India’s Pharmaceutical Trade with Africa: A Modern Colonial Continuum

India’s rise as the “pharmacy of the world” stands at a striking intersection of modern economic accomplishment and the enduring machinery of colonial-era extraction. Nowhere is this duality more pronounced than in Africa—a continent of 1.4 billion people, whose public health infrastructures, industrial capacities, and regulatory systems still carry the deep scars of colonial manipulation. On the surface, Indian pharmaceuticals have facilitated crucial access to essential medicines across African countries. Beneath this, however, is a current of strategic dependency and extraction that closely echoes the exploitative relationships of imperial trade15.

Over the last two decades, Indian pharmaceutical exports to Africa have surged astonishingly—from just $0.75 billion in 2007 to $3.93 billion in 2025—a fivefold leap that underscores not just market growth, but a profound reconfiguration of Africa’s medical supply chains1. Even as Indian pharma exports worldwide soared to $30 billion in FY25, Africa remained one of its most critical markets, with the continent accounting for over 83% of India’s pharma exports and South Africa sitting at the top as its largest African export destination12345. The most rapid growth was recorded between 2010 and 2016, as Indian generics opened the floodgates to affordable antiretrovirals, antibiotics, insulin, vaccines, and malaria treatments—categories of drugs for which local production remains inaccessible due to inadequate infrastructure and the persistent effects of colonial underdevelopment125.

This pharmaceutical dependency did not form in isolation. Under colonial regimes, African industry was deliberately weakened, with local economies reconstructed to prioritize extraction and supply to external masters. Critical sectors—including pharmaceuticals—were denied the investment and autonomy needed for self-sufficiency. Manufacturing was stunted, and what technical capacity did exist was closely managed or outright suppressed to foster a reliance on imported goods5. Today, most African states struggling for domestic economic empowerment find themselves locked into this inherited vulnerability: lacking the scale, policy support, and technical foundations to stand up robust pharmaceutical industries of their own, they remain subject to the shifting priorities and prices of foreign suppliers5.

India’s entry into this void wasn’t a matter of charity, but of policy vision and industrial agility. Armed with export-centric strategies, expertise in reverse engineering, and enormous manufacturing scale, Indian pharma rapidly superseded Western companies as Africa’s primary drug supplier. During the COVID-19 pandemic, this role intensified sharply—2021 saw India’s exports to Africa peak at $3.92 billion as countries rushed to secure scarce essential medicines16. In 2024 alone, $669 million worth of drugs were shipped from India to South Africa, while markets like Malawi, Kenya, and Namibia experienced pronounced spikes, reflecting both a growing reliance and the volatility inherent in such dependency45.

Beneath the headline numbers and public health successes, however, runs a darker current: the widening crisis of drug abuse and illicit pharmaceutical trafficking. This shadow economy, built on African regulatory fragility, is a direct echo of colonial powers’ historic weaponization of addictive substances—a means of generating profit and exerting control. Recent investigative reporting has revealed that certain Indian firms, such as Aveo Pharmaceuticals, have been pivotal in flooding West African markets with unlicensed, highly addictive drug cocktails. These products mix opioids like tapentadol (a powerful painkiller) with carisoprodol—a muscle relaxant banned in Europe due to its addictive potential—and are shipped under various brand names for sale in Nigerian, Ghanaian, and Ivorian street markets5.

The social and public health fallout is vast. An estimated four million Nigerians alone abuse some form of opioid, a number that captures only part of the continent-wide reality. Youth are especially targeted by these drugs, drawn by the promise of a cheap, euphoric high. Overdose deaths and hospitalizations from cocktails of these substances are common, and the combination can cause severe respiratory depression, seizures, and sudden death. The BBC’s undercover investigations have documented Indian pharma executives, fully aware of the lethality and addictiveness of these products, admitting to targeting teenagers in West Africa and dismissing the ensuing harm as the cost of business. Even as Indian regulations officially prohibit the export of unlicensed drugs, loopholes and lax enforcement remain easily exploitable5.

The logic here is classic colonial extraction: the profits from both legal and illicit pharmaceutical trade flow overwhelmingly back to India and to distribution intermediaries, while African populations disproportionately absorb the risk—be it through addiction, poorer-quality medicines, or hollowed-out domestic industry. The immediate beneficiaries—local sellers, complicit officials, and drug traffickers—are marginal compared to this broader dynamic of external profit versus internal harm. African health agencies, caught in a bind, remain dependent on Indian suppliers for critical, life-saving ARVs and antibiotics, even as the infrastructure facilitating their delivery is also leveraged to channel illicit substances and perpetuate dependency15.

This “pharmaceutical diplomacy” is lauded as a badge of South-South solidarity, but such rhetoric cannot disguise the reality that the overwhelming bulk of innovation, profits, and technological know-how is retained offshore while African attempts to build in-region capacity face daunting obstacles: underinvestment, regulatory fragmentation, distribution bottlenecks, and lingering skepticism from international actors158. Indian pharmaceutical expansion into Africa is increasingly tied to joint ventures, technology transfer arrangements, and public-private collaborations, yet these often cement Indian leadership and reinforce existing hierarchies rather than democratize production or knowledge.

When crises strike, such as the global supply chain breakdowns during COVID-19, the costs of dependency are laid bare. African states, lacking local manufacturing, found themselves waiting at the end of the global queue for vital drugs and vaccines16. Even as Indian exports to Africa plateaued at roughly $3.9 billion from 2021 to 2025—with some smaller markets registering gains and others, like South Africa, experiencing minor contractions—this volatility reveals the continent’s exposure to shifting global economic winds and regulatory shocks1238.

All told, India’s pharmaceutical dominance in Africa is a contemporary replay of the colonial script. The tools have changed: the pill replaces the gunboat; the trade mission replaces the colonial office. But the fundamentals remain familiar: Africa as a captive export market, dependency zone, and a springboard for soft power maneuvers. Profits, industrial control, and technological innovation all accrue elsewhere, while African industrialization is circumscribed by inherited structures of dependency and the profit-driven priorities of external actors158.

To break free from these patterns, Africa must look beyond import deals and aid dependency, investing instead in local pharmaceutical production, regulatory harmonization, technical training, and a new ethic of health sovereignty. This is the real antidote to the pill pipeline’s twenty-first-century colonial logic—one in which Africa rewrites its pharmaceutical future by its own design, for its own people123458.