New era of opportunity for TZ’s healthcare in industrial drive

Dar es Salaam. As the industrialisation agenda continues to gain momentum in Tanzania, the ultimate wish of many healthcare stakeholders from both the public and private sectors is not to be left out in the process. This comes as policy researchers have at various fora in the recent past, revealed how the healthcare industry could grow and be of major impact to society.

Prof Maureen Mackintosh and Paula Tibandebage noted in a joint report published by the Economic and Social Research Foundation (ESRF), that Tanzania’s healthcare has the potential to be much more economically and socially productive if the country’s health and industrial policies were more closely integrated.

“It is possible for economic and social policy, working together, to strengthen and deepen economic ties for the benefit of both the effectiveness of health services and public health, and manufacturing employment and development,’’ they noted in the report, titled ‘Health as a Productive Sector: Integrating Health and Industrial Policy’.

Contrary to popular belief that healthcare is a purely “social” phenomenon and a burden on the economy, researchers now argue, in the report published last year, that the health sector opens and offers industrial-level investment opportunities.

Already, there are notable steps being taken.

On November 13 and 14 this year, over 1,000 stakeholders drawn from the public and private sectors are scheduled to gather in Dar es Salaam as part of the efforts to raise the profile of the healthcare industrialisation agenda during the Tanzania Health Summit (THS).

Inspired by the theme: ‘Tanzania Health Sector Industrialisation. Progress Review and Unlocking Persistent Challenges’, the summit is geared towards setting a platform for experts to ponder on Tanzania’s direction in healthcare industrialisation.

THS president Omary Chillo believes the summit will be a chance for private and public institutions in the country to zero-in on the challenges likely to face the health sector as Tanzania strives to build a middle income economy through industrialisation.

Dr Chillo cites the pharmaceutical industry as one key aspect that researchers and policy makers need to discuss critically in trying to find solutions on how it can make strides in talking the shortage of medicine and medical supplies.

“The pharmaceutical industry has been poorly progressing since 1962 when healthcare industrialisation per se began in Tanzania,’’ he points out.

“By now, it [the pharmaceutical industry] does not meet the national demands. What have we achieved so far in reviving this industry? How do we move from here? That’s what this year’s summit is all about,’’ says Dr Chillo.

History shows that pharmaceutical production had been a Tanzanian industrial success in the mid-90s, says a 2014 report by the Research on Poverty Alleviation (Repoa), titled ‘Reversing Pharmaceutical Manufacturing Decline in Tanzania: Policy Options and Constraints’. But, that success story remains history.

By the year 2014, the industry was already in decline, says the report. Insiders in the industry estimate that market shares of both public and private local pharmaceutical producers fell from around 30 per cent in 2006 to less than 20 per cent in 2013, yet not much has been done to rescue the falling industry until to date. An experts’ report review, ‘Making Medicines in Africa’, says there is more to be done beyond policy reforms in the drug industry sector.

“It requires a change of mind-set for policy makers in Tanzania to turn to prioritising and actively engaging in selective support of the sector,’’ suggests the 2016 report, titled: “Pharmaceutical Manufacturing Decline in Tanzania: How Possible Is a Turnaround to Growth?

Social impact of healthcare industry

And it’s already being discussed in many forums in Tanzania that the health sector creates beneficial social and economic impact because good health care contributes to a more capable, energetic, skilled and productive workforce.

On the business-side, experts in healthcare financing say government spending on health has a multiplier effect on domestic demand and attracts aid funding.

But, looking at it in the industrial sense, the experts say healthcare industries—if well developed and are functioning—they become a major purchaser of goods and services.

Commenting on how Tanzania Health Summit can take the healthcare industrialization agenda forward, the director of Health, Social Welfare and Nutrition Services (DHSWNS) in the President’s Office, Dr Ntuli Kapologwe, says it’s possible if all actors come together.

He says there is a level of seriousness that needs to be cultivated in the mind of stakeholders if the opportunities created by the healthcare industry have to be tapped into.

“This will make the Tanzanian health sector strong and vibrant and will create enabling environment towards becoming medical tourism hub in the region,’’ says Dr Kapologwe.

For many years now, the health sector in Tanzania has been going through industrialization. However, the stage hadn’t been set yet to evaluate how the process can better be achieved, the challenges it’s currently facing and how to mitigate risks associated.

Can THS set the agenda?

Investment in healthcare has a multiplier effect of inclusive and sustainable industrialization on all other areas of development and will contribute to the achievement of all the Sustainable Development Goals (SDGs).

The chief executive officer of the Association of Private Health Facilities of Tanzania (Aphta), Dr Samwel Ogillo, says THS is opportune moment to focus on industrialization because it’s one of the critical steps in achieving SDGs.

“Over the years, THS has proved to be a national platform that brings together healthcare players from both public and private sectors. This year’s theme is in line with Tanzania’s Vision 2025, focusing on healthcare industrialization, a major component towards achieving SDGs,” says Dr Ogillo.

Investors in health, hospitals, distributors, healthcare researchers as well as NGOs are expected to take part in THS which now enters its 5th year. The summit was first held in the country in 2014.

It is expected to be branded with level discussions on the future trends and opportunities in Tanzanian’s healthcare industry, including scientific presentations, health symposiums and exhibitions.

The platform is expected to expose healthcare stakeholders to investment opportunities through giving them a chance to showcase innovative health projects.

Interplay of the industry

According to researchers who compiled the ESRF report, a high level of demand for goods and services is generated by the healthcare industry, citing an example of purchase of medical supplies in the country.

This, says the report, works through procurement activities of government health care providers and the government wholesaler (the Medical Stores Department, MSD), as well as purchasing from private wholesalers by all sectors of health care. “The more that this demand is supplied by domestic producers, the more the demand generates employment in the non-health industrial and service sectors,’’ reads the report.

In other words, health service procurement opens up opportunities for industrial investment and commercial investment generating economic growth, it says.

The health sector, they further argue, acts as a locus and stimulator for research, innovation, investment, and growth in the wider economy.

The chairman of THS, Dr Chakou Halfani, says the government has so far made the efforts to rectify challenges associated with industrialisation, including fast-tracking licensing and registration process, introduction of single processing center.

“But you may agree with me that, there are still some pending matters that once sorted, we will be on track with what we want to achieve as the country. It’s my belief that through public private dialogue, we will move far and achieve what every one of us wishes to,” he explains.

Position of health professionals

Technology is advancing and there an inevitable change in the role of healthcare workers. The changes hold the promise of a more efficient and effective health system but there are issues of concern to address such as, physicians’ loss of autonomy, disruption of doctor-patient relationship and the potential erosion of professional values.

Elsewhere around the world

The delivery of health care is in the process of “industrialization.” This means that it is undergoing changes in the organization of work which mirror those that began in other industries many years ago.

This process is characterized by an increasing division of labour, standardization of roles and tasks, the rise of a managerial superstructure, and the degradation (or de-skilling) of work, says a report ‘Health Care Becomes an Industry’ published in the Pub Med Journal.

Researchers say the consolidation of the health care industry, the fragmentation of physician roles, and the increasing numbers of nonphysician clinicians will likely accelerate this process.

Although these changes hold the promise of more efficient and effective health care, physicians should be concerned about the resultant loss of autonomy, disruption of continuity of care, and the potential erosion of professional values.

Health care appears to be headed in the same direction as other industries in that the fragmentation and standardization of physicians’ work, as well as the construction of a managerial superstructure, are already well underway.

These changes bring the promise of better quality and more efficient health care. Physicians, however, will continue to be pressured to sacrifice their autonomy and will increasingly feel like cogs in a machine.