Reforms: a quest for efficiency or an opportunity for vested interests’? a case study of pharmaceutical policy reforms in Tanzania

Abstract

BackgroundRegulation of the pharmaceutical sector is a challenging task for most governments in the developing countries. In Tanzania, this task falls under the Food and Drugs Authority and the Pharmacy Council. In 2010, the Pharmacy Council spearheaded policy reforms in the pharmaceutical sector aimed at taking over the control of the regulation of the business of pharmacy from the Tanzania Food and Drugs Authority. This study provides a critical analysis of these reforms.MethodsThe study employed a qualitative case-study design. Data was collected through in-depth interviews, focus group discussions and document reviews. Data was analyzed thematically using a policy triangle framework. The analysis was done manually.ResultsThe reforms adopted an incremental model of public policy-making and the process was characterized by lobbying for political support, negotiations and bargaining between the interest groups. These negotiations were largely centred on vested interests and not on the impact of the reforms on the efficiency of pharmaceutical regulations in the country. Stakeholders from the micro and meso levels were minimally involved in the policy reforms.ConclusionRecent pharmaceutical regulation reforms in Tanzania were overshadowed by vested interests, displacing a critical analysis of optimal policy options that have the potential to increase efficiency in the regulation of the business of pharmacy. Politics influenced decision-making at different levels of the reform process.

Explaining the slow transition of child-appropriate dosage formulations from the global to national level in the context of Uganda: a qualitative study

“…Similarly, Orem and colleagues [ 32 ] argued that policy makers in Uganda might reject evidence if it is not in their favour or because of political interests and economic viability. A similar study of pharmaceutical reforms in Tanzania also showed that policy reforms were based on vested interests as opposed to the efficiency and effectiveness of the regulations [ 33 ]. Interests in cheaper adult formulations in the case of Uganda overwhelm those of evidence based child-appropriate dosage formulations that are child friendly, safer and more effective.…”

Economic cost of substandard and falsified human medicines and cosmetics with banned ingredients in Tanzania from 2005 to 2015: a retrospective review of data from the regulatory authority

“…Limited access to affordable essential medicines in the public health system has resulted in the opening of many private retail pharmacies and small accredited drug dispensing outlets in the country which have proven very difficult to control. 19 As a consequence, malpractices are common including selling medicines without prescriptions, stocking medicines from unofficial sources, poor documentation and hiring of people without the required qualifications, making them the prime target for the business of substandard and falsified medicines. 12…”

Counterfeit drugs and medical devices in developing countries

“…A study was undertaken in Tanzania to identify whether reforms of pharmaceutical policy were undertaken to in fact improve efficiency or whether they just presented an opportunity for vested interests. 48 Findings from the study highlighted the influence of politics on decision making at many levels of the reform process, with regulation remaining a challenge. There is a call on governments to limit the political influence on policy, in the interests of appropriate public health outcomes for the populations of developing countries.…”

“…There is a call on governments to limit the political influence on policy, in the interests of appropriate public health outcomes for the populations of developing countries. 48 Despite all these efforts, ineffectual governance and divergent interests are reported by Mackey and Liang 49 to be the reason for the limited surveillance of counterfeit medicines and the continuing global public health threat. Despite the fact that as early as 1988, the World Health Assembly of WHO called for global action on counterfeit medicines in the interest of medicine safety, arguments over terminology have detracted attention from the crisis and the threat to public health.…”