Getting Medicines to the People of Tanzania

Tanzania is officially committed to providing medicines free of charge through the public sector, but public facilities regularly have gaps in stock. In addition, approximately 75 percent of all Tanzanians live in rural areas where essential drugs and basic medicines are often not available. Many people in need must spend much of their hard-earned money to buy medicines at duka la dawa baridi (private drug shops) in their communities, and the expense can be staggering. For example, a single course of adult treatment for mild pneumonia can cost 18 to 59 percent of a day's wages. While duka la dawa baridi are licensed in Tanzania to sell only nonprescription medicines, they typically provide a much broader range of products and services to those who find the means to pay for them.

The SEAM Program in Tanzania

In an effort to provide safe, affordable, and essential medicines to people in need, the Tanzanian Ministry of Health is working with Management Sciences for Health's Strategy for Enhancing Access to Medicines (SEAM) Program, funded by the Bill & Melinda Gates Foundation, to initiate a network of Accredited Drug Dispensing Outlets (ADDOs). The ADDOs were officially launched in August 2003 when Tanzania's Minister of Health, the Honorable Anna Abdallah, traveled to the southern city of Songea for a planned celebration. Activities started with a procession led by the first 46 certified dispensers and 23 accredited shop owners, and ended with a crowd of thousands at the Songea Football Stadium. At the closing ceremonies, the audience was addressed by the Regional Commissioner, the Honorable Minister of Health, the Tanzania Food and Drugs Authority (TFDA) Director, the Songea District Commissioner, and the MSH SEAM Director. Upon conclusion of the opening ceremonies, Minister Abdallah officiated the opening of the first ADDO, locally known as Duka la Dawa Muhimu or essential drug shop.

In a related initiative, the SEAM Program and The Tanzania Food and Drug and Authority have been collaborating since February 2002 on establishing a new accreditation model for nonpharmacy drug outlets. This model seeks to change the behavior of shop owners and dispensing staff by providing education, training, and supervision on pharmaceutical access and rational use.

A regulatory system that uses local government officials deputized as inspectors by the Pharmacy Board will help ensure that accredited shops maintain approved standards and that nonaccredited shops compete fairly by not selling prescription drugs.

The SEAM Conference in Dar es Salaam

Tanzania is also hosting the SEAM Program's third international conference to be held in Dar es Salaam from December 10-12, 2003. The 2003 SEAM Conference is being presented in collaboration with the Ministry of Health of the United Republic of Tanzania, the World Health Organization's Department of Essential Drugs and Medicines Policy, the Rockefeller Foundation, the International Network for Rational Use of Drugs (INRUD), and MSH's Rational Pharmaceutical Management Plus (RPM Plus) Program, which is funded by the U.S. Agency for International Development (USAID). The conference theme is Targeting Improved Access. It will feature many of the World's leading authorities, providing a combination of plenary and parallel-track sessions and roundtable discussions so that all participants will have the opportunity to share their knowledge and experiences.

Holding the third SEAM conference in Dar es Salaam not only provides an international forum for sharing information and debating policy; it also focuses attention on Tanzania's role in implementing innovations for improving pharmaceuticals access that may serve as models for other programs throughout the World.