Improving access to essential drugs in Tanzania

Governance reform of the pharmaceuticals’ procurement chain and smart incentives for domestic producers of drugs

Research question

Access to affordable medicines in Tanzania is known to be poor. One of the many reasons is the presence of corruption at all levels of the supply chain. What are the governance and corruption vulnerabilities and resource leakages in the procurement of pharmaceuticals and how could these be reduced for better access to medicines in Tanzania?

Project summary

Local and affordable pharmaceuticals production is key to sufficient availability of essential drugs. This project asks where do resources leakages occur in the procurement of pharmaceuticals and how could these be reduced? In doing so, it looks into the most vulnerable stages of the procurement chain to corruption – from tendering conditions, bidding process and registered companies’ selection, to labelling, stocking, distribution and prescription of essential drugs. We also consider the systemic and non-systemic factors along the pharmaceutical procurement chain that allow rents capture opportunities and obstruct the delivery of effective health care. Pharmaceutical production in Tanzania has declined in recent years and this project will identify the barriers which led to this decline, including the role of existing procurement processes, in particular the design of the essential drug list. How could firms be incentivised to produce pharmaceuticals locally through procurement reforms?

We will identify feasible ways to reduce resource leakages along the procurement chain and avoid situations in which reforms simply shift resource capture opportunities from one stage to another of the chain. Alongside the introduction of the ‘vendor model’, we expect to find other systems addressing vulnerabilities in areas of quality assurance and a coordinated system of medicine supply, including using powerful players to encourage local procurement and eventually local production of medicines.

Main partners

The London School of Hygiene and Tropical Medicine (LSHTM) and the Ifakara Health Institute (IHI) in Tanzania.

Read the project summary