Tanzania: Score Justification Summary

2026

1.1 Antimicrobial resistance (AMR)

1.1.1 AMR surveillance, detection and reporting

1.1.1a National plan for AMR priority pathogens

Score: 50

There is evidence that Tanzania has a national antimicrobial resistance (AMR) plans for the surveillance, detection and reporting of priority AMR pathogens. Zanzibar has an AMR plan (2019-2024) and the budget for a new plan is finalized, however it is unclear if surveillance, detection and reporting of priority AMR pathogens will be covered in the new plan.

Tanzania's national AMR plan is called 'The National Action Plan on Antimicrobial Resistance 2023-2028'. ¹ Objective 3 of the plan addresses both AMR surveillance and reporting through "standardized, comparable and validated data". (p.38) Furthermore, this objective introduces interventions that addresses AMR detection through designating laboratories for AMR testing, capacity building for laboratories, and strengthening the supply chain. (p.45) ²

The Zanzibar plan 'Zanzibar Action Plan on Antimicrobial Resistance 2019-2024' similarly promotes the development of a AMR surveillance system, designate laboratories, and increased capacity. (p. 9) ³ In February of 2025, the budget for an updated Action Plan 2025-2029 was finalized. ⁴ However, as of early July 2025, an updated plan has not been published on the website of the Ministry of Health or the Ministry of Agriculture of Zanzibar. ⁵⁶

The Joint External Evaluation of the International Health Regulations (IHR) Core Capacities of the United Republic of Tanzania-Zanzibar, conducted 21-25 August 2023, reported that there was "a lack of implementation of the developed monitoring and evaluation framework for the ZAP [Zanzibar Action Plan]". (p.17) ⁷

1.1.1b Capacity of national lab/lab system to test for AMR priority pathogens

Score: 50

There is evidence that Tanzania and Tanzania-Zanzibar have national laboratory/laboratory systems, which test for priority antimicrobial resistance (AMR) pathogens. However, it is unclear which of the 7+1 pathogens are tested.

The Joint External Evaluation of the International Health Regulations (2005) core capacities of the United Republic of Tanzania, conducted 14-18 August 2023, reports that mainland Tanzania has made tremendous progress in its public health laboratory network. (p.33) ⁸ The country has reasonable testing abilities, and laboratories regularly test priority diseases. The National Action Plan on Antimicrobial Resistance 2023-2028 mentions the training of laboratory techniques for pathogen identification, including AMR-priority pathogens, as an intervention to increase AMR surveillance and reporting. (p.47) ⁹ However, the report does not mention which priority pathogens need to be identified. The National Action Plan on Antimicrobial Resistance 2017-2022 stated that the National Health Laboratory Quality Assurance and Training Centre "is capable of conducting 7 of 10 priority testing areas: Bacteriology, virology, serology, parasitology, biochemistry, hematology and molecular, including sequencing". (p.6) ¹⁰ Similar information is not mentioned in the National Action Plan on Antimicrobial Resistance 2023-2028. ¹¹

The Joint External Evaluation of the International Health Regulations (‎2005)‎ core capacities of the United Republic of Tanzania-Zanzibar, conducted 21-25 August 2023, reports that a framework is available for priority pathogens and microbes, but that Zanzibar does not have an accredited laboratory for AMR detection, isolation and identification. (p. 32-35) ¹²

No further evidence is found through the websites of the Ministry of Health and Ministry of Agriculture of both Tanzania and Tanzania-Zanzibar. ¹³¹⁴¹⁵¹⁶

1.1.1c National environmental surveillance for AMR residues/organisms

Score: 0

There is no evidence that either Tanzania or Tanzania-Zanzibar conduct detection or surveillance activities (e.g., in soil, waterways) for antimicrobial residues or AMR organisms.

The Joint External Evaluation of the International Health Regulations (2005) core capacities of the United Republic of Tanzania, conducted 14-18 August 2023, and the Joint External Evaluation of the International Health Regulations (‎2005)‎ core capacities of the United Republic of Tanzania-Zanzibar, conducted 21-25 August 2023 indicate that AMR surveillance systems are not in place for the environment, crops, and/or food sectors. ¹⁷¹⁸

The National Action Plan on Antimicrobial Resistance 2023-2028 aims to establish an antimicrobial residue testing program, which includes freshwater, marine waters in the wild, end various types of farming systems. (p.60) ¹⁹ However, surveillance activities are not included.

The Zanzibar plan 'Zanzibar Action Plan on Antimicrobial Resistance 2019-2024' promotes the development of a AMR surveillance system, designate laboratories, and increased capacity. (p.9) ²⁰ However, the action plan does not specifically mention environmental detection for antimicrobial residues or AMR organisms. There is no further evidence available through the Ministry of Health of the Ministry of Agriculture. ²¹²²

1.1.2 Antimicrobial control

1.1.2a National law(s) requiring prescription for antibiotic use (humans)

Score: 50

There is evidence that both Tanzania and Tanzania-Zanzibar have national legislations or regulations in place requiring prescriptions for antibiotic use for humans, however for both locations, the restrictions are not always enforced.

Mainland Tanzania has a standard treatment guideline and essential medicine list, last updated in 2021, which provides health practitioners with standardized guidance in decision making about appropriate care. This includes treatment options as well as the prescription of medication such as antibiotics for humans. ²³ The Joint External Evaluation of the International Health Regulations (2005) core capacities of the United Republic of Tanzania, 14-18 August 2023, reported that "human sector standardized treatment guidelines also include ‘AWaRe’ categorization of antibiotics and National Essential Medicines List." (p.18) ²⁴ Furthermore, Tanzania has 'the Pharmacy (Prescription Handling and Control) Regulation, 2020', Article 3 restricts the selling of prescription medicines including antibiotics. ²⁵

Tanzania-Zanzibar similarly has a standard treatment guideline, third edition published in 2009. ²⁶ The Zanzibar Food and Drugs Agency regulates pharmaceutical products including antibiotics. ²⁷ However, its enforcement is fragmented according to the Joint External Evaluation of the International Health Regulations (2005) core capacities of the United Republic of Tanzania-Zanzibar. (p.18)²⁸

Ndaki et al. (2022) reports that antibiotics are prescription only drugs, but that they are still widely available over the counter in Tanzania. ²⁹ Sellers rarely ask clinically relevant questions or provide antibiotic stewardship. ³⁰

1.1.2b National law(s) requiring prescription for antibiotic use (animals)

Score: 50

There is evidence that both Tanzania and Tanzania-Zanzibar have national legislations or regulations in place requiring prescriptions for antibiotic use for animals, however for both locations, the restrictions are not always enforced.

