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<\/p>\nDar es Salaam. Each time a patient is told that medicines are out of stock at a public health facility, the same questions arise: who is responsible and why does the problem persist despite increased government spending on healthcare?<\/p>\n
This concern continues to trouble many citizens, particularly at a time when the government has pledged to improve access to medicines nationwide.<\/p>\n
In a recent interview in Dodoma, Chief Government Pharmacist Daudi Msasi offered a detailed explanation of how the health commodities supply chain operates, from dispensary level to the national stage, and where breakdowns can occur.<\/p>\n
Supply chain begins at facility level<\/p>\n
According to Mr Msasi, the availability of medicines does not start at the Ministry of Health or the Medical Stores Department (MSD), but at individual health facilities.<\/p>\n
Each year, more than 8,000 health facilities across the country prepare medicine forecasts between August 1 and December 31. During this four-month period, health workers collect data on patient numbers, disease trends and medicine usage to estimate demand for the following year.<\/p>\n
\u201cThis system uses modern technology known as the Electronic Logistics Management Information System (eLMIS), through which all facilities submit their requirements digitally,\u201d he explained.<\/p>\n
No facility is allowed to submit requests outside the system, a measure aimed at enhancing transparency and accountability.<\/p>\n
However, this raises a key question: do frontline health workers have the capacity to make accurate forecasts?<\/p>\n
Multi-level review process<\/p>\n
Mr Msasi said once facilities submit their forecasts, the data undergoes several stages of review\u2014at council, regional and ultimately national level through the President\u2019s Office\u2013Regional Administration and Local Government (Tamisemi).<\/p>\n
At each stage, the projections are scrutinised, adjusted and aligned with available funding. They are then submitted to the National Medicines Forecasting Committee, chaired by the Chief Government Pharmacist.<\/p>\n
\u201cWe receive national demand estimates, analyse them and ensure they reflect reality before forwarding them to MSD for implementation,\u201d he said.<\/p>\n
Yet, the multiple layers of review raise further concerns about whether actual needs may be altered or diluted along the way, ultimately affecting medicine availability.<\/p>\n
Funding gaps drive shortages<\/p>\n
After approval, the next step involves planning for procurement and distribution, undertaken jointly by the Ministry of Health, Tamisemi and MSD.<\/p>\n
This stage assesses existing stock levels against projected needs for the year. However, a major challenge arises when available funds fall short of actual requirements.<\/p>\n
\u201cWhen there is a mismatch between funding and real demand, that is where another source of shortages begins,\u201d Mr Msasi noted.<\/p>\n
Roles of MSD and health facilities<\/p>\n
Once funds are secured and medicines procured, MSD is responsible for distributing them to health facilities based on orders placed every two months.<\/p>\n
Health facilities, in turn, must submit timely and accurate orders based on their needs.<\/p>\n
If MSD fails to deliver, it bears responsibility. However, if facilities make errors in forecasting or fail to order correctly, accountability shifts to facility staff and local government authorities.<\/p>\n
\u201cThis is a chain involving many actors, each with their own responsibility,\u201d Mr Msasi emphasised. Still, for the ordinary citizen, such explanations may offer little comfort when medicines are unavailable.<\/p>\n
<\/p>\n
A pharmacist dispenses medicines at a public health facility. Every year, more than 8,000 health facilities across the country prepare medicine forecasts between August 1 and December 31. PHOTO | FILE<\/p>\n
The government has invested in digital systems to improve medicine tracking. In addition to eLMIS, health facilities use electronic medical records systems.<\/p>\n
The goal is to integrate these platforms to provide real-time data\u2014from when medicines enter the system to when they are dispensed to patients.<\/p>\n
\u201cWe aim to reach a point where, within minutes, we can identify which facility has shortages and take immediate action,\u201d he said.<\/p>\n
Artificial intelligence is also being introduced to enhance forecasting accuracy.<\/p>\n
However, questions remain as to whether technology alone can address deeper structural challenges such as shortages of skilled personnel and limited financial resources.<\/p>\n
