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Rwanda's diplomatic rift with South Africa poses challenges for the African Medicines Agency's success

Lenias Hwenda
By Lenias Hwenda
5 Mar 2025
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The strained relations between Pretoria and Kigali raise questions about whether this diplomatic conflict will further discourage South Africa from joining the African Medicines Agency.

The African Medicines Agency (AMA) officially found its home in Kigali, Rwanda. The November 2024 handover of the agency’s headquarters and a fleet of vehicles by the Rwandan government will facilitate AMA’s operations and is a significant step towards harmonising pharmaceutical standards on the continent.

But the agency’s long-term success in Rwanda faces potential geopolitical and operational challenges due to the recent diplomatic tensions between Rwanda and South Africa.

Following the deaths of 14 South African soldiers near Goma in eastern Democratic Republic of Congo (DRC), President Cyril Ramaphosa called for Rwanda to take a measured approach.

He said South Africa held Rwanda’s government responsible for supporting the M23 rebels using the Rwandan Defence Forces (RDF). After the M23 rebels captured most of Goma — the biggest city in the east of the DRC — President Ramaphosa warned that any additional attacks on South African troops would be considered “a declaration of war”.

In turn, Rwandan President Paul Kagame accused South Africa of being part of a “belligerent force” involved in “offensive combat operations” to help the Congolese government “fight against its own people”. Kagame warned that “if South Africa prefers confrontation, Rwanda will deal with the matter in that context any day”.

This war of words led to a deterioration of already fraught diplomatic relations between the two countries.

In 2014, South Africa expelled three Rwandan diplomats after an attack on an exiled Rwandan dissident in Johannesburg. The government of Rwanda responded by expelling six South African envoys. Tensions had since eased after efforts to mend the relationship.

However, the deaths of South African peacekeepers deployed in the DRC by the Southern African Development Community (SADC) have caused another flare-up. These geopolitical tensions are playing out on the eve of the AMA officially opening its headquarters in Kigali in Q1 of 2025.

Interviews for an AMA director-general are concluding to allow the agency to begin its business. It is unclear how this situation might affect the agency and its future. Suffice to say that the escalating feud between Ramaphosa and Kagame throws a cloud of uncertainty over the AMA’s future in Rwanda.

The diplomatic rift: a threat to AMA’s future?


Talk of using force to resolve the Rwanda-South Africa conflict raises concerns for regional peace and security. Belligerence has implications for regional institutions like the AMA and risks undermining regional stability.

South Africa, as Africa’s largest economy, is a key player in continental affairs. It has contributed significantly to developing the AMA, though it has yet to fully ratify the AMA Treaty.

The strained relations between Pretoria and Kigali raises questions about whether this diplomatic conflict will further discourage South Africa from joining the agency. If South Africa opts to stay out, then the AMA risks operating without the backing of a regulatory powerhouse that is a major producer and market for pharmaceuticals and vaccines, which would significantly weaken its impact.

Beyond geopolitics, potential labour challenges for the AMA


Beyond geopolitics, Rwanda has specific structural challenges for the AMA. One key issue is the country’s labour laws. According to the International Labour Organisation “the Rwandan labour force suffers from low levels of education”. A 2019 survey showed that 4.5% of the workforce had completed university or a higher learning institution, while “49.7% has not attended or finished primary school”.

Rwanda’s law imposes quotas on foreign employees requiring that “at least 70% of employees engaged must be Rwandans”. This is important for protecting local employment.

However, it could present a challenge for the AMA which requires a diverse, highly specialised workforce, including regulatory experts and pharmacologists. Its pan-African mandate is best served by pan-African experts.

Besides, Rwanda’s labour market is already facing a shortage of skilled healthcare professionals, including pharmacists and regulatory professionals. Due to the shortage of pharmacists, some of Rwanda’s pharmacies are served by nurses.

Rwanda’s is also highly dependent on foreign aid and has used expatriates to fill the skills gap, limiting career advancement opportunities, professional development and sustainable pharmacy and regulatory workforce development in Rwanda.

Furthermore, a significant proportion of the workforce is not fluent in English or French — both critical languages for the AMA. Given these multiple bottlenecks, can Rwanda’s 70% requirement for local content meet the needs of the AMA? This matters. Insisting that the AMA strictly follow Rwanda’s labour quotas could limit its access to requisite talent and compromise its success.

The path forward for AMA


The AMA will soon begin operating in Rwanda. A high priority should be to address uncertainty about its future caused by the security, political and logistical concerns resulting from the ongoing geopolitical tensions.

It is important to bear in mind that while the handover of the headquarters is a symbolic milestone, the agency’s long-term success depends on regional cooperation.

Economic powerhouses like South Africa are indispensable. It is therefore important to resolve ongoing diplomatic tensions lest they influence South Africa’s decision not to join, which would complicate the agency’s prospects.

Additionally, Rwanda must consider exercising flexibility in its labour laws to ensure the AMA can attract the necessary talent to succeed. Inflexibility could obstruct the agency’s ability to attract top-tier pharmaceutical and regulatory experts and undermine the very purpose of creating a regional agency to oversee medicines’ quality and safety across Africa.

Therefore, as the dust settles on this diplomatic rift, one question remains: can AMA thrive in Rwanda under the current conditions, or will the challenges force a rethink of its location and operational base? DM

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