一项最新研究显示，中国正在非洲12个疟疾重灾国挑战印度长期以来在抗疟疾药物市场的主导地位。
China is challenging India’s long-held dominance of the African market for antimalarial drugs in 12 of the continent’s hardest-hit countries, according to a new study.
印度市场研究公司Sol Gravitas的数据显示，去年中国抗疟疾药物出口额达到8930万美元，几乎与印度的8960万美元持平。
Last year, Chinese exports of antimalarial drugs reached US$89.3 million, nearly matching India’s US$89.6 million, according to Indian market research company Sol Gravitas.
自2021年以来，这一差距已大幅缩小，当时印度的出口额为1.21亿美元，而中国的出口额为62.6万美元。
The gap has closed significantly since 2021, when Indian exports stood at US$121 million compared with US$62.6 million for China.
此外，该研究还调查了全球基金在2021年至2025年期间对同样这12个国家以及肯尼亚的采购情况。
Separately, the study examined Global Fund purchases for the same 12 countries plus Kenya between 2021 and 2025.
该基金是疟疾项目的主要国际资助者，其购买了用于治疗重症疟疾的注射用青蒿琥酯以及用于季节性预防的泡罩包装药物，其中大部分在中国工厂生产。
The fund, a major international backer of malaria programmes, bought injectable artesunate for severe malaria and blister packs for seasonal prevention, most of which were made in Chinese factories.
这一转变可以通过提供更多供应商选择，帮助重塑拥有全球最高疟疾发病率之一的国家的供应链安全性，同时更激烈的竞争也可能有助于拉低价格。
The shift could help reshape supply security for countries with some of the world’s highest rates of malaria by offering a greater choice of providers, while more competition may help bring down prices.
但随着中国和印度企业在价格上展开竞争，这也可能引发对产品依赖性以及当地抗疟疾研发前景的担忧。
But it might also raise questions about product dependence and the future of local antimalarial research and development as Chinese and Indian firms compete on price.
杜克大学全球卫生与医学教授唐盛兰（音）表示，中国在非洲抗疟疾市场份额的不断增长，反映了其制药生产实力、具有竞争力的价格以及制造符合国际标准药品的日益增强的能力。
China’s growing share of Africa’s antimalarial market reflects its pharmaceutical manufacturing strength, competitive prices and increasing ability to make medicines that meet international standards, according to Shenglan Tang, a professor of Global Health and Medicine at Duke University.
他还表示，中国在基于青蒿素的药物方面具有独特优势，青蒿素是由中国科学家发现的一种植物提取药物。
He also said China had a particular advantage in medicines based on artemisinin, a plant-based drug that was discovered by Chinese scientists.
唐盛兰还指出中国对其制药行业的投资，并表示企业已经从生产原料药——即产生药物治疗效果的物质——发展到生产成品药。
Tang also pointed to the country’s investment in its pharmaceutical industry, saying companies had gone beyond producing active pharmaceutical ingredients – the substances that produce a medicine’s therapeutic effect – to making the finished product.
他说，这增强了它们竞标全球基金和联合国儿童基金会等全球主要卫生采购机构合同的能力。
That had strengthened their ability to compete for contracts from major global health buyers, including the Global Fund and Unicef, he said.
但唐警告，不要将中国的增长解读为其在更广泛的平价药品市场上正在超越印度的迹象。
But Tang cautioned against reading China’s gains as a sign that it was overtaking India in the broader market for affordable medicines.
他说，后者仍然是仿制药和疫苗的主要供应商，拥有成熟的制造产能、国际监管经验和广泛的分销网络。
He said the latter was still a major supplier of generic medicines and vaccines, with established manufacturing capacity, international regulatory experience and extensive distribution networks.
根据Sol Gravitas的分析，如果不看出口药品的美元价值，而看货运重量，印度去年仍处于领先地位，占向这12个市场发货总重量的54.5%。
Looking beyond the US dollar value of the drugs exported, India was still ahead when it came to cargo weight shipped last year, according to the Sol Gravitas analysis, accounting for 54.5 per cent of the combined weight shipped to the 12 markets.
去年，按价值计算，中国向尼日利亚、刚果民主共和国、乌干达、马里、布基纳法索和尼日尔出口了更多抗疟疾药物。与此同时，印度在埃塞俄比亚、莫桑比克、安哥拉、坦桑尼亚、科特迪瓦和马达加斯加处于领先地位。
Last year, China exported more antimalarial medicines by value to Nigeria, the Democratic Republic of Congo, Uganda, Mali, Burkina Faso and Niger. Meanwhile, India led in Ethiopia, Mozambique, Angola, Tanzania, Ivory Coast and Madagascar.
但该分析确定的是全球基金药品的生产地，而非发货地，进口国的海关记录显示的变化比出口商记录显示的要小。
But the analysis identified where the Global Fund medicines were made rather than where they were shipped from and the importing countries’ customs records showed a smaller shift than the exporters’ records.
