Country Context: Tanzania

Taganyika, a former British Colony, gained its independence in 1960. Four years later, upon union with the sovereign nation of Zanzibar, it became the United Republic of Tanzania in 1964. For more than 30 years, Tanzania was a one-party democracy, and Julius Nyerere was Tanzania’s president from 1961-1985. President Nyerere, who aligned his policies with the socialist policies of China and Russia, championed African socialism. With a free universal education policy and free primary health care under Nyerere, Tanzania reached the highest literacy rate in Africa and life expectancy rates increased. President Nyerere was very proud of African unity and Tanzania’s cultural heritage, chosing Swahili – a trading language used by many African countries – as the national language of Tanzania to unite its 132 ethnic groups. Many attribute Tanzania’s relatively peaceful and stable political environment to these policies.
Despite the stability introduced through Nyerere's policies, Tanzania’s economy was stagnant and its debt burden was high. Bound to the International Monetary Fund’s Structural Adjustment Program, Tanzania was required to institute user fees for education and basic health services.1 The fees reduced access to health services, especially among the poor. During this period, the HIV/AIDs epidemic hit Tanzania, resulting in steep declines in both literacy and life expectancy rates. The 1990s also ushered in a period of direct foreign investment in Tanzania, much of it in gold and tourism, and established multi-party elections during this decade.
Today, Tanzania is ranked as one of the world's poorest nations. Roughly three-quarters of Tanzanians are subsistence farmers, fishermen and pastoralists spread throughout Tanzania’s large varied topographic landscape – nearly the size of New Mexico and Texas combined. Although, corruption is seen as a constant problem that hampers progress by costing an estimated 20% of the government budget, 2 Tanzania has nonetheless shown steady GDP growth in the past decade, ranging 5-8%. 3Tanzania frequently receives accolades from the international community both for effectively coordinating and using health aid and consistently meeting IMF debt payments and structural adjustments. This environment has proved conducive to improvements and investments in Tanzania and has resulted in tens of thousands of NGOs working within its borders. In addition, international donations account for over one third of the government’s annual expenditures, 5.2 of 13.5 billion TSH for 2011-2012.  4 PEPFAR, the Global Fund, the International Development Assistance of the World Bank, and DANIDA account for over two thirds of the annual $552 million donated to Tanzania’s health sector in 2008. In 2010, Tanzania was one of the top five countries funded by PEPFAR and the Global Fund. Much of this funding passes through the Medical Stores Department (MSD) of Tanzania to faciliate the procurement of essential medicines and supplies. 5
  • 1. Structural Adjustment and the Fragile Nation: The Demise of Social Unity in Tanzania. Paul J. Kaiser, The Journal of Modern African Studies , Vol. 34, No. 2 (Jun., 1996), pp. 227-237, Published by: Cambridge University Press Article Stable URL:
  • 2. Chene, Marie.  Overview of Corruption in Tanzania, Transparency International, March 4, 2009.
  • 3. Tanzania Country Report by Global Finance accessed on May 16, 2012 at
  • 4. The United Republic of Tanzania's Government Budget for Financial Year 2011/12: Citizens' Budget Edition. Issued by the Ministry of Finance in collaboration with the Policy Forum.
  • 5. Musau, Stephen, Grace Chee, Rebecca Patsika, Emmanuel Malangalila, Dereck Chitama, Eric Van Praag and Greta Schettler. July 2011. Tanzania Health System Assessment 2010. Bethesda, MD: Health Systems 20/20 project, Abt Associates Inc.

 Background Resources

WHO Country Profile: Read this for general health statistics inTanzania.

USAID in Tanzania: Browse the website to find general overview facts about USAID's work in Tanzania, particularly around HIV/AIDS and agricultural.

Tanzania Health System Assessment 2010 by USAID.  Read the section on Pharmaceutical Management in Tanzania.



Click on photo above to enlarge. Source CIA The World Factbook.