For an industry that increasingly speaks the language of resilience, diversification and long-term value creation, does the global distribution of air cargo capacity tell a more uneven story? A new white paper from Pharma.Aero and The International Air Cargo Association (TIACA) suggests how stark that imbalance remains – and why Sub-Saharan Africa represents both a critical vulnerability and a significant opportunity for the air cargo sector.

The recently released Food and Farm for Health white paper draws on a decade of data, market analysis and economic modelling to examine how current airfreight capacity allocation is constraining healthcare access and economic development across one of the world’s fastest-growing regions.

The headline statistic is striking: Sub-Saharan Africa receives just 2% of global air cargo capacity, despite rapid population growth, increasing demand for medicines, and untapped potential in high-value agricultural exports.

Rather than framing this solely as a development challenge, the study positions the issue squarely within the strategic remit of airlines, airports, forwarders and logistics providers.

The central argument is clear: rethinking bidirectional air cargo flows into and out of Africa is not only a humanitarian imperative, but a commercial and operational one.

Healthcare dependency exposes structural weaknesses

Few regions are as reliant on airfreight for healthcare as Sub-Saharan Africa. According to the white paper, up to 90% of critical pharmaceuticals (including vaccines, biologics and lifesaving therapies) arrive by air.

This reliance is driven by limited local manufacturing, the temperature sensitivity of many medicines, and the urgency associated with public health responses.

Yet the mismatch between demand and available uplift capacity creates systemic fragility. Predictable seasonal vaccine campaigns and recurring disease outbreaks, such as malaria, cholera and influenza, generate surges in demand that existing networks struggle to absorb.

When capacity is constrained or poorly aligned, the consequences are not measured in yield loss, but in delayed treatment and reduced health outcomes.

From an industry perspective, the findings challenge the notion that healthcare flows to Africa are episodic or purely humanitarian in nature. Instead, they represent a consistent, forecastable and growing demand base that requires more agile and reliable cargo planning.

“…rethinking bidirectional air cargo flows into and out of Africa is not only a humanitarian imperative, but a commercial and operational one.”

The missed opportunity in outbound flows

While inbound pharmaceuticals dominate the healthcare narrative, the white paper places equal emphasis on outbound flows – particularly perishables and high-value agricultural exports.

Despite favourable growing conditions and a strong labour base, Africa’s airfreight exports have stagnated over the past decade, especially when compared with Asia and Latin America.

This stagnation is not attributed to a lack of production, but to structural barriers in logistics connectivity. Limited freighter access, insufficient bellyhold capacity, and fragmented cold chain infrastructure have all restricted the ability of producers to reach global markets. The result is lost export revenue, constrained job creation and reduced foreign-exchange earnings.

Crucially, the study argues that inbound pharma and outbound perishables should not be treated as separate challenges. Optimised, two-way cargo flows offer a pathway to improved aircraft utilisation, more sustainable trade lanes and stronger business cases for capacity deployment.

“Optimised, two-way cargo flows offer a pathway to improved aircraft utilisation, more sustainable trade lanes and stronger business cases for capacity deployment”

A shifting competitive landscape

The white paper also situates Africa’s air cargo challenge within a broader geopolitical and commercial context. China and India are identified as increasingly influential players, investing heavily in logistics gateways, airport infrastructure and trade corridors across the continent.

These investments are reshaping trade dynamics and positioning Asian carriers and logistics providers to capture future growth. For European and Middle Eastern stakeholders, the message is unambiguous: maintaining a passive approach to African air cargo risks ceding long-term relevance in a region with significant demographic and economic momentum.

Frank Van Gelder, secretary general of Pharma.Aero and expert coordinator of the project, underscores the dual nature of the opportunity. “By offering more air cargo capacity, we unlock a dual opportunity: helping Africa grow stronger local economies and ensuring healthcare products reach the populations that need them most,” he said. “If we fail to act, we risk missing not only an economic opportunity, but also the chance to meaningfully support the growth and health resilience of one of the world’s most dynamic regions.”

Implications for air cargo strategy

For airlines, the findings raise questions about how capacity strategies are defined for emerging markets. Rather than viewing Africa through the lens of marginal yields or fragmented demand, the white paper calls for a more integrated assessment of long-term value, including stable healthcare volumes and export-led growth.

Airports, meanwhile, are encouraged to consider how targeted investment in cargo handling, cold chain infrastructure and regulatory facilitation could reposition them as regional gateways.

For freight forwarders, the report highlights opportunities to develop tailored trade-lane solutions that combine health-critical cargo with perishables, improving reliability for shippers on both ends of the supply chain.

Glyn Hughes, director general of TIACA, frames the issue as one that transcends operations alone. “These limitations are not just operational; they impact lives, livelihoods, and long-term development,” he said. “Strengthening air cargo links between Europe and Africa is a clear opportunity to improve healthcare access, boost rural incomes, and build more resilient supply chains.”

“For freight forwarders, the report highlights opportunities to develop tailored trade-lane solutions that combine health-critical cargo with perishables, improving reliability for shippers on both ends of the supply chain”

From insight to action

Ultimately, the value of the Food and Farm for Health white paper lies in its ability to connect data-driven insight with practical relevance for decision-makers.

Governments and economic agencies are urged to align industrial, trade and health policies more closely with air cargo development, while private-sector stakeholders are challenged to collaborate across traditional silos.

For an industry grappling with how to deploy capacity more intelligently in a volatile global environment, Sub-Saharan Africa emerges not as a peripheral market, but as a strategic test case.

The question posed by the white paper is not whether demand exists, but whether the air cargo sector is prepared to adapt its networks, partnerships and priorities to meet it.

In that sense, the study serves less as a warning and more as a roadmap – outlining how smarter capacity allocation could unlock economic value, strengthen supply chain resilience and deliver tangible social impact in parallel.

The White Paper of the Food and Farm for Health Project is available here.