Medicine policy in East Africa has developed through regional frameworks aimed at improving pharmaceutical access, quality, and regulation. These approaches hold relevance for other African nations confronting similar challenges, such as Gabon, particularly within the domain of maternal and reproductive healthcare. This analysis critically examines key East African medicine policies to identify transferable lessons and potential pitfalls. Its objective is to assess the relevance of these regional approaches for strengthening Gabon’s national medicine policy, with a focus on obstetric and gynaecological care. A qualitative critical policy analysis was conducted. This involved document analysis of regional policy frameworks, strategic plans, and implementation reports from East Africa. The findings were synthesised with a review of Gabon’s extant policy landscape to enable a comparative analysis and identify thematic insights. The critical importance of regional harmonisation of medicine registration was a central finding. East African policies demonstrated that collaborative regulation can streamline approval times for essential medicines. However, challenges in equitable implementation persist, revealing a key tension between regional cooperation and national sovereignty. East African medicine policies offer a valuable, though not directly transferable, model for regional cooperation. For Gabon, engaging with Central African initiatives while adapting proven strategies on essential medicines lists and supply chain security could address specific gaps in women’s health provision. Gabonese policymakers should prioritise joining or strengthening Central African medicine harmonisation initiatives. National policy should be revised to integrate regional procurement strategies for essential obstetric medicines and to establish a robust post-marketing surveillance system for women’s health products. Policy analysis, medicine policy, East Africa, Gabon, essential medicines, maternal health, regional harmonisation This analysis contributes a novel comparative perspective, bridging East African regional policy experiences with the specific national context of Gabon to inform maternal health policy development.