1. HP+ Tanzania Kuki Tarimo
October 4, 2017
An Assessment of the Government of Tanzania’s Budget Execution Performance on Allocations to Medicines and HIV
HP+ Tanzania
Kuki Tarimo

2. Budget for Pharmaceutical Services for the year 2016/17
For FY 2016/17, new allocation of TZS 251 billion in the MOHCDGEC development vote
Source: MOFP Budget Books FY 2016/17
New
A specific point of concern for health financing this past FY was the growing amount owed to Medical Stores Department (MSD) representing GOT’s share of the procurement and supply chain management (PSM) expense for donated commodities.
MSD is the established agency that has managed procurement and distribution of medicines, medical supplies, and laboratory supplies for the Ministry of Health, Community Development, Gender, Elderly, and Children (MOHCDGEC) in Tanzania since 1993
Included in this is a first time ever TZS 10 billion allocation for the purchase of ARVs
GOT supply chain responsibilities, which includes a standard contribution for HIV commodities based on MSD fees and expense ratios, equivalent to 5.6% of the cost of commodities purchased by GFATM and 11.6% of the cost of commodities purchased by PEPFAR.

3. FY 2016/17 Budget Execution for Pharmaceuticals Budget Line
Only TZS 11.2 billion disbursed for MSD debt
Only TZS 7.1 for ongoing PSM expenses
Nothing disbursed at all for purchase of ARVs
Overall disbursement rate of 53% for Pharmaceuticals budget line or TZS Nominally this amount is quite high compared to previous years
MSD debt grew by estimated TZS 12 billion in FY 2016/17 to TZS 156 billion
Source: Pharmaceuticals Service Unite at MOHCDGEC

4. Historic Budget Execution to TACAIDS
Personal emoluments, which account for 70% of TACAIDS recurrent budget is the only thing that gets disbursed consistently on time
NACP does not have a specific budget line, it is part of the Preventative Services budget, so not possible to track on-budget execution performance. NACP heavily on external funds to perform all of its functions.
Source: MOFP,

5. Root Causes for Poor Budget Execution
Lack of adequate resources to finance the country budget
Health is low in the priority-setting process
Health budget ambitions exceed available revenue
Budget execution for MOHCDGEC vote 52 was 57% for FY2016/17. Overall GOT budget execution rate as of March % and for the financial year 2015/16 was 90%.
All respondents indicated that sufficient investment for the supply chain system should be prioritized.
In conclusion, improving budget execution is an important part of the DRM agenda because it increases the ability of MOHCDGEC to produce defensible budget requests.

6. Advocacy Massages
Budget execution for health be given priority as other first charge items
Need to improve quality of quantification exercises for health commodities
Reducing some of PSM costs
Estimations of PSM cost to be reviewed
Budget execution for MOHCDGEC vote 52 was 57% for FY2016/17. Overall GOT budget execution rate was 90%.
All respondents indicated that sufficient investment for the supply chain system should be prioritized.
In conclusion, improving budget execution is an important part of the DRM agenda because it increases the ability of MOHCDGEC to produce defensible budget requests.