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The report analyzes the African medical manufacturing landscape, highlighting a heavy reliance on imports (over 70% for health technology) and a concentration of capabilities in North Africa, South Africa, and Nigeria. It identifies critical gaps in Active Pharmaceutical Ingredient (API) production and medical device manufacturing, while noting that vaccine production is limited to four countries. The study argues that localization is a political project requiring a shift from generic-drug business models to more complex technologies, supported by patient capital, innovative public procurement, and the establishment of specialized pharmaceutical parks. It emphasizes the need for regulatory harmonization and the development of local 'notifying bodies' for medical devices to reduce compliance costs.