In 2022, The United Republic of Tanzania – Ministry of Livestock and Fisheries published the 'Standard Treatment Guidelines for Animal Diseases in Tanzania'. ³¹ These guidelines provide veterinary practitioners with standardized guidance in making decisions about appropriate care including treatments of various diseases and prescription of medication including antibiotic use for animals. ³² Furthermore, 'The Tanzania Food, Drugs and Cosmetics (Scheduling of Medicines) (Amendment) Regulations, 2018' prohibits the sale and administering of prescription drugs without a prescription. ³³ In particular, article 5B provides the criteria for the scheduling of controlled veterinary medicines. ³⁴ The Joint External Evaluation of the International Health Regulations (2005) core capacities of the United Republic of Tanzania, 14-18 August 2023, indicated that the National Essential Medicines List is incomplete and enforcement of compliance with regulations is inadequate. (p.18) ³⁵

'The Zanzibar Food, Drugs, and Cosmetics Act No.2 of 2006' by the Revolutionary Government of Zanzibar regulates the safety and quality of antibiotics use for animals. ³⁶ Articles 74 through 77 pertain to the dealing of drugs and herbal drugs. ³⁷ According to the Joint External Evaluation of the International Health Regulations (‎2005)‎ core capacities of the United Republic of Tanzania-Zanzibar (JEE), 21-25 August 2023, the final draft of the standard treatment guidelines for animal diseases has been completed. (p.16-19) ³⁸ However, this document is not publicly available through the Tanzania-Zanzibar Ministries of Health and of Agriculture. ³⁹⁴⁰ Furthermore, the JEE Tanzania-Zanzibar states that "enforcement of regulations for antimicrobial use in veterinary medicine and practices is poor." (p.19) ⁴¹

1.2 Zoonotic disease

1.2.1 National planning for zoonotic diseases/pathogens

1.2.1a Laws/plans on zoonotic disease

Score: 100

There is evidence that Tanzania and Tanzania-Zanzibar have national legislations, plans, or equivalent strategy document on zoonotic disease, which includes prioritization, detection, and reporting.

The Joint External Evaluation of the International Health Regulations (2005) core capacities of the United Republic of Tanzania, 14-18 August 2023, notes that "the United Republic of Tanzania utilized the CDC One Health tool for national prioritization of zoonotic diseases and identified six zoonotic diseases of interest from a multisectoral, multidisciplinary perspective. The list of priority zoonotic diseases includes rabies, Rift Valley fever and other viral haemorrhagic fevers (Marburg and Ebola virus disease); zoonotic influenza, anthrax, human African trypanosomiasis (sleeping sickness) and brucellosis." (p.20) ⁴² The 'National One Health Strategic Plan 2022-2027' indicates that it considers both mainland Tanzania and Tanzania-Zanzibar. ⁴³ Its goals include: "to strengthen joint surveillance, of prioritized zoonotic diseases, AMR, and other public health threats at all levels", and " to enhance prioritized zoonotic disease detection capacity at national (100%), zonal/regional (60%) and district (30%) levels". (p.36) ⁴⁴

Additionally, the Joint External Evaluation of the International Health Regulations (‎2005)‎ core capacities of the United Republic of Tanzania-Zanzibar, 21-25 August 2023, reported that there is a coordination mechanism available through the Zanzibar Disaster Management Commission under the Second Vice President's Office. However, capacity for zoonotic disaster surveillance is generally low. (p.20) ⁴⁵

1.2.1b Laws/plans on zoonotic disease spillover from animals to humans

Score: 0

There is no evidence of national legislations, plans or equivalent strategy documents which includes measures for risk identification and reduction for zoonotic disease spillover events from animals to humans in either Tanzania or Tanzania-Zanzibar.

Neither the Joint External Evaluation of the International Health Regulations (‎2005)‎ core capacities of the United Republic of Tanzania-Zanzibar, 21-25 August 2023, nor the Joint External Evaluation of the International Health Regulations (2005) core capacities of the United Republic of Tanzania, 14-18 August 2023, make mention of legislations that target zoonotic disease spillovers. ⁴⁶⁴⁷

Chapter three of the National Disaster Management Strategy (2022-2027) and chapter one of the National Action Plan for Health Security (NAPHS) 2017-2021 mention risk analysis and risk management, but do not include information on zoonotic disease spillovers from animals to humans. ⁴⁸⁴⁹

The 2025 Marburg Virus Disease (MVD) Response Plan does include response strategies for the reduction of disease spillover, but was only published in light of a Marburg virus outbreak. ⁵⁰

The National One Health Strategic Plan 2022-2027 covers zoonotic diseases, however does not specifically mention disease spillover events from animals to humans. (p.4-5) ⁵¹

1.2.1c Laws/plans for surveillance & control of multiple zoonotic pathogens

Score: 100

There is evidence that national legislation, plans, or guidelines that accounts for the surveillance and control of multiple zoonotic pathogens of public health in both Tanzania and Tanzania-Zanzibar.

