Ensuring sustainable access to essential medicines remains a persistent challenge for health systems in Southern Africa. Namibia faces pressures from limited resources, disease burden, and supply chain vulnerabilities, necessitating critical analysis of its pharmaceutical policy. This policy analysis aims to evaluate the evolution, implementation, and sustainability of Namibia’s national pharmaceutical and therapeutic strategies. It seeks to identify key strengths, persistent gaps, and future challenges in achieving a resilient medicines supply system. The study employs a qualitative policy analysis framework. It involves a desk review of key policy documents, strategic plans, and legislative frameworks. Thematic analysis was used to synthesise data and identify dominant policy themes. Analysis revealed a consistent policy direction towards local capacity building and regional collaboration. A dominant theme was the strategic shift from a purely procurement-focused model to one emphasising local manufacturing potential and pooled regional procurement. However, implementation gaps, particularly in human resource capacity and regulatory harmonisation, were identified as critical barriers. Namibia’s pharmaceutical policy framework demonstrates a clear, long-term vision for sustainability. While strategic intent is robust, translating policy into practice requires sustained investment and stronger regional institutional partnerships to address systemic implementation challenges. Policy efforts should prioritise strengthening the domestic pharmaceutical workforce and accelerating regulatory harmonisation within the Southern African Development Community. Investment in feasibility studies for local production of select essential medicines is also recommended. Pharmaceutical policy, medicine security, sustainability, Namibia, Southern Africa, health systems, therapeutic access This analysis provides a consolidated review of Namibia’s pharmaceutical strategy, offering evidence to policymakers for strengthening programme implementation and regional cooperation for sustainable medicine access.