National production sidelined despite HIV test shortages in Morocco

An alarming paradox persists in Morocco’s healthcare system: public health facilities frequently face year-long stockouts of rapid HIV tests, forcing patients to leave without diagnosis, while domestic manufacturers hold ready-to-ship kits awaiting orders. This recurring shortage isn’t merely a logistical failure—it exposes a deeper flaw in the country’s public procurement system, where legally mandated national preference is systematically ignored.

When procurement rules fail the nation

Moroccan law clearly stipulates that public contracts must prioritize domestic production through technical specifications based solely on performance criteria—not brand, origin, or patent constraints. Yet this principle, as outlined in Decree No. 2.22.431, is routinely circumvented. Abdelhay Rhorba, administrative law expert at Hassan II University of Casablanca, emphasizes that such practices constitute clear violations of equal opportunity and may amount to abuse of power.

Under Moroccan administrative law, contracts with exclusionary technical specifications can be challenged if their effect is unjustifiably discriminatory. Affected parties may first file a recours gracieux with the National Public Procurement Commission before pursuing legal action within 60 days. In cases involving suspected corruption, criminal provisions on influence-peddling may also apply.

Kafkaesque barriers for local manufacturers

On the ground, the reality is stark. Technical procurement documents—known as Cahiers des Prescriptions Spéciales—are frequently drafted around foreign products already in use, ignoring emerging domestic manufacturing capabilities. One anonymous Moroccan medical device manufacturer, whose certified products are successfully exported across Africa, struggles to secure even 2% of the public market in its segment.

«The technical specifications should be based on Moroccan-made products, which is not happening today», the manufacturer states. Requests for clarification from contracting authorities are met with silence or inaction, leaving procurement decisions unchanged.

This contradiction extends beyond the Ministry of Health. While the Ministry of Finance recently raised customs duties on certain imported medical devices to boost domestic production, the Ministry of Health continues purchasing more expensive foreign alternatives despite the availability of equivalent local products at competitive prices.

Government response falls short

The Ministry of Health’s supply division asserts that all procurement processes are conducted «in strict compliance with current regulations», emphasizing openness to all operators meeting eligibility criteria—provided they are established in Morocco. However, this interpretation focuses solely on company registration, not the origin of manufacturing. As a result, importers based in Morocco receive the same treatment as domestic producers, regardless of where the product is made.

The HIV test case is telling. Officials acknowledge «occasional supply tensions» in some health facilities, attributing delays to «procurement procedural timelines and international supply chain disruptions». Urgent procurement efforts and «complementary alternatives» are allegedly under review. Yet critics question why local manufacturers with certified, in-stock products were not engaged during these prolonged shortages.

The Ministry denies using direct award procedures (gré à gré) for these acquisitions, claiming all 2025 procurement was conducted through competitive tenders. This contradicts multiple reports from sources close to the file. Legal experts note that direct awards are only permissible under strict conditions: extreme unforeseen urgency, justified technical exclusivity, or failed tender processes. Written justification and proof of no alternatives are mandatory—otherwise, the procedure is illegal.

Sovereign health: a distant goal

The HIV test supply crisis underscores a broader challenge: achieving health sovereignty. Dr. Jaafar Heikel, a leading infectious disease specialist, highlights the critical role of rapid tests in reaching populations that avoid traditional laboratories. «NGOs like OPALS and the ALCS rely on these tests to screen populations that might never step into a lab», he explains. «When supply stops, outreach stops—and the fight against HIV loses ground».

Local production, once validated by state agencies, offers dual benefits: cost efficiency and strengthened health independence. «Producing these tests domestically allows Morocco to meet its financial and public health goals while moving toward true health sovereignty», Dr. Heikel emphasizes.

Can Morocco meet its 2030 HIV targets?

Morocco has committed to the UNAIDS 95-95-95 targets: 95% of people living with HIV know their status, 95% of those diagnosed are on treatment, and 95% of those treated have undetectable viral loads—aiming to end AIDS as a public health threat by 2030. These goals depend heavily on widespread, rapid, and accessible testing.

«Without tests, fewer people get tested—and the virus spreads», warns one producer. Dr. Heikel concurs: «Meeting the 95-95-95 targets will be faster and more reliable with validated rapid tests and domestic manufacturing».

The Ministry of Health insists it remains «fully committed to ensuring continuous testing services». Yet sector stakeholders demand to see this commitment reflected in revised procurement specifications and transparent decision-making.

Unanswered questions linger: Are some members of technical validation committees prioritizing foreign suppliers or personal interests over ministerial directives? The risk is clear: sustained exclusion of local producers could stifle investment in domestic manufacturing at a time when Morocco most needs it—and continue funneling public funds abroad for products the country can produce itself.