The Rising Concern of Unregulated Medicine Sales in Tanzania
In Dar es Salaam, a growing concern is emerging among public health experts regarding the increasing practice of pharmacies selling medicines—especially antibiotics—without requiring a doctor’s prescription. This trend is raising alarms as it poses a serious threat to public health.
Pharmacies were originally established to dispense medicines strictly on medical prescriptions. However, they are increasingly becoming unofficial treatment points where patients can obtain drugs without consulting a doctor. This shift has led to significant concerns about the potential consequences of such practices.
According to the Pharmacy Council of Tanzania, certain medicines like antimalarial drugs and antibiotics are classified as prescription-only. These should only be issued under a doctor’s written authorization. Despite this, many Tanzanians now rely heavily on pharmacies for diagnosis and treatment, often bypassing hospitals altogether.
The convenience of accessing medicines from pharmacies is undeniable, but experts warn that the risks involved are grave. One of the most dangerous outcomes of this practice is the rise of antimicrobial resistance (AMR), where bacteria and other pathogens evolve to resist the drugs designed to kill them.
A Global and Local Concern
Antimicrobial resistance is not just a local issue; it is a global challenge. A study published in The Lancet revealed that AMR was linked to 4.71 million deaths worldwide, with 24% of these deaths directly attributed to drug resistance. Experts predict that AMR-related deaths could increase by 70% by 2050, with sub-Saharan Africa expected to be one of the hardest-hit regions.
Research conducted by Dr. Pendo Ndaki at the Catholic University of Health and Allied Sciences (CUHAS) found that 89% of pharmacy workers in Mwanza dispense antibiotics for urinary tract infections without prescriptions. Additionally, 87% admit to offering incomplete doses based solely on patients’ symptoms rather than diagnostic tests.
A test conducted in Sinza, Dar es Salaam, highlighted how common this practice is. When a reporter posed as a patient with gonorrhoea symptoms, they were handed medication and instructed to visit another pharmacy for administration. Another pharmacy sold a full course of malaria medication after a brief description of fever-like symptoms.
When this experiment was repeated at 30 pharmacies in the city, 20 of them provided medicines without asking for a prescription or medical history. Some attendants claimed they had received informal medical training during hospital field placements, which they now use to advise patients.
Government Response
The government has taken steps to address this issue. According to the Government Chief Pharmacist, Daudi Msasi, misuse of medicines, especially antibiotics, is a leading cause of antimicrobial resistance. He noted that more than half of Tanzanian patients use medicines without professional guidance, often purchasing them directly from pharmacies or reusing leftover drugs at home.
To combat this, the government has implemented the National Action Plan on Antimicrobial Resistance. This plan promotes rational medicine use, disease prevention, improved laboratory diagnostics, and public awareness. The initiative, called ‘Holela Holela Itakukosti,’ has reached millions of people and has been recognized as one of the continent’s most impactful public health campaigns.
Despite these efforts, enforcement remains a challenge due to weak monitoring mechanisms and limited manpower. Some pharmacies operate in residential areas, making inspections more difficult.
Public Perception and Legal Framework
For many Tanzanians, pharmacies have become the first—and sometimes only—point of medical care. Residents interviewed by The Citizen said they often resort to pharmacies because of long queues, limited staff, and high consultation costs in hospitals.
The legal framework prohibits the sale of prescription-only medicines without a valid prescription. Violators face fines ranging from Sh500,000 to Sh5 million, or imprisonment of up to 12 months, or both. Each prescription is valid for seven days from the date of issue.
However, enforcement remains challenging. Experts call for stronger enforcement and broader awareness campaigns to address the growing culture of self-medication. They emphasize the need for increased access to affordable healthcare, expanded public hospitals, and ensuring that pharmacies are manned by certified professionals.
As the government continues its crackdown and awareness drives, the challenge remains balancing enforcement with accessibility. Ensuring that essential medicines remain within reach while safeguarding public health is crucial.
Unless urgent measures are taken, experts warn that Tanzania risks joining the global list of countries facing a silent but deadly epidemic—an age where ordinary infections become untreatable because the drugs meant to cure them no longer work.