3. Strengthening Health Systems

In Tanzania, local drug shops are important sources of drugs. They are required to obtain a permit each year and to meet certain conditions related to premises, qualifications of the seller, and products (nonprescription medicines only). A study in three districts found that, despite regular inspections of drug shops, infringement of the regulations was widespread—including the sale of prohibited or inappropriately packaged drugs, which inspectors must have known about. Illegal drug sales may have contributed to poor-quality treatment and encouraged the development of drug resistance, but they had important benefits in terms of accessibility, because drug supplies in drug shops were more reliable than those in government facilities. Revising the regulations to permit drug shops to stock a small set of oral antibiotics, for example, would allow more constructive engagement between sales staff members and regulators, including the provision of information on essential drugs, registered brands, appropriate dosing, and consumer advice. The Strategies for Enhancing Access to Medicines Project is experimenting with allowing a wider range of drugs to be provided in one region using accredited outlets for dispensing drugs (drug shops that meet specified quality criteria and whose staff members have been trained by the project).

Source: Goodman 2004.