According to the Joint External Evaluation of the International Health Regulations (2005) core capacities of the United Republic of Tanzania, 14-18 august 2023, " the United Republic of Tanzania utilized the CDC One Health tool for national prioritization of zoonotic diseases and identified six zoonotic diseases of interest from a multisectoral, multidisciplinary perspective. The list of priority zoonotic diseases includes rabies, Rift Valley fever and other viral haemorrhagic fevers (Marburg and Ebola virus disease); zoonotic influenza, anthrax, human African trypanosomiasis (sleeping sickness) and brucellosis. " (p.20) ⁵² Four of these priority zoonotic diseases have prevention and control plans, while the other two have preparedness and response plans. Currently the implementation of these plans is hampered by inadequate resources. (p.20) ⁵³

The National One Health Strategic Plan 2022-2027 includes both mainland Tanzania and Tanzania-Zanzibar. ⁵⁴ Strategy Pillar 2 target surveillance, detection, prevention, and control, with the main target being: "functional and quality joint human and animal health surveillance systems to reduce the burden of zoonotic diseases, Antimicrobial Resistance (AMR) and other public health events established". (p.70)

The Joint External Evaluation of the International Health Regulations (‎2005)‎ core capacities of the United Republic of Tanzania-Zanzibar, 21-25 August 2023, does not provide evidence for a plan or guideline solely pertaining to Zanzibar. ⁵⁵ However, does state that there is a good policy climate. (p.20-22)

1.2.1d Cross-ministerial department/agency/unit for zoonotic disease

Score: 100

There is evidence that both Tanzania and Tanzania-Zanzibar have a department/agency that is dedicated to zoonotic disease that functions across ministries.

The National One Health Strategic Plan 2022-2027 indicates that the One Health Coordination Desk (OHCD) under the Disaster Management Division in Prime Minister’s Office is responsible for zoonotic diseases. (p.11-12) ⁵⁶ The OHCD is mandated to coordinate activities to ensure appropriate interventions across health sectors to minimize zoonotic outbreaks. ⁵⁷⁵⁸

While the National One Health Strategic Plan applies to both Tanzania and Tanzania-Zanzibar, Zanzibar also has its own coordination mechanism through the Zanzibar Disaster Management Commission (ZDMC) under the Second Vice President’s Office is functional. ⁵⁹ However, capacity for zoonotic surveillance is limited. ⁶⁰

1.2.1e Presence of One Health strategic plan

Score: 100

Tanzania has a One Health strategic plan in place, the One Health Strategic Plan (2022-2027), managed by a National Coordination Unit under the Prime Minister's Office.

1.2.2 Surveillance systems for zoonotic diseases/pathogens

1.2.2a Surveillance/reporting mechanism for zoonotic disease for livestock owners

Score: 100

There is some available evidence that Tanzania and Tanzania-Zanzibar have national mechanisms (either voluntary or mandatory) for owners of livestock to conduct and report on disease surveillance to a central government agency.

According to George et al. (2021) "Tanzania’s animal health surveillance is under the custody of the Directorate of Veterinary Service (DVS) through the Epidemiology Unit in the Ministry of Livestock and Fisheries (MoLF)."⁶¹ The reporting ladder is well known and collected data tends to be shared weekly to higher authorities. It is said that MoLF has established a national animal surveillance strategy, which includes the promoting of real-time technology for surveillance of livestock. ⁶² George et al. claim that the system has been using and relying on data from farmers. ⁶³ A broad search of the web and the website of MoLF shows no public evidence of this strategy. ⁶⁴

The Food and Agriculture Organization (FAO) of the United Nations (UN) has upgraded its Event Mobile App (EMA-i+). The EMA-i+ facilitates "the reporting of animal diseases in real time and support the capabilities of veterinary services, this multilingual tool improves the quantity and quality of reports by generating standardized forms for suspected disease threats". ⁶⁵ This app was introduced in 17 countries, including Tanzania.

The United Republic of Tanzania – Ministry of Livestock Development has published a 'National Livestock Policy 2006', which is aimed at stimulating development in the livestock industry in order to increase rural and national income, improve food security and environmental conservation. (p.2) This policy does not include a requirement that livestock owners must report diseases. ⁶⁶ There is no further evidence available on the websites of the country's Ministry of Health or Ministry of Agriculture. ⁶⁷⁶⁸

The Joint External Evaluation of the International Health Regulations (2005) core capacities of the United Republic of Tanzania, 14-18 August 2023, indicates that sharing of surveillance data regularly takes place, but does not make mention of livestock owners. (p.38-40) ⁶⁹ The same can be said for Joint External Evaluation of the International Health Regulations (‎2005)‎ core capacities of the United Republic of Tanzania-Zanzibar, 21-25 August 2023. (p.36-38) ⁷⁰

There is no evidence available on the website of the Zanzibar Ministry of Health or Ministry of Agriculture. ⁷¹⁷²

1.2.2b Laws/regulations on data confidentiality to protect livestock owners

Score: 0

There is no publicly available evidence that Tanzania and Tanzania-Zanzibar have laws or guidelines that safeguard the
confidentiality of information generated through surveillance activities for animals (for owners).

The United Republic of Tanzania has introduced the Personal Data Protection Act No. 11 of 2022, which went into effect in 2023. ⁷³ This act makes no mention of confidentiality regarding surveillance activities for animals.

The National One Health Strategic Plan 2022-2027 covers human as well as animal surveillance. ⁷⁴ The report includes suggestions on how to improve the surveillance, detection, prevention and control of zoonotic diseases, antimicrobial resistance and other public health events. (p.32-37) Again confidentiality is not mentioned.

