Tanzania Public-Private Partnership Increases Access to Medicines
The MSH East African Drug Seller Initiative and the Tanzania Food and Drugs Authority (TFDA) finalized the rollout model for Tanzania’s accredited drug dispensing outlet (ADDO) program at a workshop in Morogoro, Tanzania, in September. MSH Senior Program Associate Edmund Rutta presented elements of the revised model at the Corporate Council on Africa’s 2009 US–Africa Business Summit, in a panel supported by the Rockefeller Foundation.
Many people in rural Tanzania seek health care and medicines from retail medicine shops, called duka la dawa baridi, for convenience and other reasons. Historically, the TFDA authorized duka la dawa baridi to provide nonprescription medicines, but a 2001 assessment showed that many shops sold prescription medicines illegally and that the medicine sellers were generally unqualified and untrained.
In response, MSH’s Strategies for Enhancing Access to Medicines (SEAM) Program, funded by the Bill & Melinda Gates Foundation, collaborated with TFDA to develop and launch the ADDO program. The goal was to improve access to affordable, quality medicines and pharmaceutical services in retail medicine outlets in areas where few or no registered pharmacies exist.
To achieve this goal, the SEAM Program took a holistic approach that combined training, accreditation, business incentives, and regulatory enforcement with efforts to increase consumer demand for quality products and services.
By 2005, the TFDA had accredited more than 150 shops in Ruvuma. Results of the pilot in the Ruvuma region provided proof that ADDOs could improve access to quality medicines and pharmaceutical services. The Danish International Development Assistance agency (Danida) funded an independent evaluation of the program, which confirmed SEAM’s findings. Based on the SEAM and Danida evaluations, the Ministry of Health and Social Welfare approved a plan to roll out the ADDO concept to mainland Tanzania.
Many have recognized the potential of ADDOs not only to increase access to essential medicines, but also to serve as a platform for community-based public health interventions, such as improving child health.
Numerous organizations and programs, both public and private, have played a role in expanding the services that ADDOs provide and their geographic reach—about 900 ADDOs currently serve four regions. Successful efforts of this magnitude require creative partnerships and solid commitment to productive collaboration. The timeline below shows the range of partners who have contributed to the success of the ADDO program.