Upheaval in the global external environment, including the recent COVID-19 pandemic, infectious disease outbreaks such as the Marburg virus, and the most recent development aid funding cuts, has created a sense of urgency among African nations to relook at health systems resilience and self-sufficiency in the supply of healthcare products. This Working Paper focuses on how South Africa’s strategic engagement in the Group of 20 (G20) could enhance its ability to mobilise international partnerships, influence global pharmaceutical policy, and attract investment for pharmaceutical manufacturing to facilitate export-led sector growth.