How USAID's health partnership with Tanzania is evolving

Where do public health goals fit into an agenda focused on trade and investment, and what message have health ministers brought with them to the first ever gathering of African heads of state in the United States? Devex caught up with Tanzanian Minister of Health and Social Welfare Tanzania Dr. Seif Seleman Rashid on the sidelines of the U.S.-Africa Leaders Summit to learn how the high-level rhetoric around a new narrative of partnership with the continent means for a ministry that still relies heavily on foreign aid programs and assistance. Rashid shared his views on emerging health sectors where investment and innovation are the words of the day, discussed recent agreements with the U.S. Agency for International Development to upgrade Tanzania’s electronic health management systems, and talked about his own ambitions to leave behind a more “independent” national health system. Below are highlights from our conversation with the minister outside an event sponsored by Squire Patton Boggs and the Tanzania Investment Center on the sidelines of the U.S.-Africa Leaders Summit in Washington, D.C. This U.S.-Africa Leaders Summit is focused on “investing in the future,” and a lot of the announcements we’ve seen have focused on building the economic and trade relationship between the United States and Africa. What message are you bringing from the ministry of health? How do your goals fit into this agenda? Africa, including Tanzania, is in a transformation. It is moving from the stage of being an aid recipient to the point of generating and establishing much more cooperation, much more partnership, and that’s the spirit of trying to be self-dependent … and that’s the key point that we are talking about. Now, as far as health is concerned, we are looking forward to embrace the partnership, the investors … and we’re looking forward to work together in line with our policy changes that have already happened, in line with our business changes that have already taken place. Initially we were in the position that all health care services needed to be provided by the government and private sector were completely not allowed. Now we’ve moved from there. The private sector has been allowed since 1990, and thereafter some partnership was already started. Government has worked not only [for the] private sector to come and build their hospitals, but even to work in partnership with the private sector — public-private partnerships — in the construction of the hospital, in the running of the hospital, and in the provision of the services. As a minister, I’m looking forward to working with the private sector in the training aspect of human resource capacity … We are looking for the investors to come in and invest in the training, support the government, instead of the government money to go into capital investment … let the private sector do it. The government will make sure standards are maintained, the quality output is achieved. Are there specific areas of health care or health services administration where you think private investment can be particularly helpful in advancing your goals as minister? What are the health sectors where you see the greatest opportunity for investment? We are looking forward to really seeing something similar to what Obamacare is talking about. We want to ensure that every person, every Tanzanian is health insured … Different models have already started. Now I’m in the meat of the process of changing the law from the voluntary willingness to have health insurance to compulsory health insurance. In that way … private health insurance investors are most welcome. The government health insurance is already there … What we’re saying is, is it necessary the government should continue with this, or is this something that can be given out? That is still under debate, but private investors are most welcome. Innovation, technology, uptake of technology. Definitely health care service delivery is going in line with the changes in technology … access to sophisticated equipment … simplification of provision of services, communication between one facility and the other — we’re talking about telemedicine … There is room for the private sector from [the U.S.] to come in and invest in the innovative state of the art high-tech hospital … but we also invite partnership, not necessarily for the investor to come to Tanzania, but for the investor to bridge communication. We can have patients in Tanzania, screened there, send the message or image to the [U.S.], and the [doctors] look at it and say, “do a, b, c, and d.” There is another area of e-health … computerized information system. We are currently looking for [an] investor to work with Tanzania in the development of the computerized health management information system that will be a backbone system, or an infrastructure system, which all health care facilities can access … In real time, the minister of health will be in a position to know the events that are happening in each of their facilities. I need to know how many health workers have attended the health care facility today and how many hours they have worked. And that will give the capacity to really monitor, the capacity to really manage these facilities and to … use appropriately the meager resources that we have. Can these e-health systems — and the other technologies you’ve mentioned — apply to Tanzania’s rural populations? Yes, applicability is there … Tanzania has got to radiate fiber-optic connectivity to almost all regions, and that’s a key advantage. We have already expanded to some of the districts. And the program to expand the fiber-optic activities is still going on. In a very short time, all the districts will be connected … E-health accessing to the lower facilities, the villages, where the fiber optic is not there, that’s the challenge. Most likely the mobile system can work. A lot of the discussion at events like this is about the relationship changing to partnership and a more equal way of dealing with problems. How has that changed your relationship with programs like PEPFAR and with agencies like USAID? Are those relationships evolving? What else needs to happen for that partnership mentality to take over within these health programs? The partnership is changing, because initially it was a donor driven program, but now it is a discussion on both sides. I myself discuss with USAID regarding the support for the e-health program, and therefore it is come from me as a recipient … Very, very recently I got the information that USAID is ready to support my ministry … on the e-health program. This is the partnership. Before USAID would have been saying, “the program for application is already stated, and you need to apply for this.” Therefore it is a program from U.S. But now it is mutual discussion, saying what exactly I want. And U.S. — look at it, find whether that is feasible, and make the decision. USAID is supporting, for example in the e-health and supporting us in the medical supplies chain, supporting us in the infrastructure … for the care and treatment centers. All these are capacity building. Once the supply chain is appropriate, that means we will be in a position to use those meager resources that we have to monitor and to ensure that these drugs that are purchased, they are actually directly going to the patients … and that’s independence. For the most comprehensive coverage of the U.S.-Africa Leaders Summit, check out daily updates via Storify, and be sure to follow Devex on Twitter and Facebook. You may tweet questions and comments to our reporters Michael Igoe @twigoe and Kelli Rogers @kellierin. Read more on U.S. aid reform online, and subscribe to The Development Newswire to receive top international development headlines from the world’s leading donors, news sources and opinion leaders — emailed to you FREE every business day.