A national medicine policy (NMP), previously known as a national drug policy (NDP), represents a governmental pledge and strategic framework designed to ensure that medicines are safe, effective, of reliable quality, accessible, affordable, and used rationally. This study provides the first comprehensive examination of how the 16 countries within the Southern African Development Community (SADC) have implemented various components of their NMPs over a ten-year period (2011–2021). Published materials from 2011 to 2021, including national pharmaceutical profiles, official governmental publications, datasets from WHO, HAI and the World Bank, as well as peer-reviewed research addressing implementation activities, were systematically assessed. Over the decade under review, the 16 SADC nations demonstrated notable advances in putting their NMPs into practice. Commonly executed components involved essential medicines policies, pricing mechanisms, and regulatory measures, while the integration of traditional and herbal medicine elements remained largely absent in most countries. The pharmacist-to-population ratio, measured at 1:2300, fell short of recommended benchmarks in every country, highlighting the need to strengthen human resources for pharmacy services within national health systems. Continued investigations into medicine pricing, affordability, and availability are crucial for the development of equitable pricing frameworks that enhance access to medicines across individual countries and the wider SADC region. Except for the Republic of Tanzania, all SADC member states need to promptly update their NMPs and consider incorporating modern approaches such as Health Technology Assessment (HTA). Establishing a robust evaluation culture with an international orientation is essential for embedding monitoring processes into policy development. As the first study to assess the implemented components of NMPs in the SADC context, these findings may help countries collectively address shared pharmaceutical challenges and strengthen their preparation for achieving universal health coverage (UHC). Further detailed cross-national investigations are recommended to thoroughly assess NMP implementation across the SADC region.
