pharmacy

 Cynthia (left) cares for her grandson, Alime, orphaned to AIDS and living with HIV, in East London, South Africa.

This post is an excerpt from "Medicine Movers," written by Daphne Northrop, and videos by Emily Judem

EAST LONDON, South Africa -- Nine-month-old Alime and his grandmother Cynthia sit at a table piled with pill bottles, cardboard cartons, and syringes. There are 19 items in all. 

The squiggly Alime, who traveled that morning on his grandmother’s back to the hospital, happily munches on a cookie while the pharmacist counsels his grandmother on when he should take each of his medicines and how much to give him. It’s hard to believe such a tiny boy needs so many pills to survive.

Alime has been HIV-positive since birth. His treatment seems to be working. His weight has doubled, and as he smiles and gurgles quietly in Cynthia’s arms, he looks like a healthy toddler. He rarely takes his eyes off his grandmother, and he reaches out to touch her face as she talks.

Medicine Movers: South Africa from Management Sciences for Health on Vimeo.

{Photo credit: Warren Zelman.}Photo credit: Warren Zelman.

This post originally appeared on the Frontline Health Workers Coalition blog.

Ayelew Adinew was working as a pharmacist in a large public hospital in Addis Ababa, Ethiopia. He looked around and saw that the 100-year old pharmaceutical system was broken.

There was no transparent and accountable system for providing the information needed for effective monitoring and auditing of pharmaceuticals and other commodities. There was not sufficient documentation to track consumption, inventory discrepancies, wastage, product over-stock or under-stock. There were no procedures to ensure the availability of essential medicines. The regulations were outdated and there was no enforcement of the relevant regulations in place to protect the safety of clients, ensure proper utilization of resources, and deter professional malpractice.

 {Photo credit: Rachel Lieber/MSH.}ADDO owners and dispensers in Mafia Island, Tanzania, learn to use the mobile applications developed by SDSI. The applications allow ADDO personnel to access an SMS-based Pharmacy Council helpline, send service utilization reports to the Pharmacy Council, and to pay annual licensing fees via mobile money.Photo credit: Rachel Lieber/MSH.

Cross-posted with permission from mHealthKnowledge.org.

In the private sector, Tanzania has more than 1,000 pharmacies, 2,500 pharmaceutical personnel, 6,000 accredited drug dispensing outlets (ADDOs), and more than 18,000 ADDO dispensers. The Pharmacy Council of Tanzania has overseen these facilities and personnel since 2011, but lacked a comprehensive system to manage regulatory information. Without such a system, basic facility and personnel information was inaccessible, the locations of rural ADDO facilities were unclear, and tracking business and professional licensing status, including fees collection, was difficult. Furthermore, the Pharmacy Council had no way to efficiently communicate directly with the outlets.

 {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.

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