Gates Foundation Delegation Visits Tanzania Accredited Drug Dispensing Outlets Program

Gates Foundation Delegation Visits Tanzania Accredited Drug Dispensing Outlets Program

 {Photo credit: Jafary Liana/MSH.}Gates Foundation delegates visit an Accredited Drug Dispensing Outlet in Tanzania.Photo credit: Jafary Liana/MSH.

Dr. Trevor Mundel and other senior staff of The Bill & Melinda Gates Foundation traveled to Tanzania this summer to see first-hand the successes of Accredited Drug Dispensing Outlets (ADDO). The ADDO program, which began in 2001, grew out of the need to transform the duka la dawa biridis—unlicensed retail drug shops—into profitable, government-accredited drug dispensing outlets that supply quality medicines and services to underserved populations in Tanzania.

Dr. Mundel, Gates Foundation's President of Global Health, was hosted by Management Sciences for Health’s (MSH) Sustainable Drug Seller Initiatives (SDSI) team along with Tanzania’s Ministry of Health and Social Welfare through the Tanzania Food and Drugs Authority (TFDA) and the Pharmacy Council (PC). The Bill & Melinda Gates Foundation has provided generous funding to support Tanzania’s health sector—including the piloting, sustainability, and maintenance of the ADDO program.

[Gates Foundation delegates visit with MSH, TFDA, and PC staff.] {Photo credit: Jafary Liana/MSH.}Gates Foundation delegates visit with MSH, TFDA, and PC staff.Photo credit: Jafary Liana/MSH.

Combining training, marketing, commercial incentives, regulation, local inspections, and support strategies, the ADDO program built on the existing private retail drug shops—the duka la dawa baridis—which were conveniently located close to where most people live and were often communities’ first access point for medicines, especially in rural areas. During the visit, the Gates Foundation delegation met with partners from the Pharmacy Council and the TFDA to discuss the progress made in Tanzania in scaling up the ADDO program nationwide. Dr. S.S. Ngendabanka, TFDA’s Acting Director General, spoke about the evolution of the program from 2003 to 2011, which is when the Pharmacy Council was given the mandate to regulate the ADDO program. Dr. Ngendabanka also spoke about the strong collaboration and support provided by many stakeholders including national and local government offices, drug outlet owners and dispensers, donors, and implementation partners. 

The ADDO program began by soliciting the support and expertise of stakeholders—including health professionals from the public and private sector as well as commercial associations. The next step was developing the standards and requirements to regulate the ADDOs and to build stewardship and governance capacity within the public sector. At the same time, the ADDO program worked to build private sector capacity—strengthening the business skills of the drug shop owners; developing dispensing, record-keep and communication skills of shop dispensers; and facilitating the formation of drug shop associations to support owners and dispensers. The incentives provided to shop owners were significant—an expanded range of medicines that ADDOs can legally sell, improved business and dispensing skills, development of marketing strategies to increase shop visibility and access to microfinancing institutions for business loans.

[Gates Foundation delegates visit with representatives from MSH, Pharmacy Council, and Kibaha District staff.] {Photo credit: Jafary Liana/MSH.}Gates Foundation delegates visit with representatives from MSH, Pharmacy Council, and Kibaha District staff.Photo credit: Jafary Liana/MSH.

The Gates Foundation delegation met with both the Chief Pharmacist and the Director of Health Quality Assurance under the Ministry of Health and Social Welfare. There Dr. Mundel expressed his appreciation to the Tanzanian government for taking the lead in the ADDO program and making it part of the country’s health care system.

The capstone of the visit was the excursion to four ADDOs located in Kibaha district, about two hours from the city of Dar es Salaam. Kibaha District Medical Officer Dr. Victorina Ludovick and District Pharmacist Mr. Geofrey Mjema spoke to the delegation about the district’s health services and the linkages to the ADDO program. While presenting the ADDO initiatives to the delegation, the district health team members highlighted how the ADDOs have been an important alternative source of medicines and community-based public health commodities and services such as distribution of mosquito nets.

[Dr. Mundel (left) and Dr. Suleiman Kimatta (center) meet with an ADDO owner and dispenser (right).] {Photo credit: Jafary Liana/MSH.}Dr. Mundel (left) and Dr. Suleiman Kimatta (center) meet with an ADDO owner and dispenser (right).Photo credit: Jafary Liana/MSH.

Today, the ADDO program has been scaled-up nationwide with over 6,000 ADDOs and over 3,000 additional drug outlets in the accreditation application process. There are now more than 18,000 trained ADDO dispensers operating at the community level.

Under the leadership of Tanzania’s medicines regulatory agencies and with the support of partners such as the Bill & Melinda Gates Foundation and MSH, more Tanzanians have access to quality drugs and services at the community level.

Learn more about Sustainable Drug Seller Initiatives, including the ADDO program

 

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