Treating pneumonia in Tanzania

Treating pneumonia in Tanzania

From Every Breath Counts member, Results for Development (R4D)

Despite global progress in fighting some of the deadliest diseases, including HIV/AIDS, tuberculosis, and malaria, progress in combating pneumonia has been much slower. Pneumonia remains the leading infectious killer of children under the age of five even though a highly effective child-friendly antibiotic – amoxicillin in dispersible tablet form – exists.

The WHO recommends these tablets as the preferred treatment for non-severe pneumonia in children under five. They are effective, lightweight, easy to transport, and simple to accurately dose. They are also relatively affordable at about 50 cents per course of treatment.

However, making sure this medicine is consistently accessible to the children in many parts of the world is complicated.  

In Tanzania, pneumonia has been a particularly vexing problem. With its goal of reducing child mortality by 80% by 2030, the government has prioritized efforts to reduce childhood pneumonia. To do this, Results for Development (R4D) has been working with the government to increase the availability of amoxicillin. This market shaping program was designed to tackle the barriers to the financing, supply, demand, and regulatory aspects of the market.

At the outset of the program in 2015, the urgent priority was securing funding. That year, external programs that previously funded and purchased the tablets for Tanzania were winding down — and no transition plan had been developed to address the upcoming gap. Without funding, the supply of amoxicillin in Tanzania would have quickly depleted — leaving millions of children without treatment. To prevent any interruptions in coverage, R4D helped source funding for six million courses of pneumonia treatment and co-developed a multi-year plan to strengthen the capacities of key government agencies to ensure a reliable supply of amoxicillin dispersible tablets in the country. The government agreed to gradually scale up funding as external funding scaled down.

R4D worked with the government to improve the systems and processes for quantification (the process for determining how much to order). In addition, R4D supported Tanzania’s Medical Stores Department in taking on the responsibility of amoxicillin dispersible tablet procurement, which external donors had previously managed.

To date, the program has achieved the following results:

        • Significant funding has been mobilized and an emergency stockout was avoided: More than 100 million tablets of dispersible amoxicillin have entered the public health system since 2017
        • Improvements to the quantification process are leading to fewer shortages: By the end of 2017, 60% of health facilities had the tablets on their shelves, a 30% increase over the previous year
        • Government is now leading procurement: In April 2018, the first shipment of government-funded amoxicillin procured by the Medical Stores Department was delivered to public health facilities. In 2019, they purchased and delivered another shipment.

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December 2019