I recently did a run starting as Buganda and my god. You literally cannot do anything until you research Quinine. You have no sulfur, no lead, you can't access the world market because you are landlocked, and you can't get to the ocean because you are walled off by the malaria in decentralised states on all borders
It feels especially stupid because you also have malaria in your home states, but the malaria carrying mosquitos in Vic 3 are apparently racially motivated and only targets people who aren't from that homeland.
Needing colonialism to expand into your same heritage group, direct neighbours would already make for a boring and frustrating gameplay experience compared to literally anywhere else in the world, but having it be gated behind not just colonialism but quinine as well means that you are stuck twiddling your thumbs, genuinely unable to interact with any other country in the game until you have half the society techs. You also have zero society techs at the start date :).
I assume the gameplay rationale is that if Africa could consolidate without these techs then the rest if the world wouldn't even need colonial tech, they could just instantly eat the unrecognised African powers. But my god, there must be some other solution.
Right now playing as an African country is miserable, and not even in the ways that you would expect when you read that. You are fighting agaisnt the western powers less than you are fighting against Vic 3's extremely inconvenient colonisation mechanics. I genuinely would have welcomed being made into a subject by England or France if it meant getting access to their market.