The economic case for investing in Africa’s health R&D

When Ebola returns, as it has again this year in the Democratic Republic of Congo and Uganda, the immediate focus is rightly on containing the outbreak and saving lives. But anyone who has worked on the front line of an epidemic knows the outcome depends on decisions made years before the first patient is diagnosed.

High-quality, safe laboratories cannot be built in the middle of an outbreak. Seasoned researchers cannot be trained overnight. Clinical-trial networks, regulatory systems and manufacturing capacity cannot simply be switched on once a virus crosses a border.

The devastating 2014-16 West African Ebola virus disease outbreak and the current outbreak of Ebola disease caused by Bundibugyo virus are stark reminders of the consequences of failing to invest in health research and development and preparedness between outbreaks. This is economically short-sighted. The World Bank estimated^[1] that Ebola caused US$2.2bn in GDP losses in Guinea, Liberia and Sierra Leone in 2015 alone. A 2018 peer-reviewed analysis^[2]estimated the comprehensive global economic and social burden of the outbreak at more than $53bn.

By the time an emergency begins, the foundations for the response either exist or they don’t. That lesson extends well beyond outbreak preparedness.

Too often, health R&D is discussed as if it were simply another item in a health budget. It is perceived as high-risk, only generating returns on investment in ten to 20 years. Working together on a study^[3] to make the case for African investment in health R&D, we found ourselves looking at it differently. The strongest case for investing in health R&D was made by mainstream economics. Countries that invest consistently in research are better prepared for the next health emergency, but that is only part of the story. The evidence pointed to stronger productivity, more skilled jobs, greater private investment, growing GDP and new industrial capability, alongside better health outcomes. Investment in health R&D generates economic value long before it delivers a new vaccine or medicine.

That matters for Africa. The continent carries around a quarter of the world's disease burden yet produces less than 1% of the research that leads to new vaccines, diagnostics and therapeutics.^[4] African scientists already make vital contributions to global research, for example the African-led H3Africa genomics initiative has produced more than 700 scientific papers and helped uncover millions of previously unknown human genetic variants.^[5] In 2025, Ugandan scientists confirmed an Ebola outbreak and generated preliminary whole-genome sequencing within 24 hours, working with South African researchers to rapidly establish the virus's genetic origins.^[6] However the scale of investment and the infrastructure around that science have not kept pace. Much of the investment, and the economic value it creates, remains elsewhere. Of the $71bn invested by high-income country governments in global health R&D between 2007 and 2023, 90% remained in high-income countries.^[7] As a result, Africa continues to import many of the technologies it needs while too many talented researchers leave to pursue opportunities abroad. Much of the local manufacturing potential is relegated to late-stage, fill-and-finish production lines. South Africa’s Aspen facility, for example, initially filled and finished the Johnson & Johnson Covid-19 vaccine using active vaccine material supplied from outside Africa.^[8]

Our analysis, undertaken by Global Health Ecosystems on behalf of Africa CDC, and funded by Enabel, the Belgian Development Agency through the AU-EU Health Partnership, asked a simple question: what would happen if African governments treated health R&D as a long-term investment in economic growth rather than just expenditure?

The findings are compelling. If African countries met the African Union's long-standing commitment to invest 1% of GDP in research and development, with 15% of that dedicated to health R&D, the model projects an additional $668bn in GDP over the next 20 years.^[9] Every $1 invested returns $137 in economic value, and each $1 of public investment crowds in about $5 of private capital. The model suggests more than 4.5m skilled jobs could be supported, alongside significant increases in private investment, stronger manufacturing capability and improvements in trade. The investment reaches break-even within four years—well within a single political cycle.

Importantly, these estimates measure only the economic returns of investing in the R&D itself. They do not attempt to quantify the value of lives saved, outbreaks contained or future pandemics mitigated by Africa-owned and Africa-developed innovations. The real returns would be far greater.

There are already examples of what this looks like in practice.

South Africa's Afrigen Biologics has shown that African institutions can lead cutting-edge research in mRNA technology while training scientists, strengthening regulatory capability and sharing knowledge with partners across the continent. What has followed is not simply scientific achievement, but growing manufacturing capacity and broader economic opportunity.

Egypt did not eliminate hepatitis C simply by buying more medicines. It built the capability to turn pharmaceutical innovation into affordable, population-scale access. Once facing one of the world’s highest hepatitis C burdens, Egypt combined a national treatment programme with regulatory capacity and locally manufactured generic direct-acting antivirals. This helped bring the cost of a three-month treatment course down to around $58 and enabled more than 4.1 million people to be treated, with a reported cure rate of 98.5%^[10]. The economic value was also substantial: the World Bank estimated that hepatitis C cost Egypt close to $1bn in lost GDP in 2015 alone.^[11]Egypt’s experience shows how domestic regulatory and manufacturing capability can help reduce treatment costs, expand access and enable health innovation to reach populations at scale.^[12]

The sequence is important. Countries rarely build globally competitive manufacturing sectors before they have invested in science, research institutions and innovation. Manufacturing follows capability.

This conversation has become more urgent as the global landscape changes. Governments everywhere are placing greater emphasis on resilience, strategic industries and domestic innovation. The era in which countries could assume that essential health technologies would always be developed and produced elsewhere is coming to an end.

Africa has no shortage of scientific talent, with around 675,000 STEM graduates entering the job market every year,^[13] and across the continent there are outstanding universities, research institutes, biotechnology companies and public-health institutions that have demonstrated what is possible. The challenge is not a lack of ideas or ability, it is the scale and consistency of investment needed to turn individual successes into a stronger continental innovation ecosystem.

That is why we believe the commitment made by African leaders almost two decades ago deserves renewed attention. Investing 1% of GDP in research and development, with 15% allocated to health R&D, should not be seen simply as a target for science or health ministries. It is a strategic economic decision that should be championed by finance ministers and parliamentarians and feature at the centre of national development plans.

The next outbreak will reveal how prepared Africa is. The investments made today will determine whether Africa continues primarily to import the technologies that shape its future, or increasingly helps to create them. That is why investing in health R&D should be seen as an investment in Africa's economic growth as well as preparedness against the next outbreak.

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