From November ’07 to March ’08, the Cooperation Framework on Innovation Systems between Finland and South Africa (Cooperation Framework on Innovation Systems between Finland and South Africa (COFISA)) held a successful Foresight exercise that focused on the future of the Eastern Cape as a whole, with a particular emphasis on the role of innovation in that future. Following on from this, and in support of DST’s biotechnology “grand challenge”, Cooperation Framework on Innovation Systems between Finland and South Africa (COFISA) decided to hold a biotechnology Foresight exercise for the Eastern Cape during late 2008 and early 2009.This report outlines the outcomes of the Foresight exercise.