In 2006, the United Republic of Tanzania – Ministry of Livestock Development published the 'National Livestock Policy', aimed at stimulating development in the livestock industry in order to increase rural and national income, improve food security and environmental conservation does not address confidentiality of surveillance data. (p.2) ⁷⁵

There is no evidence of guidelines to safeguard confidentiality on the websites of the Ministry of Health, Ministry of Agriculture, Ministry of Livestock and Fisheries Development, and the Joint External Evaluation of the International Health Regulations (2005) core capacities of the United Republic of Tanzania, conducted 14-18 August 2023. ⁷⁶⁷⁷⁷⁸⁷⁹ The same can be said for Ministry of Health and Ministry of Agriculture in Zanzibar, and the Joint External Evaluation of the International Health Regulations (‎2005)‎ core capacities of the United Republic of Tanzania-Zanzibar, conducted 21-25 August 2023. ⁸⁰⁸¹⁸²

1.2.2c Wildlife zoonotic disease surveillance

Score: 0

There is evidence that Tanzania and Tanzania-Zanzibar conduct surveillance of zoonotic disease in wildlife and livestock. However, poultry is not mentioned.

The Joint External Evaluation (JEE) of International Health Regulations (IHR) Core Capacities of the United Republic of Tanzania, conducted 14-18 August 2023, notes that "a large percentage (72%) of emerging zoonotic diseases originate from wildlife". (p.20) ⁸³ Similarly, the National One Health Strategic Plan 2022-2027 by the Prime Minister's Office of the United Republic of Tanzania, covering both mainland Tanzania and Tanzania-Zanzibar, indicates that interaction between, humans, wildlife and livestock likely has an effect on disease dynamics. (p.5) ⁸⁴ Therefore, the one health method targets both surveillance of zoonotic diseases in humans and animals, which includes wildlife and livestock. (p.12). The National One Health Strategic Plan 2022-2027 contains the objective "to strengthen joint surveillance, of prioritized zoonotic diseases, AMR [Antimicrobial Resistance], and other public health threats at all levels". (p.32) ⁸⁵ Poultry is not specifically mentioned in either the JEE or the National One Health Strategic Plan 2022-2027. ⁸⁶⁸⁷

The Joint External Evaluation of the International Health Regulations (‎2005)‎ core capacities of the United Republic of Tanzania-Zanzibar, conducted 21-25 August 2023, indicates that surveillance for animal diseases is available but that the system is deficient. (p.37) ⁸⁸

No additional evidence of surveillance of zoonotic disease in wildlife was found via Tanzania's Ministry of Health, Ministry of Agriculture, and Ministry of Livestock and Fisheries websites, nor via Tanzania-Zanzibar's Ministry of Health or Ministry of Agriculture websites. ⁸⁹⁹⁰⁹¹⁹²⁹³

1.2.3 International reporting of animal disease outbreaks

1.2.3a Annual reporting to OIE on zoonotic disease incidence

Score: 100

There is evidence that Tanzania and Tanzania-Zanzibar have reported notifiable diseases to the World Organisation for Animal Health (WOAH).

The surveillance and control measures page on the website of the WOAH, shows information on targeted surveillance data, official vaccination data, and a list of control measures for Tanzania. ⁹⁴ Data is available up to december 2024, and indicates a broad range of diseases such as anthrax, rift valley fever virus, rabies virus, and rinderpest virus, and covers a broad range of species.

1.2.4 Animal health workforce

1.2.4a Number of veterinarians per 100,000 people

Score: 1.77

1.2.4b Number of veterinary para-professionals per 100,000 people

Score: 9.43

1.2.5 Private sector and zoonotic disease

1.2.5a Inclusion of private sector in national plan/law on zoonotic disease

Score: 0

There is insufficient evidence that Tanzania and Tanzania-Zanzibar have a national plan, legislation, or regulations in place for working with the private sector in controlling or responding to zoonoses.

The National One Health Strategic Plan 2022-2027 by the Prime Minister's Office of the United Republic of Tanzania, covering both mainland Tanzania and Tanzania-Zanzibar, provides information on both zoonoses and the private sector but does not appear to connect these topics. ⁹⁵ The plan having several strategy pillars, aims to work on surveillance, detection, prevention and control as well as the strengthening of One Health coordination at all levels. ⁹⁶ The latter includes targets and strategies pertaining to the private sector. For example, relevant stakeholders will be identified and workshops will be held to further include the private sectors in the One Health system. (p.30-32) Surveillance on the other hand is specifically applied to zoonoses, antimicrobial resistance and other health events. (p.32-37) ⁹⁷ In practise these topics may or may not connect, but this is not made explicit in the plan.

The Joint External Evaluation of the International Health Regulations (2005) core capacities of the United Republic of Tanzania, conducted 14-18 August 2023, indicates that collaboration between sectors take place "including in the management of zoonotic disease outbreaks, utilizing the National One Health strategic plan". (p.20) ⁹⁸ However the report does not specify how the private sector was involved. The Joint External Evaluation of the International Health Regulations (‎2005)‎ core capacities of the United Republic of Tanzania-Zanzibar, conducted 21-25 August 2023, mentions a multisectoral approach regarding the surveillance of zoonotic diseases, but does not elaborate on whether or not this includes the private sector. (p.20-21) ⁹⁹

There is no further evidence available through the websites of the Ministry of Health in either Tanzania or Tanzania-Zanzibar. ¹⁰⁰¹⁰¹

1.3 Biosecurity

1.3.1 Whole-of-government biosecurity systems

1.3.1a Updated national records of especially dangerous pathogen/toxin inventories

Score: 0

There is no publicly available evidence to show that Tanzania and Tanzania-Zanzibar have records, updated within the past 5 years, of the facilities in which especially dangerous pathogens and toxins are stored or processed, including details on inventories and inventory management systems of those facilities.

