Industrial Productivity, Health Sector Performance and Policy Synergies for Inclusive Growth: A Study in Tanzania and Kenya

Investigators

Maureen Mackintosh, The Open University (Principal Investigator)
Roberto Simonetti, The Open University
Paula Tibandebage, REPOA, Dar es Salaam, Tanzania and The Open University
Watu Wamae, The Open University
Samuel Wangwe, Executive Director, REPOA, Dar es Salaam, Tanzania

Funding

Funding is gratefully acknowledged from the Economic and Social Research Council, UK, and the Department for International Development, UK, under the DFID-ESRC Growth Programme project ES/J008737/1. All content on this page is the sole responsibility of the project investigators.

Grant period: 1 June 2012 - 31 March 2015

Summary

This project studied the supply chains into the health systems in Tanzania and Kenya of essential medicines and medical equipment and supplies from local industries and from imports. Shortages and unaffordability of these commodities are persistent causes of exclusionary and poor quality health care in low income Africa.

The project hypothesis was that better integration between industrial and health policies could contribute to higher employment, industrial upgrading, and improved health system performance and accessibility. If this is correct, improved industrial production – higher productivity, more appropriate and cheaper products, and innovative production methods – could improve health service performance while raising economic output: in other words, contribute to inclusive growth.

The project interviewed  health facilities, shops and wholesalers in all sectors, in urban and rural contexts, about their procurement practices and problems. Mapping of supply chains was followed by data collection at firm level. Private sector businesses and policymakers, and health sector managers and policymakers, debated in project workshops the scope for more integrated policy making.

Publications

Mackintosh M. Mugwagwa J. Banda G. Tunguhole J. Tibandebage P. Wangwe S. Karimi Njeru, M. (2018) Health-industry linkages for local health: reframing policies for African health system strengthening. Health Policy and Planning  33(4) pp. 602–610

Mackintosh M, Tibandebage P. Karimi Njeru M.  Kariuki Kungu J, Israel C, Mujinja PGM (2018) Rethinking health sector procurement as developmental linkages in East Africa. Social Science and Medicine 200: 182-189

Mackintosh M. Mugwagwa J. Banda G. Tunguhole J. (2017) Local production of pharmaceuticals and health system strengthening in Africa: An Evidence Brief. German Health Practice Collection, BMZ

Mackintosh M, Banda G, Tibandebage P, Wamae W (eds), (2016) Making Medicines in Africa: the Political Economy of Industrializing for Local Health Palgrave Macmillan (Open Access publication free to download at http://www.palgraveconnect.com/pc/doifinder/10.1057/9781137546470)

Kariuki J, Karimi Njeru M, Wamae W, Mackintosh M, (2015) Local Supply Chains for Medicines and Medical Supplies in Kenya: Understanding the Challenges ACTS Inclusive Bioeconomy Issue Paper 001/2015, Nairobi

Kariuki J, Karimi Njeru M, Wamae W, Mackintosh M, (2015) Improving the Supply Chains for the Health Sector: What Role for Locally Manufactured and Imported Medicines and Medical Supplies in Kenya? ACTS Inclusive Bioeconomy Issue Paper 002/2015 Nairobi

Tibandebage P, Mackintosh M, Israel C, Mhede E, Mujinja PGM, (2014) The Tanzanian Health Sector as Buyer and User of Medicines and Other Essential  Supplies REPOA Working Paper 14(5) Dar es Salaam

Israel C, Mackintosh M, Tibandebage P, Mhede E, Mujinja PGM, (2014) Improving the Supply Chain for the Health Sector: What Role for Local Manufacturing? REPOA Working Paper 14 (6) Dar es Salaam

Wangwe S, Tibandebage P, Mhede E, Israel C, Mujinja PGM, Mackintosh M, (2014) Reversing Pharmaceutical Manufacturing Decline in Tanzania: Policy Options and Constraints. REPOA Brief 43 Dar es Salaam, July

Wangwe S, Tibandebage P, Mackintosh M, Israel C, Mhede E, Mujinja PGM, (2014) From Passive to Active Industrial Policy: Improving Locally Manufactured Supplies to the Tanzanian Health Sector  REPOA Brief 46 Dar es Salaam September

Wamae W, Kariuki Kungu J, Clark N, (2014) Value-Added Tax in the Pharmaceutical Industry: What Does It Really Mean for Kenyan Industrialisation? ACTS Working Brief No 1, Nairobi, September

