Public health facilities in Tanzania now report much better medicine availability than a few years ago, yet shortages still reach patients. The reason is that availability is an average, and the averages hide weak links: demand forecasts that miss items, procurement that takes months, funding that arrives late, facilities that order poorly or pay late, and roads that make the last stretch slow. For pharmacy professionals, the useful question is where in that chain a stock-out starts, because the cause decides who can fix it.
What the headline figures show, and what they leave out
In March 2026, the Health Minister told Parliament’s health committee that average availability of medicines and medical supplies at service delivery points had risen from 73 percent to 88.8 percent, measured between 2021/22 and February 2026. The same report gave a gradient by level of care: 97.68 percent at national, specialised and zonal hospitals, 83.81 percent at district hospitals, 82.83 percent at health centres and 79.46 percent at dispensaries.
A month later, a deputy minister at the Medical Stores Department (MSD) cited a 2026 assessment putting availability at 89 percent in hospitals and 88 percent in both health centres and dispensaries. The report does not say who ran the assessment or how availability was defined, so it cannot be set directly beside the March figures.
Older evidence paints a harsher picture. The Ifakara Health Institute’s mid-term review of the Health Sector Strategic Plan V, based on data collected in October and November 2024, found 81 percent availability for a basket of 28 products against a target of 95 percent. Tracer items were available at 95 percent of regional referral hospitals and 92 percent of tertiary hospitals, but only 72 percent at primary facilities. The overall stock-out rate was 16 percent, rising to 22 percent in dispensaries.
The pattern is consistent even where the numbers differ: the lower the level of care, the more likely a shortage. Each figure also depends on which products were counted and how, so it should be quoted with its source and date.
Where the chain breaks
Forecasting and procurement
The mid-term review names unrealistic demand forecasts as a major cause of frequent MSD stock-outs. It found that at least 15 essential items were left out of forecasting in 2022/23. Imported medicines add delay, since international procurement carries long lead times, and the reforms meant to make procurement demand-driven moved more slowly than planned.
Money
The review reports that health commodities are often treated as project expenses without ring-fenced funding, leaving an annual gap of about TZS 163 billion and a reliance on external funders whose disbursements can be late. Payment problems also run downstream. A 2023 evaluation of the Jazia prime vendor system in Singida Region found that only about 43 percent of payments to the vendor were made on time and that roughly 20 percent of orders were filled. The authors link the two. That study covered one region and one year after the intervention, so it shows how late payment can undermine a supply arrangement, not how common it is nationally.
Debt has also surfaced at the centre. In September 2023, a parliamentary committee urged institutions owing MSD to settle their debts, noting that hospitals were waiting on the National Health Insurance Fund. MSD said it needs those payments to keep paying its own suppliers.
Facility ordering and stock management
Some shortages begin at the facility. The mid-term review found order-processing data quality of 75 percent against a 90 percent target, and it reported access and data-entry problems with the electronic logistics system (eLMIS). Few facilities held stock within the recommended two to four months, and some items were overstocked, including cotrimoxazole 480 mg and sulfadoxine-pyrimethamine. About 12 percent of surveyed facilities reported expired medicines. A facility can therefore run out of one product while another sits on the shelf until it expires.
The review links part of this to workforce gaps, reporting gaps of 71 percent for pharmacists, 82 percent for pharmaceutical technicians and 99 percent for pharmaceutical assistants. Weak stock records feed back into weak forecasts, so the facility problem becomes a national one.
The last stretch
Inadequate transport and storage in rural areas slow delivery to primary facilities, which remain below target. Among its recommendations, the review suggests motorcycles or small vehicles for hard-to-reach areas.
What pharmacy professionals can influence
Several fixes sit with people who work in these facilities. Accurate consumption data entered on time improves the forecasts that MSD and the ministry depend on. Routine stock review catches overstock before it expires and flags low stock while there is still time to order. The review also recommends mentorship and e-learning for supply chain staff, ring-fenced commodity funding, performance-based supplier contracts and faster tendering.
At policy level, the April 2026 report mentions a ministerial directive for pharmacists to join facility management teams, aimed at better medicine management and accountability. The report describes it as a planned move and gives no timeline.
What the evidence does not yet show
The 2026 availability figures come from ministerial statements, and the reports available do not describe the sampling or the definition of availability behind them. Most of the supply chain evidence also concerns public facilities, so we know far less about how private pharmacies and ADDOs experience shortages. Until method notes are published and independent surveys repeat the 2024 measurements, the safest reading is that availability has improved on the best-supplied levels and that dispensaries remain the gap to watch.
