Press Releases
U.S. Government Increases Access to Malaria Treatment through Accredited Drug Dispensing Outlets in Tanzania
November 17, 2007
With an estimated 10 million uncomplicated malaria cases diagnosed per year, malaria is a major public health problem in Tanzania. In 2006, facing rapidly progressing resistance to the standard treatment of malaria, the National Malaria Control Program in Tanzania revised its treatment policy to recommend artemether-lumefantrine, an artemisinin-based combination therapy, as the first-line treatment for uncomplicated malaria. However, because most Tanzanians treat malaria through the private sector, a comprehensive strategy to assure that the majority of people have access to the new medicines must include private retail shops, where many purchase antimalarial treatments.
On November 17 in Kilosa District, the Ministry of Health and Social Welfare's Director of Preventive Services, Dr. Donan Mmbando and the U.S. Agency for International Development (USAID)/Tanzania Mission Director Pamela White together with Director General of the Tanzania Food and Drug Authority Margaret Mdomondo-Sigonda will launch the distribution of U.S. government subsidized artemether-lumefantrine through an innovative private-sector drug seller program, called accredited drug dispensing outlets (ADDOs) or Duka La Dawa Muhimu, Swahili for ‘essential drug shops.’ This launch is part the U.S. President’s Malaria Initiative’s (PMI) broad campaign to support the control of malaria in Tanzania. In addition to this program which will improve access to artemether-lumefantrine through the private sector, PMI/Tanzania is supporting the distribution of insecticide treated bed nets, the use of indoor residual spraying in select districts, and case management of malaria. The event will promote both the public’s use of the new first-line medicine to treat simple malaria early and the convenience of using ADDOs as a source for the subsidized treatment.
ADDOs resulted from a public-private initiative headed by the Ministry of Health and Social Welfare and the Tanzania Food and Drugs Authority with technical assistance from Management Sciences for Health, with a goal of improving access to affordable, quality medicines and pharmaceutical services in underserved communities. To achieve this goal, the ADDO program developed a dispenser training program covering issues such as how to identify and counsel patients on common health problems, such as malaria, and dispense appropriate treatment. Outlet owners are trained in regulations, ethics, and basic business management. In addition, the initiative provides owners business incentives and strengthens the supervision and regulatory system by delegating related activities to local government authorities.
The early success of ADDOs in the Ruvuma region, where the initiative was piloted, led to the Tanzanian government’s decision to expand ADDOs to 21 regions nationwide. Through the President’s Emergency Plan for AIDS Relief, the U.S. Government is supporting a scale-up in Morogoro region, while the Government of Tanzania is financing the rollout in Mtwara and Rukwa regions. In addition, the Tanzanian Government and USAID are expanding the scope of services that ADDOs provide by using them to strengthen community-based health care interventions in child health, home-based care for HIV/AIDS patients, and rolling out of ACTs, being launched today.
The U.S. President’s Malaria Initiative, PMI, has pledged $1.2 billion over five years to reduce deaths from malaria—Tanzania was one of the first three countries that PMI targeted. So far, PMI has committed $790,953 for the purchase of artemether-lumefantrine in Tanzania, which covers almost 650,000 treatment courses—70 percent of which will be given to children under 12 years. This is only one of several programs the U.S. Government provides as direct assistance to Tanzania on behalf of the American people. During the fiscal year beginning October 1, 2007, the U.S. Government will provide approximately $648 million (over 721 billion Tanzanian shillings) in direct assistance and through multilateral organizations to Tanzania.
In Ruvuma and Morogoro regions, 1,363 ADDO dispensers have been accredited and trained and are now identifying and treating uncomplicated malaria with ACTs. In comparison, only 600 pharmacists exist in both public and private sectors in the entire country. This illustrates the enormous potential of ADDOs to improve the community’s access to recommended malaria medicines through the private sector.