[afro-nets] Use of private sector to scale up malaria treatment

General afro-nets
1

Hello!

Malaria is still one of the leading causes of morbidity and mortality in developing countries. Global initiatives are taking place to ensure access to essential medicines; particularly Artemesinin based combination therapy (ACTs). One of the initiatives being distribution of subsidized ACTs through private sector (particularly drug shops). From extensive experience, I understand challenges associated with this initiative including:
(i) unqualified staff (i.e. with no medical/pharmaceutical background) running drug shops
(ii) inappropriate dispensing of medicines
(iii) poor regulatory mechanism at grassroot level
(iv) poor storage capacity
The consequence of these setbacks is poor dispensing practice and irrational use of medicines in the community. This will ultimately lead to increased drug resistance.

Some work has been done in Tanzania related to improving quality of services offered by drug shops (through accreditation, trainings, community mobilization and improving regulations). The Program in Tanzania is known as Accredited Drugs Dispensing Outlets (ADDO). However, I don’t have much information on how other countries are tackling this problem. In view of this, I would like to do literature review of problems existing in private drug shops and some of the initiatives undertaken to solve the problems. I request anyone who knows literatures related to this subject to share with me. I will write a small report on the proposed precautionary interventions to be undertaken by governments and their partners during distribution of subsidised ACT through private sector. This report will be shared with e-druggers.!

--
Mwemezi Ngemera, MA Health Mgt, Planning & Policy; BPharm
As. ADDO* Coordinator
Tanzania Food & Drugs Authority
Ministry of Health & Social Welfare
Dar es salaam
Tel +255 713 134030
mailto:ngemera@gmail.com
*ADDO = Accredited Drugs Dispensing Outlets (a National Public Private Partnership Program aimed at improving access to quality medicines and pharmaceutical services in rural and peri-urban areas)

2

Dear Ngemera,

Greetings from your "next door neighbor!".

I am writing to you on behalf of the Association of Private Health Facilities in Tanzania (APHFTA). Many of ADDOs in Songea are APHFTA members. Thanks for doing so much to them! I have one comment. It is hard to understand why the private clinics and dispensaries with trained personnel are denied access to the ALU, while the small shops are supplied with the medicines! The private medical practitioners in Tanzania are wondering why they are denied access while they see the patients and do the diagnosis, but have no access to the subsidized ALU. The Drugs cost up to 12 US$ in the private market, but in government stores it costs less than a dollar, and also very much less in your ADDO program. People attending the private facilities can’t afford the cost, and some have actually died!

May we kindly meet to discuss this if possible, you may at least enlighten me, because so far I was struggling to know who was in charge of this wonderful program, which, if well utilised, can be of great benefit to millions of Tanzania who suffer annually from malaria.

Regards,

Dr. Samwel Ogillo
Program Manager
Association of Private Health Facilities in Tanzania (APHFTA)
55/644 Lumumba Street
P.O. Box 13234
Tel: +255 22 2184667/2184508
Cell: + 255 754 520 396
   or + 255 784 520 396
Fax: + 255 22 2184508/2184667
mailto:ogillo@aphfta.org
Website: http://www.aphta.org