Underdeveloped but essential: Findings from a survey of private pharmaceutical firms in South Sudan

Introduction: Private pharmaceutical firms are important for access to essential medicines. Unreliable access to medicines contributes to avoidable deaths and was most evident during the COVID-19 pandemic in South Sudan. A better understanding of the private pharmaceutical sector would help inform approaches to health systems strengthening in South Sudan. Method: A survey was conducted of private, for-profit pharmaceutical firms in South Sudan, adopting the World Bank Enterprise Survey 2014. Outcomes of interest included firm characteristics that impact innovation – such as firm’s age, size, employees’ skillset, manager’s gender, ownership, and quality certification. Comparators were drawn from all private firms in South Sudan and firms across sub-Saharan Africa. Results: Nineteen firms were included in the analysis, with the average private pharmaceutical firm proving older than a private sector comparator in South Sudan. However, firms were smaller than the average for the country and sub-Saharan Africa. Ten times more pharmaceutical firms had quality certification, compared with other firms in South Sudan, but they had less foreign ownership and fewer skilled personnel. None of the pharmaceutical firms manufactures, and medium-sized pharmaceutical firms had female majority ownership, even though none had a female top manager. Conclusion: Findings reflect evidence in the literature. They reveal the need for supportive regulations and investments for a sustainable pharmaceutical sector in South Sudan.