Management Sciences for Health

To fight the danger of anti-microbial resistance, regulate, train and certificate sellers of essential medicines in hard to reach communities to dispense appropriate drugs.

Freedom for Health

Reducing drug-resistant infections in Tanzania

Antimicrobial resistance (AMR) is one of the most serious and growing risks to human health and development worldwide. Modern medicine relies on being able to treat infectious diseases with antimicrobial drugs. But overuse of antibiotics in both humans and animals is leading to resistance to treatments for infectious diseases including tuberculosis, HIV, and malaria. We must act now to limit the future impact of drug-resistant infections.

People in rural Tanzania often have to travel long distances to access the country’s healthcare system, so when they fell ill, many would buy antibiotics from poorly regulated local dispensers. These dispensers were only legally allowed to sell over-the-counter medicines, but many who were untrained and unqualified illegally sold prescription medicines of questionable quality and didn’t counsel patients on how to use them. This encouraged overuse of antibiotics and the spread of antibiotic resistant infections.

That was until the government of Tanzania, its Pharmacy Council, and the international non-governmental organisation, Management Sciences for Health, introduced a program to improve how antibiotics and other essential medicines are dispensed. They set up a national program to accredit drug dispensing outlets and their staff. To become accredited, dispensers are trained to provide safe, quality medicines and referrals to a health facility for more complex care. They can better advise on medicine choice and on the correct dose and duration. Crucially, they can also tell a patient when drugs are not necessary.

Audensia owned the local drug shop in her community and joined the accredited drug dispensing outlet (ADDO) program as soon as it was introduced in her district in 2010.She emphasised how the training and accreditation improved how she was able to provide health services for her community, “My medicines dispensing skills have improved and I learned how to communicate with clients better. The accreditation allows me to stock and dispense more medicines than I could before due to the laws. Also, my clients seem to trust my services more: I now have legal documents in the shop which signify recognition by the government; the conditions at the outlet are better; and, now I have a uniform, a white coat from the Tanzanian Food and Drug Authority.”

The programme has helped facilitate access to essential medicines in hard to reach areas, and importantly, better regulated the dispensing of these medicines to help combat AMR. The initiative has been so successful that the model is being adapted in other countries in Africa and beyond.

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