According to the Joint External Evaluation of the International Health Regulations (2005) core capacities of the United Republic of Tanzania, conducted 14-18 August 2023, "The United Republic of Tanzania has an agreed list of Pathogenic agents and toxins of concern as outlined in the National laboratory biosafety and biosecurity guidelines (2022) annex 1. However, the country does not have a national consolidated inventory of where the pathogens are housed; laboratories handling these pathogens that include reference laboratories, research and academic institutions, have established procedures for pathogen inventory with relevant records." (p.26) ¹⁰²

The storing and processing of dangerous pathogens and toxins is not mentioned in the biosafety and biosecurity section of the Joint External Evaluation of the International Health Regulations (‎2005)‎ core capacities of the United Republic of Tanzania-Zanzibar, conducted 21-25 August 2023. ¹⁰³

No evidence as such is found from the websites of Tanzania's Ministry of Health, Ministry of Agriculture, Ministry of Livestock and Fisheries as well as the Ministry of Defence and National Service and Tanzania-Zanzibar's Ministry of Health and Ministry of Agriculture. ¹⁰⁴¹⁰⁵¹⁰⁶¹⁰⁷¹⁰⁸¹⁰⁹

A search of the VERTIC BWC Legislation database does not provide any evidence of Tanzania or Tanzania-Zanzibar has in place a record, updated in the past five years, of facilities in which especially dangerous pathogens and toxins are stored. ¹¹⁰

1.3.1b Biosecurity laws on facility security for especially dangerous pathogens

Score: 0

There is no evidence that Tanzania and Tanzania-Zanzibar have in place legislation and/or regulations related to biosecurity which address requirements such as physical containment, operation practices, failure reporting systems, and/or cybersecurity of facilities in which especially dangerous pathogens and toxins are stored or processed.

According to the Joint External Evaluation (JEE) of the International Health Regulations (2005) core capacities of the United Republic of Tanzania, conducted 14-18 August 2023, Tanzania has an Environmental management (biosafety) regulation 2009, however this act does not cover biosecurity and appears to be focussed on GMOs. "It emphasizes mainly issues related to importation, exportation, deliberate release, confined use, contained use, transition and placing on the market of genetically modified organisms and their products". (p.26) ¹¹¹ Requirements for physical containment, operation practices, failure reporting systems and/or cybersecurity facilities are not mentioned in either the Environmental management (biosafety) regulation 2009, or the Environmental Management (Hazardous Waste Control and Management) Regulations 2021, both mainly targets biosafety as opposed to biosecurity. ¹¹²¹¹³

The Joint External Evaluation of the International Health Regulations (‎2005)‎ core capacities of the United Republic of Tanzania-Zanzibar, conducted 21-25 August 2023, indicates that there is no biosecurity policy and guideline. (p.26) ¹¹⁴

No evidence of legislations or regulations is available from a review of the websites of the Ministry of Health, Ministry of Agriculture, and the Ministry of Defence and National Services for Tanzania nor from the websites of the Ministry of Health and Ministry of Agriculture of Tanzania-Zanzibar. ¹¹⁵¹¹⁶¹¹⁷¹¹⁸¹¹⁹

A search of the VERTIC Biological Weapons Convention (BWC) Legislation database does not provide any evidence of Tanzania or Tanzania-Zanzibar having a biosecurity law. ¹²⁰

1.3.1c Agency for enforcement of biosecurity laws/regulations

Score: 0

There is insufficient evidence that Tanzania and Tanzania-Zanzibar has an established agency responsible for the enforcement of biosecurity legislation and regulations.

According to the Joint External Evaluation (JEE) of the International Health Regulations (2005) core capacities of the United Republic of Tanzania, conducted 14-18 August 2023, "the United Republic of Tanzania has a functional multisectoral TWG [technical working group] for biosafety and biosecurity coordinated through the One Health Section in the Prime Ministers’ Office. The TWG oversees the biosafety and biosecurity measures implementation including legislation, training and certification of high-containment facilities." (p.26)¹²¹ The National One Health Strategic Plan 2022-2027 by the Prime Minister's Office of the United Republic of Tanzania, covering both mainland Tanzania and Tanzania-Zanzibar, reiterates the importance of strengthening biosafety and biosecurity measures, through activities such as conducting bio-risk management training, and conducting meetings on biosafety and biosecurity guidelines. (p.37) ¹²² A specific agency responsible for the enforcement of legislation is not mentioned.

The Tanzania Biological Safety Association (TaBSA) provides biosafety and biosecurity trainings and certification. The TaBSA describes itself as "a professional association that congregates practitioners for promotion of biosafety and biosecurity to facilitate the sharing of information to scientists, laboratory personnel, engineers, academics and policy makers who have a common interest in biosafety and biosecurity issues", rather than an agency that concerns itself with biosecurity and biosafety regulations. ¹²³

A search of the VERTIC BWC Legislation database does not provide any evidence of Tanzania or Tanzania-Zanzibar having a biosecurity law or agency. ¹²⁴ The United Republic of Tanzania has an Environmental Management Act 2004, which does not include biosecurity. ¹²⁵¹²⁶

No evidence of agencies responsible for the enforcement of biosecurity legislation is available from a review of Tanzania's Ministry of Health, Ministry of Agriculture, or Ministry of Defence websites, nor from Tanzania-Zanzibar's Ministry of Health or Ministry of Agriculture websites. ¹²⁷¹²⁸¹²⁹¹³⁰¹³¹

1.3.1d Consolidation of especially dangerous pathogens into minimum # of facilities

Score: 0

There is no evidence that Tanzania and Tanzania-Zanzibar have taken action to consolidate its inventories of especially dangerous pathogens and toxins into a minimum number of facilities.

According to the Joint External Evaluation (JEE) of the International Health Regulations (2005) core capacities of the United Republic of Tanzania, conducted 14-18 August 2023, "The United Republic of Tanzania has an agreed list of Pathogenic agents and toxins of concern as outlined in the National laboratory biosafety and biosecurity guidelines (2022) annex 1. However, the country does not have a national consolidated inventory of where the pathogens are housed; laboratories handling these pathogens that include reference laboratories, research and academic institutions, have established procedures for pathogen inventory with relevant records." (p.26) ¹³² The JEE does not mention if inventories have been consolidated.