Wamae W, Kariuki Kungu J, Clark N, Mackintosh M, (2014) Spotlight on Pharmaceutical Pricing Regulation in Kenya: How Much Does It Really Contribute to Access? ACTS Working Brief No 2, Nairobi, September

Wamae W, Kariuki Kungu J, (2014) Pharmaceutical Manufacturing in Kenya: Key Trends and Developments. ACTS Working Brief No 3, Nairobi, September

Mujinja PGM, Mackintosh M, Justin-Temu M, Wuyts M, (2014) Local Production of Pharmaceuticals in Africa and Access to Essential Medicines: 'Urban Bias' in Access to Imported Medicines in Tanzania and its Policy Implications. Globalization and Health, 10(12)

Events: Policy Dialogue and Knowledge Exchange

Are Manufacturers in Tanzania Losing Out in an Expanding Health Sector Market? Policy Dialogue, hosted by REPOA, 25 November 2014, Dar es Salaam, Tanzania.

Presentations at the workshop:

• Are manufacturers in Tanzania losing out in an expanding health sector market? If so, what can be done about it? Introductory remarks.
• Enhancing the capabilities of pharmaceutical firms for economic transformation and better health care in Tanzania: What will it take?

Watch video of interviews of participants at the workshop.

Improving Health Sector Performance in Kenya and Tanzania: Is There a Future for the Local Manufacturing Industry? High-level round table, hosted by ACTS, 17 September 2014, Nairobi, Kenya.

Presentations at the workshop:

• Towards an Active Industrial Policy for the Health Sector in Tanzania
• Improving Health Sector Performance in East Africa: The Local Pharmaceutical Industry
• Health Sector Supply Chains in Kenya: Prospects for Improving Performance

Improving the Supply Chain for the Health Sector: What Role for Local Manufacturing? Policy Dialogue, hosted by REPOA, 27 June 2013, Dar es Salaam, Tanzania.

Presentations at the workshop:

• Industrial productivity and health sector performance: A study in Tanzania and Kenya - project overview
• Locally manufactured and imported medicines and medical supplies in Kenya
• The Tanzanian public health sector as buyer and user of medicines and other supplies and equipment
• Local supply chains of medicines and medical supplies in Kenya: Understanding the challenges
• Local supply chains of medicines and medical supplies in Kenya: Understanding the challenges - private distributor chains
• The Tanzanian private health sector as buyer and user of medicines and other supplies
• Local manufacturing and the Tanzanian health sector market

Conference Presentations and Other Knowledge Exchange

Mackintosh, M. Invited presentation at the UNCTAD14 World Investment Forum, Nairobi July 2016, Special Session UNCTAD-UNAIDS-African Union event on “Supporting Access to Medicines and Industrial Development in Africa: Investing in Domestic Pharmaceutical Manufacturing”.  Industrial development and access to medicines: Identifying and creating mutual interests.

Mackintosh, M. spoke at the Globelics conference 2015 in Havana, Cuba, at a special session to inform the next Globelics Thematic Review (GTR) on Health Systems Strengthening: Lessons from Innovation Studies, on the topic “Manufacturing Pharmaceuticals in Africa: Innovation and Health System Strengthening”.

The project book, Making Medicines in Africa, was launched at an event in Goodenough College, London, May 2016.  Distinguished speakers included Dr Janet Byaruhanga, Health Policy Officer at the African Union Commission, and Professor Luigi Orsenigo of the Institute of Advanced Studies, Pavia Italy.

Dr Julius Mugwagwa spoke at an invited session at the East Africa Pharmaceutical Summit in Nairobi, February 2016, to launch the project book Making Medicines in Africa, to an audience of pharmaceutical manufacturers and policy makers.

Mackintosh M, Kale D, Orsenigo L, Simonetti R, Submission to UN Secretary-General's High-Level Panel on Access to Medicines, 28 February 2016

Wangwe, S. Enhancing industrial productivity, health sector performance and policy synergies for local health in Kenya and Tanzania, 12th Globelics International Conference, 29 - 31 October 2014, Addis Ababa, Ethiopia

Kariuki J, Tibandebage P, Mackinosh M, Local procurement and supply as part of people centred care: Evidence from Kenya and Tanzania. Health Systems Global Symposium, 1 - 3 October 2014, Cape Town, South Africa

Mackintosh M, Invited participant in WHO/Health Action International Consultation on development of indicators to measure the public health impact of increasing local pharmaceutical production,  November 2014, Amsterdam, The Netherlands.

Project website: IPHSP: Local Production for Better Health 

Contact

Maureen Mackintosh