Tanzania public sector

Around half of essential medicines used in Tanzania are obtained via public and non-profit procurement. MSD s public sector procurement gives local firms a 15% price preference in competition with importers when both meet the quality hurdles. The effective preference rate is somewhat lower (one interviewee suggested around 9%), because importers prices are landed prices at the port, while local firms price includes delivery to MSD s zonal warehouses. 

Our supply chain data (Table 8.1) show that the public sector wholesaler in each country had bought a higher proportion of the tracer essential medicines from local manufacturers than had the private wholesalers. The faith-based wholesaler in Kenya (MEDS) was the most likely of all to source these medicines locally. All Kenyan wholesale sectors, furthermore, were more likely than their Tanzanian counterparts to buy these essential medicines from their local manufacturers (Table 8.1). Finally, while Tanzania buyers sourced medicines from Kenya ( other African for Tanzania in Table 8.1 is largely Kenyan), the Kenyan buyers bought little from non-Kenyan African suppliers. 

Tanzania, which investigated supply chains from local producers and importers into the health sector. Qualitative interviews and quantitative data collection on availability, somce and price of a checklist of tracer medicines and other essential supplies were conducted in hoth countries. In Tanzania, 42 health facilities (public, faith-based and private), pharmacies and drug shops across four very diverse districts were visited (Tibandebage et al., 2014), while in Kenya, 55 health facilities, pharmacies and shops were interviewed in a comparative study (Kariuki et al., 2015). Following these supply chain studies, wholesalers, manufacturers and poUcy and regulatory stakeholders were interviewed in both countries in 2013-14. This chapter draws also on some of these interviews, alongside secondary data somces. 

The Tanzanian and Kenyan health sectors, like many others in Africa, rely heavily on private individual expenditure for financing hence, fees and charges operate as barriers to access to adequate health care for much of the population (Chuma and Okungu, 2011 Maluka, 2013). WHO data for 2012 estimate that private out-of-pocket (OOP) spending funded 48% of Kenyan health care, with another 6% from private insurance. The hgures for Tanzania were 32% OOP, with negligible private insurance. Charges are applied quite widely in the public as well as private sectors in both countries. 

Country of origin of tracer essential medicines, by procurement sector, Tanzania and Kenya, 2012-13 Pharmacy dispensing fee fee in rands (R) plus permitted mark-up (%), by band of SEP in rands (R) and date of publication of schedule... 

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