The consolidation of inventories of especially dangerous pathogens and toxins is not mentioned in the biosafety and biosecurity section of the Joint External Evaluation of the International Health Regulations (‎2005)‎ core capacities of the United Republic of Tanzania-Zanzibar, conducted 21-25 August 2023. ¹³³

A search of the VERTIC BWC Legislation database does not provide any evidence of Tanzania or Tanzania-Zanzibar has consolidated its inventories of dangerous pathogens. ¹⁴⁰

1.3.1e Capacity to conduct tests for anthrax/Ebola without culturing live pathogens

Score: 0

There is insufficient evidence to suggest in-country capacity to conduct Polymerase Chain Reaction (PCR)-based diagnostic testing for anthrax and/or Ebola, which would preclude culturing a live pathogen in both Tanzania and Tanzania-Zanzibar.

The Joint External Evaluation of the International Health Regulations (2005) core capacities of the United Republic of Tanzania, conducted 14-18 August 2023, states that "there are laboratories with the capacity to test molecular tests through conventional PCR and point-of-care diagnostics." (p.36) ¹⁴¹ It is not specified whether or not anthrax or Ebola are included in the PRC tests.

No evidence was identified on the websites of the Ministry of Health, Ministry of Agriculture, or Ministry of Livestock for Tanzania. ¹⁴²¹⁴³¹⁴⁴

According to the Joint External Evaluation of the International Health Regulations (‎2005)‎ core capacities of the United Republic of Tanzania-Zanzibar, conducted 21-25 August 2023, the public health laboratory in Tanzania-Zanzibar is able to conduct PCR-based diagnostic testing. (p.34) Again, whether or not this includes anthrax or Ebola is unclear. ¹⁴⁵

A review of the Tanzania-Zanzibar websites of the Ministry of Health and Ministry of Agriculture do not provide any supporting evidence. ¹⁴⁶¹⁴⁷

1.3.2 Biosecurity training and practices

1.3.2a Biosecurity training using a standardised, required approach

Score: 33.33

There is evidence that both Tanzania and Tanzania-Zanzibar provide biosecurity and biosafety training on an ad hoc basis.

According to the Joint External Evaluation (JEE) of the International Health Regulations (2005) core capacities of the United Republic of Tanzania, conducted 14-18 August 2023, "biosafety and biosecurity courses are aligned with higher learning institutions' curricula." (p.28) ¹⁴⁸ Furthermore, some training evaluations programmes as required by the ISO 15189:2022 and 17025 are available through accredited facilities. At the same time, the JEE recommends that Tanzania develops standardized training programmes for both biosafety and biosecurity. (p.28) The JEE does not indicate what is and what is not included in biosecurity trainings. ¹⁴⁹

The Joint External Evaluation (JEE) of the International Health Regulations (‎2005)‎ core capacities of the United Republic of Tanzania-Zanzibar, conducted 21-25 August 2023, indicates that Zanzibar also has some ad hoc training opportunities available through the State University of Zanzibar (SUZA). (p.26) ¹⁵⁰ Furthermore, laboratory personnel also receive training in both biosafety and biosecurity. Like in Tanzania, it is unclear what is covered in biosecurity trainings in Zanzibar. Finally, the JEE states that "there is inadequate training on biosafety and biosecurity in all relevant sectors". (p.27) ¹⁵¹

The National One Health Strategic Plan 2022-2027 also covers biosafety and biosecurity. ¹⁵² The plan calls for the strengthening of biosafety and biosecurity measures in laboratories through conducting bio-risk management trainings. (p.37) ¹⁵³ Other forms of training are not mentioned in the National One Health Strategic Plan.

No further evidence of standardized training is found from a review of the websites of the Tanzania Ministry of Health, Ministry of Agriculture, or Ministry of Defence and National Services, and Tanzania-Zanzibar's Ministry of Health and Ministry of Agriculture, as well as the VERTIC BWC Legislation Database. ¹⁵⁴¹⁵⁵¹⁵⁶¹⁵⁷¹⁵⁸¹⁵⁹

1.3.3 Personnel vetting: regulating access to sensitive locations

1.3.3a Personnel checks for permission to access to especially dangerous pathogens

Score: 0

There is no publicly available evidence to suggest that Tanzania and Tanzania-Zanzibar have regulations or licensing conditions that specify that security and other personnel with access to especially dangerous pathogens, toxins, or biological materials with pandemic potential are subject to the following checks: drug testing, background checks, and psychological or mental fitness checks.

The United Republic of Tanzania has a regulation that lightly touches on the topic of biosafety, namely: the Environmental Management (Biosafety) Regulations of 2009. ¹⁶⁰ Article 2 of the regulation enshrines the "import, export, deliberate, release, confined use, contained use, transit and placing on the market of GMOs and their products". ¹⁶¹ Biosecurity and conditions for personnel are not mentioned in this regulation.

A review of employment-related regulations in Tanzania does not provide evidence of requirements for checks. For example, the United Republic of Tanzania's Occupational Health and Safety Act 2003, the law that provides for the health safety and welfare of people at work does not mention that security and other personnel with access to especially dangerous pathogens are subject to checks. ¹⁶² Furthermore, Police Clearance Certificates may be necessary for employment. ¹⁶³ However, it is unclear what aspects are checked through this clearance certificate.

Similarly, the Employment and Labour Relations Act 2019 by the United Republic of Tanzania does not mention a requirement for checks. ¹⁶⁴ There is also no publicly available evidence from the Tanzania Ministry of Health, Ministry of Agriculture, and the Ministry of Defence and National Service. ¹⁶⁵¹⁶⁶¹⁶⁷

No evidence of regulations or licensing conditions requiring checks for personnel working with dangerous biological substances is found from the Tanzania-Zanzibar websites of the Ministry of Health and Ministry of Agriculture. ¹⁶⁸¹⁶⁹ And a search of the VERTIC BWC Legislation database does not provide any evidence of Tanzania or Tanzania-Zanzibar having regulations or licensing conditions that specify that personnel with access to especially dangerous pathogens are subject to checks. ¹⁷⁰

1.3.4 Transportation security

1.3.4a National transport regulations for Category A and B infectious substances

Score: 0

There is insufficient evidence that the United Republic of Tanzania has national regulations on the safe and secure transport of infectious substances (Categories A and B).

