Accredited Drug Dispensing Outlets in Tanzania Strategies for Enhancing Access to Medicines Program
(2008; 105 pages)

Abrégé

In 2000, Management Sciences for Health (MSH) received a grant from the Bill & Melinda Gates Foundation to identify and test innovative approaches for improving access to essential medicines in developing countries through greater participation of the private sector. To fulfill this mandate, MSH set out to implement programs to promote access, design a method to measure the nature and extent of the lack of access to essential medicines, and monitor the impact of these programs.

The Strategies for Enhancing Access to Medicines (SEAM) Program has four components:

  1. technical collaboration with other Gates-supported global medicine and vaccine access initiatives,
  2. implementation of country-level public-private initiatives to improve access to essential medicines and commodities in two or three countries,
  3. determination of the feasibility of franchising as a mechanism to improve access, and
  4. development and deployment of information and communications tools to support technical interventions.

After several rounds of internal discussions and consultations with experts from WHO and the World Bank as well as with contacts in developing countries, six countries—Brazil (state of Minas Gerais), Cambodia, El Salvador, Ghana, India (state of Rajasthan), and Tanzania—were identified as targets for assessments based on the conceptual framework, with the understanding that only two, or at most three, countries would eventually be selected for long-term projects under the SEAM Program. The initial selection criteria included perceived or known lack of access to essential medicines, perceived enabling environment for private sector initiatives, political and economic stability, and potential for collaboration with other MSH and Gates-funded local initiatives. The countries not selected for long-term assistance are expected to have benefited from the assessment exercise, in particular from a SEAM-supported analysis of potential public-private sector initiatives to enhance access to essential medicines. With such an analysis in hand, the country can approach donors and lenders to finance such work, as appropriate. The assessments were carried out between February and May 2001. Local private, not-for-profit, and academic organizations collaborated in the adaptation of data collection instruments, sample selection, data collection, and analysis. The assessments included

  1. determining the status of public and private sector access—in terms of geographical accessibility, availability, quality, affordability, and acceptability—to essential public health medicines and health commodities;
  2. identifying opportunities for private sector participation in improving access to public health commodities; and
  3. determining the feasibility of implementing public and private sector strategies to improve access.

MSH chief executive officer and Center for Pharmaceutical Management/SEAM Program managers elected to provide full support to country programs in Ghana and Tanzania and limited support for a country program in El Salvador.

 
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