National consumption of antimicrobials in Tanzania: 2020–2022

Abstract

Background: The Global Leaders Group on Antimicrobial Resistance (AMR) beckoned nations to share surveillance data on antimicrobial consumption (AMC) and AMR while promoting access to essential antimicrobials in countries with the highest burden of AMR. Objectives: To analyse findings of the national-level AMC (years 2020-2022), building on our prior work (2017-2019), and to assess any emerging trends. Methods: Data were obtained from the Tanzania Medicines and Medical Devices Authority, Tanzania Medical Stores Department, and from local manufacturers. Results: The average defined daily dose (DDD) per 1000 inhabitants (DID) was 38.27 ± 5.17. Compared to 2020, macrolides had a nearly 3-fold increase in 2021 and 2022 driven by azithromycin (4.85 ± 2.85 DID), mainly associated with inappropriate use during the COVID-19 pandemic. In 2020, private-sector consumption accounted for 75.73% of the total, which increased to 84.02% in 2021 and then slightly decreased to 66.82% in 2022. The Access category antimicrobials met the World Health Organization target of 60% national consumption, while the Watch category has shown a steady increase in 2021 and 2022. Conclusion: The continued increase in AMC in the private sector calls for urgent antimicrobial stewardship targets, including routine reporting by the Access, Watch and Reserve categories.