevention.

For too long, medicine procurement has been driven by well-intentioned foreign budgets rather than by the needs of local communities. When this external aid disappears, medicines vanish alongside it, leaving entire health systems vulnerable and struggling to cope. The continent of Africa, for example, still bears 24% of the world’s disease burden, yet houses only 1% of global health expenditure. Less than half of Africans – just 48% - can access the healthcare services they need.

These are not temporary challenges; it is a systemic failure that demands urgent and radical change. The current funding crisis is not the origin of the problem; rather, it simply accelerates an issue that has persisted for decades.

I wonder, has the system crumbled enough to finally compel us to rethink medicine procurement entirely? What if, instead of clinging to a crumbling multilateral model, we embraced a decentralized yet coordinated, market-driven approach? Or, as our CEO Emmanuel has called it, a 'co-ordilateral' approach?

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It is time we dared to imagine, and build, a world where fragmented, inefficient procurement cycles are replaced by digital platforms that match demand and supply in real time, eliminating costly delays and unnecessary complexities. A world that moves beyond slow, top-down interventions driven by foreign political forces, toward procurement that is market-responsive, with empowered governments equipped with the right technology and affordable capital to make the right decisions.

At Axmed, we are building the infrastructure to propel this shift. Our groundbreaking B2B marketplace connects healthcare procurers with pre-qualified manufacturers, digitally coordinating national and international at-scale pooled procurement. It lays the foundation for a co-ordilateral world—one that fosters transparency, unlocks innovative financing, and digitizes LMICs' purchasing power, delivering economies of scale that drive affordability for procurers and efficiency for manufacturers, transforming the way medicines get sourced and distributed. The outdated, manual procurement systems are no longer defensible when technology offers a smarter, faster, and more resilient alternative.

The urgency of this transition was evident at the recent Axmed Access Summit in Nairobi, themed “Unlocking Access, Transforming Lives.” Unlike traditional forums, it took a bold, solutions-driven stance, confronting structural barriers and proposing radical new strategies to improve medicine availability, affordability, and quality across the continent.

By convening leaders with the power to act - government leaders, healthcare procurers, business executives, and civil society - the summit underscored a fundamental shift: moving away from reliance on multilateral systems toward localized, accountable action, empowering individual market players who can drive real change.

For too long, Africa’s healthcare challenges have been framed as insurmountable. While deep-rooted barriers such as market fragmentation, regulatory complexity, supply chain inefficiencies, weak infrastructure, and financial constraints persist, real targeted solutions already exist. Technology-enabled platforms, digital pooled procurement, data-driven forecasting, and new financing mechanisms are no longer theoretical concepts; they are active interventions reshaping healthcare systems.

The pullback in donor funding should not be seen as an excuse for inaction; rather, it is a catalyst for transformation. The resolve shown by stakeholders in response to the recent funding crunch presents a unique opportunity for coordinated, meaningful change.

By treating healthcare as a fundamental right and embracing data-driven, tech-enabled, anticipatory business models, we can ensure more medicines reach those who need them when they need them.

Africa's healthcare market represents an opportunity exceeding $300 billion in the coming years. No patient should have to walk miles for medicine; no child should suffer from preventable inaccessibility. Too many lives are lost; not because medicines are unavailable, but because they remain trapped in supply chains designed for aid rather than sustainable, long-term access.

Unprecedented progress will not come from clinging to a past that may never return. It will come from smart, tech-driven coordination, direct market engagement, and stakeholders taking full ownership of the solution and taking decisive action to innovate.

We can fix this. Technology, ideas, and frameworks to make this shift happen already exist. What is missing? The decisive determination of stakeholders to break free from outdated systems and embrace smarter, faster, market-enabled solutions.

Radical change will come from bold leaders committed to transforming the system, starting today.