title: Local production of pharmaceuticals in Africa and access to essential medicines: 'urban bias' in access to imported medicines in Tanzania and its policy implications.
abstract: BACKGROUND
  International policy towards access to essential medicines in Africa has focused until recently on international procurement of large volumes of medicines, mainly from Indian manufacturers, and their import and distribution. This emphasis is now being challenged by renewed policy interest in the potential benefits of local pharmaceutical production and supply. However, there is a shortage of evidence on the role of locally produced medicines in African markets, and on potential benefits of local production for access to medicines. This article contributes to filling that gap.
  
  
  METHODS
  This article uses WHO/HAI data from Tanzania for 2006 and 2009 on prices and sources of a set of tracer essential medicines. It employs innovative graphical methods of analysis alongside conventional statistical testing.
  
  
  RESULTS
  Medicines produced in Tanzania were equally likely to be found in rural and in urban areas. Imported medicines, especially those imported from countries other than Kenya (mainly from India) displayed 'urban bias': that is, they were significantly more likely to be available in urban than in rural areas. This finding holds across the range of sample medicines studied, and cannot be explained by price differences alone. While different private distribution networks for essential medicines may provide part of the explanation, this cannot explain why the urban bias in availability of imported medicines is also found in the public sector.
  
  
  CONCLUSIONS
  The findings suggest that enhanced local production may improve rural access to medicines. The potential benefits of local production and scope for their improvement are an important field for further research, and indicate a key policy area in which economic development and health care objectives may reinforce each other.
authors.forename: Phares G M
authors.initials: PG
authors.lastname: Mujinja
authors.affiliation: Department of Economics, Faculty of Social Sciences, The Open University, Walton Hall, Milton Keynes MK7 6AA, UK. Maureen.Mackintosh@open.ac.uk.
authors.forename: Maureen
authors.initials: M
authors.lastname: Mackintosh
authors.forename: Mary
authors.initials: M
authors.lastname: Justin-Temu
authors.forename: Marc
authors.initials: M
authors.lastname: Wuyts
mesh_terms: D000349:Africa; D003132:Commerce; D003365:Costs and Cost Analysis; D004345:Drug Industry / Q000191:economics / Q000458:organization & administration*; D018954:Drugs, Essential / Q000191:economics / Q000600:supply & distribution*; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D012424:Rural Population / Q000706:statistics & numerical data*; D013636:Tanzania; D014505:Urban Population / Q000706:statistics & numerical data*; D014944:World Health Organization
chemical_list: D018954:Drugs, Essential