Shortage of professionals<\/p>\n
A significant challenge facing the health sector is the shortage of qualified personnel, particularly pharmacists.<\/p>\n
As a result, medicine management is often handled by nurses or laboratory technicians, which can affect the quality of decision-making.<\/p>\n
Mr Msasi said the government has begun addressing this gap, including the recruitment of 12,000 health workers in the current financial year.<\/p>\n
\u201cWe are also providing extensive training. Our teams are in the field supporting staff\u2014often you find a nurse or lab technician stepping in to help with forecasting and stock verification,\u201d he said.<\/p>\n
\u201cWe believe that having the right professionals in place, as the government continues to address this, will be a key solution in reducing this challenge.\u201d<\/p>\n
Expiry losses unavoidable<\/p>\n
Despite improvements, the expiry of medicines remains an unavoidable challenge, particularly in countries that rely on imports.<\/p>\n
\u201cYou have to prepare for diseases even if they may not occur. If they do not occur, medicines remain unused and expire,\u201d Mr Msasi explained.<\/p>\n
He stressed, however, that performance is measured by the rate of expired medicines. Tanzania\u2019s rate is currently below two percent, compared to the global benchmark of five percent.<\/p>\n
\u201cIn the 2024\/2025 financial year, expired medicines accounted for about 0.9 percent\u2014far below previous levels,\u201d he said.<\/p>\n
Nonetheless, for citizens facing shortages, even such figures may appear significant.<\/p>\n
\u201cMedicine expiry at facilities or MSD warehouses is unavoidable because we procure in anticipation of diseases. If outbreaks such as cholera do not occur, some medicines will expire,\u201d he added.<\/p>\n
Diversion and accountability<\/p>\n
Mr Msasi also acknowledged the problem of medicine diversion, with reports indicating cases of theft and misuse involving some health workers.<\/p>\n
He said robust monitoring systems are in place, including internal and external audits and collaboration with institutions such as the Prevention and Combating of Corruption Bureau (PCCB).<\/p>\n
\u201cWhen medicines do not reach patients, investigations are triggered through audit units and oversight bodies such as the Controller and Auditor General (CAG),\u201d he said.<\/p>\n
\u201cThere are ongoing court cases involving staff accused of diverting medicines or medical supplies. Some have been convicted, while others are facing legal action. PCCB continues to play a key role in ensuring accountability.\u201d<\/p>\n
In situations where medicines are unavailable in public facilities, patients are often forced to purchase them from private outlets at their own cost.<\/p>\n
This increases the financial burden, particularly for low-income households.<\/p>\n
The government hopes that the implementation of universal health insurance will help ease this pressure by ensuring access to services without out-of-pocket payments.<\/p>\n
A closer look shows there is no single cause of drug shortages. The issue spans a complex chain involving health workers, local authorities, regional administrations, ministries, MSD and even the Ministry of Finance.<\/p>\n
Mr Msasi said when any link in this chain fails, the impact is ultimately felt by the patient in need.<\/p>\n
Perhaps the more important question, he suggested, is not who to blame, but how the system can be strengthened to ensure consistent availability of medicines.<\/p>\n
Because, in the end, the health of citizens cannot wait for administrative solutions.<\/p>\n","protected":false},"excerpt":{"rendered":"Dar es Salaam. Each time a patient is told that medicines are out of stock at a public…\n","protected":false},"author":2,"featured_media":368302,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[33],"tags":[103,61,60,371],"class_list":{"0":"post-368301","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-medication","8":"tag-health","9":"tag-ie","10":"tag-ireland","11":"tag-medication"},"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/posts\/368301","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/comments?post=368301"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/posts\/368301\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/media\/368302"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/media?parent=368301"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/categories?post=368301"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/tags?post=368301"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}