Linking market authorizations of medicines with disease burden in South Africa
Abstract
Background: Sub-Saharan Africa is going through an epidemiological transition, including an impressive increase in
non-communicable diseases. The introduction of medicines has not kept pace with the needs in developing coun‑
tries. The objectives of this study were to (i) examine the correlation between the number of medicine approvals and
disease burden and (ii) compare approval timelines of medicines with disease burden in South Africa in the period
2012–2017.
Methods: The dataset was compiled from publicly available data on medicines registered in South Africa between
2012 and 2017. A correlation analysis was conducted to determine the level of alignment between the number and
nature of medicines registered, as determined by the WHO ATC Classifcation and the Lancet Global Burden of Disease
data. Median registration timelines were determined to assess whether medicines for diseases of higher burden were
registered faster.
Results: A total of 3059 registered medicines were included in the study, including 2779 generic medicines, 267 new
chemical entities and 13 vaccines. There was a high level of alignment between the number of medicines registered
to treat diseases with higher disease burden levels more efectively, except for lower respiratory tract infections and
HIV/AIDS which showed less medicines registered as compared to expectations based on disease burden, respec‑
tively. HIV/AIDS showed a lower level of correlation with a much higher disease burden compared to number of
medicines registered, but simultaneously also a much shorter median registration timeline (32 months) compared to
the other disease areas.
Conclusions: There was generally a high level of alignment between disease burden and number of medicines
authorised, except for HIV/AIDS and lower respiratory tract infections. Regulatory authorities should continue to con‑
sider burden of disease data to ensure that public health needs are met.