From HIV Response to Health Security: Tanzania’s 20-Year Partnership with the US

DAR ES SALAAM: TWENTY years ago, Tanzania faced a very different public health landscape. HIV remained a major national challenge, laboratory capacity was limited, and disease surveillance systems were far less developed than they are today. Today, Tanzania is frequently cited as one of Africa’s stronger performers in HIV treatment coverage and outbreak preparedness. The transformation has been supported by a long-running partnership between Tanzania and the United States through institutions such as the US Centers for Disease Control and Prevention (CDC) and the President’s Emergency Plan for AIDS Relief (PEPFAR). As the CDC marks its 80th anniversary globally and reflects on two decades of work in Tanzania, health officials say the partnership is entering a new phase. The focus is shifting from emergency support towards sustainability, local ownership and scientific collaboration. According to CDC Tanzania Country Director Dr Mahesh Swaminathan, one of the most significant achievements has been Tanzania’s HIV response. At the height of the epidemic, HIV was widely regarded as a fatal diagnosis. Treatment options were limited, and many people faced severe illness and premature death. Today the situation is dramatically different. Around 1.5 million Tanzanians living with HIV are receiving treatment, allowing them to live longer and healthier lives. Modern therapies have also reduced transmission, helping protect families and communities. Health experts regard treatment coverage as one of the clearest indicators of progress. But the partnership extends far beyond HIV. Over the past two decades, substantial investments have been directed towards laboratory strengthening, epidemiology training, disease surveillance and emergency preparedness. These systems became particularly important during outbreaks of Covid-19, cholera and Marburg virus disease. One of the most significant shifts has been the development of local expertise. Rather than relying exclusively on external technical assistance, Tanzania now possesses a growing cadre of scientists, laboratory specialists, epidemiologists and clinicians capable of leading complex public health responses. Dr Swaminathan argues that people, rather than buildings or equipment, remain the most valuable investment. Healthcare workers provide treatment. Scientists identify diseases. Public health specialists monitor outbreaks and coordinate responses. Together, they form the foundation of national health security. ALSO READ: EAC, IOM partner for cross-border health security The results are visible in several areas. Life expectancy has improved. Maternal and child health indicators have strengthened. Laboratory systems have expanded. Disease outbreaks are detected and investigated more rapidly. Research institutions are increasingly contributing to global scientific knowledge. Tanzanian scientists have published internationally recognised research on infectious diseases including Covid-19 and Marburg. These achievements reflect a broader shift in how Tanzania is viewed within global health circles. The country is no longer simply a recipient of technical assistance. It is becoming a contributor to regional and international health security. That evolution is occurring against a backdrop of changing global health financing. Many international donors are reassessing how development assistance is delivered. Increasingly, the emphasis is moving towards domestic financing and local ownership. For Tanzania, this presents both opportunities and challenges. On one hand, greater self-reliance can strengthen national sovereignty and reduce dependence on external resources. On the other, maintaining advanced health systems requires substantial and sustained investment. Dr Swaminathan believes the future relationship between Tanzania and the United States should increasingly resemble a partnership between equals. Rather than focusing primarily on aid, future cooperation may place greater emphasis on trade, scientific exchange and joint research. This could include stronger collaboration between universities, research institutions and private-sector organisations. It may also create opportunities for investment in pharmaceutical production, medical technology and healthcare services. The transition will not happen overnight. HIV, tuberculosis and malaria remain significant public health challenges. Emerging infectious diseases continue to pose risks. Climate change, population growth and urbanisation are creating new pressures on health systems. Yet public health experts argue that Tanzania enters this period from a position of relative strength. The country has demonstrated an ability to manage outbreaks, expand treatment programmes and develop local expertise. Perhaps equally important, it has built systems capable of adapting to new challenges. Trust remains another critical compon