Promising scientific revolution at Must

This week, the Malawi University of Science and Technology (Must) unveiled an ambitious K114 billion plan to establish a modern pharmaceutical manufacturing plant by 2028. According to Must deputy vice-chancellor Wilson Mandala, this project will support the local production of antiretroviral drugs (ARVs), antibiotics and vital medicines for infants and children such as child-friendly paracetamol. The agreement signed between Must and the Rephaiah Foundation also aims to reduce the country’s heavy reliance on imported medicines.

Information from the foundation’s website indicates that in 2022, the Ministry of Foreign Affairs of Iceland appointed biopharmaceutical firm Hananja plc from that country to support the implementation of the project in Malawi with funding from the Global Goals Fund for Development Cooperation. This comes as statistics show that the Southern Region carries the highest overall burden of HIV infections at about nine percent, followed by the Northern Region at five percent and the Central Region at four percent. The announcement also enters the broader national debate about whether Malawian universities and colleges are sufficiently aligned with development priorities such as the Malawi 2063 Agenda, which envisions a transformed and self-reliant future.

To understand the weight of this announcement, we must begin with the numbers. According to the 2025 HIV estimates compiled by the National Aids Commission (NAC), Malawi had approximately 990 871 people living with HIV in 2024. That same year, Malawi also recorded about 11 757 new HIV infections, even though the figure represents a 79 percent decline since 2010.

[paywall]

That is also a remarkable achievement when one recalls that in 2004, when ART was first rolled out nationally, only 10 344 people were accessing treatment. Then there is the longer shadow. The estimates from NAC’s Malawi HIV Factsheet 2025 further indicate that since 1985, when the first recorded HIV case was officially reported in Malawi, over 1.5 million lives have been lost to HIV and Aids-related illnesses in this country, with at least 13 694 people dying in 2024 alone.

NAC data also shows that of the nearly 991 000 people living with HIV in Malawi, about 53 000 are children aged 0–14 years. In 2024, an estimated 990 871 people were living with the virus that causes HIV, including approximately 938 000 adults aged 15 years and above. The data further indicates that around 54 668 people living with HIV were unaware of their status.

Folks, these are not abstract statistics. They are families disrupted, breadwinners lost and futures altered. That is why the decision by Must to pursue the local manufacturing of ARVs and other essential medicines is more than an industrial ambition.

It is a potential game-changer in our public health history. When nearly a million people depend on daily medication for survival, supply stability ceases to be a technical matter and becomes a national security issue. And here is the structural weakness.

For decades, Malawi’s public health system has operated at the mercy of global supply chains. In simple terms, our HIV response is basically sustained by development partners who pump in 77 percent of HIV expenditure, while domestic resources account for only 23 percent. These ARVs, antibiotics, paediatric formulations and other medical supplies arrive in the country by air, and they are paid for in scarce foreign currency or supported by cooperating partners.

Now, every time the kwacha weakens, every time freight costs spike, every time there is a disruption in international production, our health system trembles. Recently, history has taught us that a country that cannot produce its own essential medicines remains perpetually exposed. The Covid-19 pandemic made this painfully clear, exposing the fragility of global supply chains when wealthy nations prioritised their own populations while poor countries like Malawi waited helplessly as many lives slipped away. This is the context against which this project must be analysed.

[/paywall]