The 2020 Industrial and Consumer Chemicals (Management and Control) Regulations by the United Republic of Tanzania contains information on the transportation of chemicals. ¹⁷¹ Articles 9 and 15 require that transporters register themselves through the Government Chemist Laboratory Authority (GCLA) and provide information on how chemicals are to be transported. ¹⁷²¹⁷³ The GCLA has a list on its website of registered chemical transports as of October 2024. ¹⁷⁴ However, the 2020 regulation does not mention the transport of infectious substances nor does it mention categories A and B. ¹⁷⁵¹⁷⁶

The 2023 Guidelines for Management of Dangerous Goods in Tanzania by the GCLA does mention the transporting of toxic and infectious substances. ¹⁷⁷ Infectious substances are described as 'class 6', however the guidelines does not expand on what this means. Furthermore requirements for class 6 are mostly related to toxic substances. ¹⁷⁸ Again categories A and B are not mentioned.

A further check of the VERTIC BWC Legislation Database and the repository of laws listed on the website of the Law Reform Commission of Tanzania does not provide evidence of national regulations on the safe and secure transport of infectious substances, particularly categories A and B. ¹⁷⁹

There is no further information available through the websites of the Ministry of Health from both Tanzania and Tanzania-Zanzibar. ¹⁸⁰¹⁸¹

There is no evidence through the Joint External Evaluation of the International Health Regulations (2005) core capacities of the United Republic of Tanzania – Zanzibar, conducted 21-25 August 2023, or the Joint External Evaluation of the International Health Regulations (2005) core capacities of the United Republic of Tanzania, conducted 14-18 August 2023. ¹⁸²¹⁸³

1.3.5 Cross-border transfer and end-user screening

1.3.5a Laws/regulations on cross-border transfer and end-user screening

Score: 0

There is no evidence of national legislation, regulation, or other guidance in place to oversee the cross-border transfer and end-user screening of especially dangerous pathogens, toxins and pathogens with pandemic potential.

Articles 9 through 18 of the Industrial and Consumer Chemicals (Management and Control) Regulations, 2020 by the United Republic of Tanzania cover the transportation of chemicals. ¹⁸⁴ However, the regulation does not make provisions on cross-border transfer and end-user screening of dangerous biological substances.

A further check of the VERTIC Biological Weapons Convention (BWC) Legislation Database does not provide evidence of national regulations on the safe and secure transport of infectious substances, particularly categories A and B. ¹⁸⁵

The Ministry of Health, Ministry of Agriculture, Ministry of Defence, the Ministry of Works and the Ministry of Industry and Trade for Tanzania do not provide publicly available evidence of such regulations. There is no mention of such regulations in the Joint External Evaluation of the International Health Regulations (IHR) Core Capacities Of the United Republic of Tanzania, 14-18 August 2023. ¹⁸⁶¹⁸⁷¹⁸⁸¹⁸⁹¹⁹⁰¹⁹¹

Neither is there evidence available on the Tanzania-Zanzibar websites for the Ministry of Health, Ministry of Agriculture or in the Joint External Evaluation of the IHR Core Capacities of Tanzania-Zanzibar, 21-25 August 2023. ¹⁹²¹⁹³¹⁹⁴

1.4 Biosafety

1.4.1 Whole-of-government biosafety systems

1.4.1a Biosafety laws/regulations

Score: 0

There is no evidence that Tanzania and Tanzania-Zanzibar have national biosafety legislation and/or regulations.

The United Republic of Tanzania has a regulation that lightly touch on the topic of biosafety, namely: Environmental Management (Biosafety) Regulations, 2009. ¹⁹⁵ Article 2 of the regulation enshrines the "import, export, deliberate release, confined use, contained use, transit and placing on the market of GMOs and their products". ¹⁹⁶ However, it does not mention biosafety concerns.

A further check of the VERTIC BWC Legislation Database and the repository of laws listed on the website of the Law Reform Commission of Tanzania does not provide evidence of biosafety legislation or regulations. ¹⁹⁷

The National One Health Strategy Plan 2022-2027 as well as the National Biosafety and Biosecurity Policy and Guidelines 2022 delve deeper into bio-risks, but neither makes mention of legislation or regulations. ¹⁹⁸¹⁹⁹

The Tanzania Ministry of Health, Ministry of Agriculture, Ministry of Defence and National Service, Ministry of Works, and the Ministry of Industry and Trade do not provide publicly available evidence of such regulations. ²⁰⁰²⁰¹²⁰²²⁰³²⁰⁴ Evidence is also not found through the Joint External Evaluation of the International Health Regulations (2005) core capacities of the United Republic of Tanzania, conducted 14-18 August 2023, and the Joint External Evaluation of the International Health Regulations (‎2005)‎ core capacities of the United Republic of Tanzania-Zanzibar, conducted 21-25 August 2023. ²⁰⁵²⁰⁶

Tanzania has been a state party to the Biological Weapons Convention (BWC) since August 2019 and is required to submit annual reports on biological research, however, there is no evidence that any reports have been submitted to date. ²⁰⁷

1.4.1b Agency for enforcement of biosafety laws/regulations

Score: 0

There is no public evidence that Tanzania and Tanzania-Zanzibar have biosafety legislation and regulations or established agencies responsible for their enforcement.

The United Republic of Tanzania has a regulation that lightly touch on the topic of biosafety, namely: Environmental Management (Biosafety) Regulations, 2009. ²⁰⁸ Article 2 of the regulation enshrines the "import, export, deliberate release, confined use, contained use, transit and placing on the market of GMOs and their products". ²⁰⁹ However, it does not mention biosafety concerns.

