Tanzania is located in the Eastern part of Africa. It is among the poorest countries in the world whereby the majority of the rural population is living on less than a dollar per day. It has a population of 35 million with about 80% living in rural area depending on subsistence farming. Majority of the urban population are engaged in micro and small business to earn their living. Tanzania has 21 regions, 119 districts and 2,766 wards which form 8 zones as per Ministry of Health and Social Welfare description. Among the indicators of abject poverty is failure of being able to access quality primary health care for a majority of the people, particularly those in rural and peri-urban areas. This has lead to reduced economic growth due to disease burden; reduced life expectancy; maternal, child and adult mortalities; and high medical services costs at both individual citizen and the government levels.
Among the components of quality primary health care is access to essential medicines and other health commodities. In view of the fact that there are a limited number of health facilities and pharmacies countrywide, particularly in rural and peri-urban areas, a provision was made under the repealed Pharmaceuticals and Poisons Act, 1978, for establishment of Part II Poisons shops. Such shops were allowed to sell non-prescription medicines to supplement services provided by health facilities, including pharmacies.
Part II Poisons shops were meant to serve the rural and peri-urban communities where there are no pharmacies though they are now also found in urban areas. Although the precise number of Part II Poisons shops is not known, one estimate puts the number at about 9,000. Based on recent data from several regions, however, the real number may be double this estimate (9,000 to 10,000). Part II Poisons shops are estimated to deliver approximately 80% of the medicines and health commodities provided by private drug outlets.
Several years ago, countrywide inspections conducted by the then Pharmacy Board and an assessment conducted by Management Science for Health (MSH) and Tanzania Food and Drugs Authority (TFDA) revealed a number of anomalies regarding operations of the Part II Poisons shops which call for redress. Anomalies found in relation to dispenser behavior included the selling of unauthorized medicines, the dispensing of medicines by unqualified personnel, and inadequate record keeping. As far as physical facilities and their location are concerned, there often was inadequate storage space and conditions for the stocking of medicines, the facilities in general were poor and not well maintained, and there was uneven distribution of shops geographically resulting in lack of access to essential medicines in certain communities.
For the products sold, some were not registered in Tanzania, quality was uncertain, shops often had an inadequate assortment of medicines for sale, stock-outs were common, and prices were often high and variable. Finally, the regulatory system was inadequate, with inspections by TFDA being infrequently carried out, with some shops never being inspected.
Such problems denied the Tanzanians living in rural, peri-urban and underserved urban communities to have an opportunity to purchase quality, affordable non-prescription and a limited number of prescription medicines from regulated and properly operated drug outlets staffed and supervised by trained drug dispensers.