在8个拥有2022年至2025年完整进口记录的国家中，印度占这两个供应商进口份额的比例从71.5%下降至64.2%。
In eight countries with complete import records for 2022-2025, India’s share of imports from the two suppliers fell from 71.5 per cent to 64.2 per cent.
在所考察的4.427亿美元交付额中，按价值计算，45.6%由中国生产——全部由桂林南药生产，其母公司复星医药将其描述为中国最大的青蒿素类抗疟药生产商。
Of the US$442.7 million in deliveries examined, 45.6 per cent by value was made in China – all by Guilin Pharmaceutical, which its parent company Fosun Pharma describes as China’s largest producer of artemisinin-based antimalarials.
该分析还发现，中国工厂生产了大部分用于季节性疟疾预防的SPAQ复方泡罩包装、大部分用于治疗重症疟疾的注射用青蒿琥酯，以及所有的双氢青蒿素-哌喹。
The analysis also found that Chinese factories made most of the SPAQ co-blisters used for seasonal malaria prevention, most of the injectable artesunate used to treat severe malaria and all of the dihydroartemisinin–piperaquine.
然而，印度工厂生产了至少一半的采购青蒿醚-苯芴醇——一种用于治疗急性疟疾的药物，也是本研究涵盖的最大药品类别。
However, Indian factories made at least half of the artemether-lumefantrine purchased – a drug used to treat acute malaria and the largest category of medicines covered by the study.
美国对外关系委员会全球卫生高级研究员普拉尚特·亚达夫（Prashant Yadav）表示，该研究仅涵盖全球基金资助的采购，不包括各国政府、其他捐助者或私立患者购买的药物。
Prashant Yadav, a senior fellow for global health at the Council on Foreign Relations, said the study only covered Global Fund-financed purchases, not medicines bought by governments, other donors or private patients.
亚达夫补充说：“在某种特定药物由一家公司或一个国家供应的情况下，总体上看起来抗疟疾药物的竞争正在加剧，但实际上可能只是特定产品的垄断。”
“Where a particular medicine is supplied by one company or country, it may appear in aggregate that competition in antimalarials is increasing, but in reality it may be just dominance in specific products,” Yadav added.
西东大学外交与国际关系学院全球卫生研究教授兼主任黄严忠表示，更激烈的竞争可能会影响价格和供应。
Yanzhong Huang, a professor and director of global health studies at Seton Hall University’s School of Diplomacy and International Relations, said stronger competition could affect both prices and supply.
黄严忠说：“我认为，更激烈的印中竞争可能会降低有质量保证的抗疟疾药物的价格，从而提高非洲地区的药物可负担性。”
“I think stronger India–China competition is likely to lower prices for quality-assured antimalarials, improving affordability in Africa,” Huang said.
他补充说，从两国采购也可以使供应更加可靠，尽管对少数几家预认证制造商的依赖仍然是一个风险。
Buying from both countries could also make supplies more reliable, he added, although reliance on a small number of pre-qualified manufacturers remained a risk.
但他同时也警告称，印度对中国青蒿素原料药的依赖可能会限制从两国采购成品药所带来的供应安全效益。中国制药企业也在非洲扩大生产。
But he also warned that India’s dependence on Chinese artemisinin APIs could limit the supply-security benefit of buying finished medicines from both countries. Chinese pharmaceutical firms are also expanding production in Africa.
复星医药正在科特迪瓦建设一座工厂以生产抗疟疾药物和抗生素，而江苏艾迪药业和南京药石科技则正与尼日利亚制药商菲德森医疗保健公司（Fidson Healthcare）合作建设一座抗逆转录病毒药物工厂。
Fosun Pharma is building a plant in Ivory Coast to make antimalarials and antibiotics, while Jiangsu Aidea Pharma and PharmaBlock Sciences (Nanjing) are working with Nigerian drug maker Fidson Healthcare to build an antiretroviral plant.
唐表示，中印两国应投资于非洲的生产、技术转让、劳动力发展和监管能力，同时非洲各国政府和国际采购组织应帮助当地制造商达到质量标准并具备商业可行性。
Tang said China and India should invest in African production, technology transfer, workforce development and regulatory capacity, while African governments and international procurement organisations should help local manufacturers to meet quality standards and become commercially viable.
黄严忠表示，新兴的非洲制造商仍然需要进口原料、熟练工人和资金。他说：“整体收益取决于质量保障和对区域生产能力的支持。”
Huang said newer African manufacturers still needed imported ingredients, skilled workers and financing. “Overall gains depend on quality safeguards and support for regional capacity,” he said.
非洲企业也开始生产抗疟疾药物，但亚达夫表示，它们可能会在中印之间的价格竞争中受损。
African companies are also beginning to produce antimalarials, but Yadav said they might be hurt in the price competition between China and India.
“在这个市场上，印度和中国企业占据主导地位，谁将承担未来抗疟疾药物的研发工作？”他说。
“In this market, with Indian and Chinese firms dominating, who will undertake R&D for future antimalarials?” he said.