That doesn’t really play out in a capitalistic system of incentives. Pharma companies charge as much as the market will bear and the market in Africa just can’t

That doesn’t really play out in a capitalistic system of incentives. Pharma companies charge as much as the market will bear and the market in Africa just can’t bear very much, so pricing them out will leave profit on the table. Drugs that are too expensive like chemotherapy usually aren’t offered except as humanitarian donations or supplied to upper class patients. The tech industry does it all the time too, pricing games and SaaS subscriptions based on the currency, so that i.e. people in Russia or India pay a cheaper rate. Not because their consumers are being subsidized but because they would get zero profit from them otherwise.