FRIEDRICH-EBERT-STIFTUNG – CHINA’S INTERNATIONAL DEVELOPMENT COOPERATION Product registration and international certification challenges “Although Africa‘s pharmaceutical industry is backward, its pharmaceutical regulatory system is basically copied from Europe and the US, and the regulatory require­ments are much higher than expected. Some countries like Nigeria mandatorily require the use of common technical documents(CTD) to submit drug registration applications, and many countries such as Ghana, Kenya, [and] Nigeria require on-site production verification in­spection of factories. The overall trend is that the regis­tration requirements for pharmaceutical products in Af­rican countries are gradually increasing, both in terms of time cost and economic cost, with some countries cur­rently taking up to three years or more to register, and currently affected by the epidemic, making registration more difficult. For companies going abroad for the first time, overseas product registration is not only the ticket to develop international markets, but also a major diffi­culty faced by companies at present.” Excerpt from an April 2022 CCCMHPIE report document 156 page titled“Fighting Covid-19 the Chinese Way”. 161 China has also been increasingly promoting the use of Artemisinin in the fight against malaria after having achieved successful results domestically. 162 Chinese TCM aligns well with the existing context of wide­spread traditional(herbal) medicine usage on the African continent. According to Ibrahim Samba, former WHO Re­gional Director for Africa, traditional medicine is the first and only option for more than 80 per cent of Africans. 163 Several African governments have entered into official agreements with China to support TCM development. 164 In addition to entering into an agreement, Namibia has endorsed TCM un­der national law. 165 TCM products containing animal parts are openly available for retail throughout Africa. However, the Environmental Investigation Agency(EIA) warns that a massive expansion of TCM could pose a major threat to endangered animal species, such as leopards, pan­golins, and rhinos, which are all potential sources of TCM in­gredients. 166 Moreover, the growth of TCM is accompanied by a growing trade in fake medicine. 167 PROMOTION OF TRADITIONAL CHINESE MEDICINE China has been using health cooperation to promote Tradi­tional Chinese Medicine(TCM) in Africa for nearly two dec­ades. The China–Africa Forum on Traditional Medicine was inaugurated in 2002, followed by the adoption of the Plan of Action for the Cooperation of Traditional Medicine. Chi­nese medical teams typically also include TCM doctors. 157 For example, in Namibia, a medical team from Zhejiang Province offers acupuncture treatments at the Katutura State Hospital in Windhoek. 158 The COVID-19 pandemic has enabled the Chinese govern­ment to further strengthen the promotion of TCM in Afri­ca. 159 China is looking to increase TCM exports but also sees it as a channel to advance soft power, framing it as a“Chi­nese wisdom” and a“Chinese solution” to global challeng­es. 160 In several African countries, Chinese embassies pro­moted the use of TCM with websites showing a link to a 156 CCMHPIE(2022). What Are the Opportunities. 157 ilimina, D.(2021). Introduction of Traditional Chinese Medicine Is the Latest Chapter in the Decades-Long Health Cooperation between China and Africa. Beijing Review, 29 October. http://www.bjreview. com/World/202111/t20211104_800262380.html 158 159 IA(2021). Fast Growth of Traditional Chinese Medicine in Africa is a Direct Ehreat to Endangered Species, Environmental Investigation Agency, 11 October. https://eia-international.org/news/fast-growth­of-traditional-chinese-medicine-in-africa-is-a-direct-threat-to-endan­gered-species/ 160 IDCA(2022). Chinese Wisdom, Solutions Contribute to Global Anti-Malarial Fight. China International Development Cooperation Agency, 28 April. http://en.cidca.gov.cn/2022-04/28/c_753705.htm ANTI-MALARIA-INTERVENTION IN THE COMOROS ISLANDS China began the implementation of the Fast Elimination of Malaria by Source Eradication(FEMSE) project in the Co­moros in 2007. By that time, the Comoros had already un­dertaken a number of unsuccessful antimalarial projects, providing its residents with items such as long-acting in­secticide-treated mosquito nets and indoor residual sprays. 168 The FEMSE project involved mass drug adminis­tration of Artequick(a fourth-generation combination of Artemisinin and a small dosage of Primaquine) to all age groups of a defined population(except those with con­traindications to the therapy) at the same time regardless of infection status. The goal of the mass drug administra­tion intervention was to eliminate malaria parasites direct­ly from the human population. 161 rocopio, M.(2020). China and Africa: The“Power” of Traditional Medicine. A-id Agenda for International Development, 25 Septem­ber. https://www.a-id.org/china-and-africa-the-power-of-tradition­al-medicine/ 162 Chinese chemist Tu Youyou won the 2015 Nobel Prize for Med­icine for her discovery of the antimalarial agent artemisinin thanks to her work with traditional Chinese medicine. See: Global Risk In­sights(2017). Under the Radar: Africa is Becoming Traditional Chi­nese Medicine’s Best Customer, 23 April. https://globalriskinsights. com/2017/04/radar-traditional-chinese-medicine-became-one-afri­cas-fastest-growing-industries/ 163 Ibid. 164 EIA(2021). Fast Growth of TCM in Africa. 165 Ibid. 166 Ibid. 167 Global Risk Insights(2017). Under the Radar. 168 his case study is based on: Ajari, E.E.(2020) Combatting Malaria in the Comoros Islands: How China Almost Got It Right. The China Global South Project, 18 September. https://chinaglobalsouth.com/ analysis/combatting-malaria-in-the-comoros-islands-how-china-al­most-got-it-right/ 32