TANZANIA

Information last updated: May 07, 2020

  • Total population: 56.3 M
  • Population +65 yo: 3%
  • GDP Per Capita: 3,240 USD
  • Informal employment: 72% (2014)
  • First registered case: 16 March
  • Hospital beds: Not available

Status

  • Level of confinement and until when: Currently, there is no lockdown, and the president has been very categorical that there will be no national and or regional lockdowns.
  • Cases treated in hospitals: All the recoveries indicated in the data are based on data reported by the Minister from Government and or [private] hospitals .
  • International flights have been banned from leaving or coming into the country. Local flights on the other hand, have suspended operations on their own, not as a result of a ban on local flights. The internal public transport system is operational, people are allowed to conduct their businesses, and civil servants go to work as usual. Although a significant number of NGOs and private sector have suspended business or reduced to minimum and essential operations. Some of the safeguards put in place include social distancing of at least one meter, use of face masks in public places (advised not mandatory), all establishments are to provide hand washing taps and soap or sanitizers, ban on community, public events and gatherings, and closure of educational l institutions from pre-primary to university levels.
  • Confirmed cases: 508. Deaths: 21 (May 20).

Response set up and capacity

Tanzania (Mainland and Zanzibar) has the largest population of the East African Community countries with a projected population of 55,890,747 (NBS 2019). Tanzanian health system governance is decentralized, and public and private health services are managed under Regional and Local Government while specialized services are provided under central government. Tanzania has 4 Highly Infectious Disease Treatment Units (HIDTUs) in Dar es salaam (Temeke), Kilimanjaro (Mawenzi) and Mwanza (Buswelu) and Muhimbili National Hospital, which act as referral facilities; 25 temporary holding facilities in the Points of Entry that can rapidly handle suspected cases before referrals. Of the 46 official entry points to the country, 50% (23) have developed capacities to screen and hold suspected cases before referral (URT, 2020).  

WHO-AFRO categorizes Tanzania as Priority 1-one of the African Countries with highest risk of case importation due to trade and flight connections with China, Europe and USA, who are most affected. COVID-19 is considered a public health emergency, and thus the national response is coordinated under the relevant lead, Ministry of Health, Community Development, Gender and Children (MoHCDG&C), through a Multi-Sectoral National Task Force (NTF), existing in Tanzania Mainland and Zanzibar. In the latter, the NTF falls under the Ministry of Health (MoH). Within the NTF, the Disaster Management Department (DMD), coordinates higher level meetings to convene Tanzania Disaster Management Council (TADMAC) who discusses, deliberates and makes decisions that feed into NTF for implementation. There are also Regional and District Task Forces (also called Crisis/Rapid Response Teams), that implement the decisions of the NTF at the Regional and Local Government Level, coordinate prevention and response efforts by different actors under the oversight and guidance of the President’s Office-Regional and Local Government (PO-RALG) charged with coordinating and linking central and local government within the decentralized governance system.  

International partners response is through engagement with the multi-stakeholder NTF, where response needs and gaps are (sometimes) jointly mapped and concept notes are developed for funding from the existing funding mechanisms for COVID response such as World Bank,(WB) Global Partnership on Education (GPE), etc. The government is also discussing its national budget and deliberating on sector budgets to respond to COVID-19. 

Stakeholder Mapping

Entities / Organizations

• MoHCDG&C (Lead)
• PO-RALG
• All Government Ministries
• CSOs and members of Multi-Sectoral NTF at National Level as well at Regional and District Level

Additional actors

• UNHCR (More so in coordinating COVID-19 Response with Refugee populations in the Kigoma Region (Kakonko, Kibondo & Kasulu districts)

Mitigating factors - What is being done?

