"An integral part of a sustainable health delivery system is the ability to facilitate equitable access to, and delivery of, the needed health services and technologies… Accordingly, the government has identified the need for strategies to ensure access; strengthen control of safety; enhance harmonization and coordination of procurement, and stocking and distribution."
Dr Mpoki M. Ulisubisya, Permanent Secretary, Ministry of Health, Community Development, Gender, Elderly and Children, Tanzania
In Tanzania, the ADP has focused on developing and strengthening capacities for supply chain management, safety monitoring and research. These are key functions for the introduction and delivery of new health technologies, which will ensure that patient needs can be met in a timely manner.
The ADP assisted the government to strengthen supply chain management of mass drug administration campaigns and address cost inefficiencies in the US$100 million NTD treatment programme. The ADP developed guidelines and training materials for the national NTD control programme, which are now used by the vast network of 67,000 community-based health workers and volunteers who deliver preventive chemotherapy to over 50 million people at risk of NTDs. These tools are now being adapted for use in Ghana as the ADP assists in strengthening the NTD supply chain there, allowing for this work to be done faster and for useful lessons to be transferred.
In collaboration with the National Institute for Medical Research, the ADP helped to develop the national agenda for health systems research to prioritize key areas for implementation research, and strengthened capacities to lead and conduct research aimed at addressing barriers to the uptake of health technologies for TB, malaria and NTDs. National researchers have now mobilized resources for key research activities, which include the formulation of strategies to expand coverage of mass drug administration campaigns and to optimize the use of rapid molecular diagnostics to improve early diagnosis and treatment of MDR-TB.
The ADP has also supported the Ministry of Health, Community Development, Gender, Elderly and Children (MOH-CDGEC) in the institutionalization of the Health Technology Assessment (HTA) approach and built key capacities of a core group of national experts, who used these new-found skills to conduct the evaluation of the Standard Treatment Guidelines and the National Essential Medicines List. This was an important exercise because the list defines the benefits package under the national health insurance schemes that currently collectively cover around 10 million beneficiaries at a cost of US$150 million annually.1
The ADP is working with the Tanzania food and drug administration to strengthen pharmacovigilance capacities and systems at the central, regional and facility levels. This has included the training of almost 300 health care providers from public and private health care facilities across 20 districts. The ADP also supported the roll-out of a system that allows for direct reporting of adverse drug reactions by the consumer to the FDA, which has led to a 50 percent increase in the reporting rate. The increased reporting rate is vital to ensure the timely and effective management of adverse events, particularly as new health technologies are introduced.
|Human Development Index ranking||151|
|Population total (millions)||54|
|Gross national income per capita (USD)||2,467|
|Population living below poverty line (%)||47|
|Public health expenditure (% of GDP)||3|
|Life expectancy at birth (years)||66|
|< 5 mortality rate (per 1000 live births)||49|
|TB incidence (per 100,000)||306|
|Deaths due to TB (per 100,000)||103|
|TB treatment coverage (%)||37|
|MDR-TB incidence (per 100,000)||5|
|Cases of malaria (per 100,000) (2013)||10,962|
|Deaths due to malaria (per 100,000) (2013)||33|
|Children aged <5 years with fever who received treatment with any antimalarial (%)||54|
|Population at risk of LF / coverage of PC||26,962,041 / 73%|
|Population at risk of OCH / coverage of PC||5,657,719 / 71%|
|SAC at risk of SCH / coverage of PC||5,148,093 / 77%|
|SAC at risk of STH / coverage of PC||9,034,860 / 73%|
All data from 2016 unless stated. SAC: school-aged children; PC: preventive chemotherapy; STH: soil-transmitted helminths; LF: lymphatic filariasis; SCH: schistosomiasis; OCH: onchocerciasis.