Monitoring, reporting and regulating medicine quality: tensions between theory and practice in Tanzania

Hamill, Heather; David-Barrett, Elizabeth; Mwanga, Joseph Rogathe; Mshana, Gerry; Hampshire, Kate

Abstract

In 2012, the WHO launched its Global Surveillance and Monitoring System (GSMS) for substandard and falsified medicines, with the aim of improving the quality of reporting and using the data to inform post-market surveillance and build regulatory capacity. However, from a regulatory governance perspective, its effectiveness depends on the willingness and ability of actors ‘on the ground’ to identify, report and investigate possible infringements and to enforce penalties. This paper presents findings from 27 interviews with representatives of agencies charged with regulating pharmaceutical markets and 4 interviews with pharmaceutical industry representatives in Tanzania. Their experiences provide important insights into how the theorised mechanism between reporting and a reduction in undesirable behaviours can play out in a low-income context, revealing hidden assumptions about regulator behaviour and motivations. A combination of chronic under-resourcing, information gaps and enforcement challenges conspires to limit the efforts of local regulators to achieve the GSMS goals, shedding new light on the relationship between apparent ‘misconduct’ and structural constraints.

Citation

Hamill, H., David-Barrett, E., Mwanga, J. R., Mshana, G., & Hampshire, K. (2021). Monitoring, reporting and regulating medicine quality: tensions between theory and practice in Tanzania. BMJ Global Health, 6(Supplement 3), Article e003043. https://doi.org/10.1136/bmjgh-2020-003043

• Journal Article Type: Article
• Acceptance Date: Oct 1, 2020
• Online Publication Date: May 28, 2021
• Publication Date: 2021-05
• Deposit Date: Sep 21, 2021
• Publicly Available Date: Sep 21, 2021
• Journal: BMJ Global Health
• Electronic ISSN: 2059-7908
• Publisher: BMJ Publishing Group
• Peer Reviewed: Peer Reviewed
• Volume: 6
• Issue: Supplement 3
• Article Number: e003043
• DOI: https://doi.org/10.1136/bmjgh-2020-003043
• Public URL: https://durham-repository.worktribe.com/output/1239970