  • January 30: Declaration of Health Emergency. The declaration of COVID-19 as a public health emergency and eventually a global pandemic (on 11th March 2020) by WHO was a rallying call for countries, including Tanzania to be on the lookout and plan preventive and response measures. 
  • March 16: First case in Tanzania is confirmed in Arusha (imported case from Belgium). Measures to minimize travels by foreigners whose permits expire during the COVID-19 are put in place, so as to reduce exposure and keep them in-country.
  • March 17: Ban on political gatherings and rallies, and restrictions on community, public events and gatherings. Efforts to enforce social distancing and prevent further spread of COVID-19. These included funerals, weddings etc, however public market places are not closed, but additional preventive measures such as wearing masks and water and soap outlets are to be enforced. On March 17 educational institutions close until further notice. 
  • March 23: Mandatory 14-day quarantine for all arrivals from COVID-Affected Countries in designated sites identified by government, at individual’s own costs.
  • April 1: SoPs for COVID-19 Case Management and Infection Prevention and Control published to guide health workers and community responders on case management and infection prevention and control.
  • April 7: Ban on all tourist flights and closure of all tourist hotels.
  • April 11: International Passenger and chartered Flights suspended.
  • April 30: Government ceases public situation announcements on status of COVID-19. The Minister (MoHCDG&C) stops further announcements of the COVID-19 daily situation report
  • May 1: COVID-19 Contingency Plan March-August 2020. The contingency plan on case management, preventive, psychosocial, community engagement, surveillance and protection of health workers is released to stakeholders. 
  • May 3: The president addresses the nation on clandestine samples sent to National Testing Laboratories that raises aspersions on samples of goat, quail and pawpaw testing positive to COVID-19 raising questions on testing kits and reagents imported, but also aspersions on safety of the imported face masks (PPE and N-95).  

Risks, vulnerabilities, obstacles

  • The suspension of Ministerial announcements of COVID-19 daily situation reports is seen as a byproduct of rising fears of data manipulation, when the population were seeing so many deaths, potentially associated with COVID-19 and burials being conducted by government officials at night. There is anecdotal evidence that the deaths reported are low compared to the reality of the situation. 
  • The government has identified weak capacity and gaps in among others: (i) formalized specimen transportation system from sample collection facilities to laboratories; (ii) effectiveness of rapid response teams in respect of protection and medical supplies; (iii) case management, and (iv) epidemiological surveillance and testing. Some of the supplies have been received, but the presidential aspersions also complicate public confidence on their use and effectiveness. 
  • The public discourse is laced with a lot of mistrust on the cause and origin of the virus, and the initial view that [Black] Africans were resistant to COVID-19, until death(s) were reported of Tanzanians and other Africans. With this reality striking home-that Africans are not resistant to COVID-19, the public has started taking measures to protect themselves using face masks (mostly made of cloth and not medically certified), social distancing and moving away from the culture of handshakes; washing hands using flowing water and soap, as well as using sanitizers and self-isolation (quarantine). These are mostly measures communicated through the WHO and national broadcasting messages and communication materials on COVID-19. 
  • Most people now believe that there are medicinal herbs and plants (alternative medicine) that can be used to manage or treat COVID-19 and such approaches have taken root, fueled by the Madagascar President indicating that they have developed herbal cure, which Tanzania is planning to import. 
  • The biggest threats to effective response in Tanzania include: (a) Community engagement mechanisms in flattening the curve; (b) lack of adequate health system capacity, protective supplies and testing kits,; (c) shying away from seeking health services, since most people do not use hospitals for fear of contracting the virus, many die at home; (d) lack of trusted data on the severity of the situation in Tanzania Mainland, and new data that seems to challenge the actual situation in Tanzania (RGZ, 2020).

Potential actions and demands

The response is coordinated at national and sub-national levels, and the success will be driven by the leadership of the response from the top. The controversies created by challenging the effectiveness of test kits and reagents, affects the public’s uptake of preventive and protective measures. In as much as some stakeholders believe that cities with high rates of community transmissions such as Dar-es-salaam, Zanzibar, Mwanza, Arusha and Dodoma should be locked-down, there are critical issues especially with most of the population living from hand-to-mouth; fear of small businesses not being able to thrive, loss of incomes and the economy grinding to a halt. These are some of the key considerations driving the national response. 

Key resources

Contributor(s): Kennedy Oulu.