Dear Neil and HIFA friends, yes, in Tanzania drugs are overprescribed, more is for antibiotics and for children. Not only in non-for-profit or private settings as in the study but also in public ones (Gwimile et al/Kilimanjaro).
However this phenomenon is not confined to Africa or poor countries, it is a worldwide trend. Just because I know it well, Italy 'has' thousand different molecule-drugs in the pharmacies. Silvio Garattini, scientist of world reputation in the field, declared that more than half of them are unnecessary, without proved efficacy, useless.
Being the pharmaceutical market flourishing all over (it is a highly lucrative market indeed) it is easy to understand why we doctors keep prescribing more and more. We are definitely under pharma companies' influence, they 'teach' us about drugs, they pay us if we prescribe their products. Worldwide.
As a youg pediatrician I was 'invited' by formula milk producers (names omitted but not one excluded) to prescribe it more, in order to 'help those mothers with little milk'.
And I did it.
Market/profit/money dominate our medical behaviour, you advocate "more information and training to prescribers", I think that political approach would be better.
Greetings from Kilimanjaro
"The king felt sick in his bed. All court's doctors arrived and soon prescribed a number of bleedings through salass, leeches, scarifications and then they made him vomit, pass stools and sweat. His death was of a big concern for he had responded well to therapy".
This happened centuries ago when medicine was in darkness. The origin of diseases was unknown therefore treatment was the one for the king. Now we know much more about diseases, we know their origin and how to diagnose them. However treatment is still unscientifically left in the hands of drugs producers and doctors that have the power (magic power) to prescribe wathever they liked to whoever they liked. As it happened to the poor king.
HIFA profile: Massimo Serventi is a long-standing Pediatrician working in Africa since 1982. He has worked for several NGOs in 6 African/2 Asian countries. His interests include clinical and community pediatrics, adherence to clinical guidelines and school education as the major determinant of good health. massimoser20 AT gmail.com