The National One Health Strategic Plan 2022-2027 as well as the National Biosafety and Biosecurity Policy and Guidelines 2022 delve deeper into bio-risks, but neither makes mention of legislation or regulations. ²¹²²¹³

The Tanzania Ministry of Health, Ministry of Agriculture, Ministry of Defence and National Service, Ministry of Works, Transport and Communication and the Ministry of Industry and Trade do not provide publicly available evidence of such regulations. ²¹⁴²¹⁵²¹⁶²¹⁷²¹⁸ Evidence is also not found through the Joint External Evaluation of the International Health Regulations (2005) core capacities of the United Republic of Tanzania, conducted 14-18 August 2023, and the Joint External Evaluation of the International Health Regulations (‎2005)‎ core capacities of the United Republic of Tanzania-Zanzibar, conducted 21-25 August 2023. ²¹⁹²²⁰

1.4.2 Biosafety training and practices

1.4.2a Biosafety training using a standardised, required approach

Score: 33.33

There is evidence that both Tanzania and Tanzania-Zanzibar provide biosecurity and biosafety training on an ad hoc basis.

According to the Joint External Evaluation (JEE) of the International Health Regulations (2005) core capacities of the United Republic of Tanzania, conducted 14-18 August 2023, "biosafety and biosecurity courses are aligned with higher learning institutions' curricula." (p.28) ²²² Furthermore, some training evaluations programmes as required by the ISO 15189:2022 and 17025 are available through accredited facilities. At the same time, the JEE recommends that Tanzania develops standardized training programmes for both biosafety and biosecurity. (p.28) The JEE does not indicate what is and what is not included in biosafety trainings. ²²³

The Joint External Evaluation (JEE) of the International Health Regulations (‎2005)‎ core capacities of the United Republic of Tanzania-Zanzibar, conducted 21-25 August 2023, indicates that Zanzibar also has some ad hoc training opportunities available through the State University of Zanzibar (SUZA). (p.26) ²²⁴ Furthermore, laboratory personnel also receive training in both biosafety and biosecurity. Like in Tanzania, it is unclear what is covered in biosafety trainings in Zanzibar. Finally, the JEE states that "there is inadequate training on biosafety and biosecurity in all relevant sectors". (p.27) ²²⁵

The National One Health Strategic Plan 2022-2027 also covers biosafety and biosecurity. ²²⁶ The plan calls for the strengthening of biosafety and biosecurity measures in laboratories through conducting bio-risk management trainings. (p.37) ²²⁷ Other forms of training are not mentioned in the National One Health Strategic Plan.

1.5 Dual-use research and culture of responsible science

1.5.1 Oversight of dual-use research

1.5.1a Evidence of national assessment of dual-use research

Score: 0

There is no publicly available evidence that Tanzania and Tanzania-Zanzibar have conducted an assessment to determine whether ongoing research is occurring on especially dangerous pathogens, toxins, pathogens with pandemic potential, and/or other dual use research.

No evidence of this is found from a review of the websites of the Ministry of Health, Ministry of Agriculture, and Ministry of Defence and National Service as well as the National Institute of Medical Research ²³⁴²³⁵²³⁶²³⁷

The Joint External Evaluation of the International Health Regulations (IHR) Core Capacities of the United Republic of Tanzania, conducted 14-18 August 2023, and the VERTIC BWC Legislation Database do not provide evidence of such an assessment either. ²³⁸²³⁹

Finally, no evidence of an assessment to determine whether ongoing research is occurring on especially dangerous pathogens, toxins, pathogens with pandemic potential, and/or other dual use research is found for Tanzania-Zanzibar through a review of the Joint External Evaluation of the IHR Core Capacities of Tanzania-Zanzibar, conducted 21-25 August 2023, as well as the health and agriculture ministries. ²⁴⁰²⁴¹²⁴²

1.5.1b National law/regulation on oversight of dual-use research

Score: 0

There is no evidence that Tanzania and Tanzania-Zanzibar have in place national policies requiring oversight of dual use research, such as research with especially dangerous pathogens, toxins, and/or pathogens with pandemic potential.

Finally, no evidence on regulations requiring oversight of research on especially dangerous pathogens, toxins, pathogens with pandemic potential, and/or other dual use research is found for Tanzania-Zanzibar through a review of the Joint External Evaluation of the IHR Core Capacities of Tanzania-Zanzibar, conducted 21-25 August 2023, as well as the health and agriculture ministries. ²⁴⁹²⁵⁰²⁵¹

1.5.1c Existence of agency responsible for oversight of dual-use research

Score: 0

There is no evidence that Tanzania and Tanzania-Zanzibar have in place agencies responsible for oversight of research with especially dangerous pathogens, pathogens with pandemic potential, and/or other dual use research.

Finally, there is no evidence of agencies requiring oversight of research on especially dangerous pathogens, toxins, pathogens with pandemic potential, and/or other dual use research found for Tanzania-Zanzibar through a review of the Joint External Evaluation of the IHR Core Capacities of Tanzania-Zanzibar, conducted 21-25 August 2023, as well as the health and agriculture ministries. ²⁵⁸²⁵⁹²⁶⁰

1.5.2 Screening requirements for providers of genetic material

1.5.2a Requirement to screen synthesised DNA against list prior to sale

Score: 0

There is no publicly available evidence of a national legislation, regulation, policy, or other guidance, requiring the screening of synthesized Deoxyribonucleic acid (DNA) before it is sold in Tanzania and Tanzania-Zanzibar.

The United Republic of Tanzania has a regulation that lightly touch on the topic of biosafety, namely: Environmental Management (Biosafety) Regulations, 2009. ²⁶¹ Article 2 of the regulation enshrines the "import, export, deliberate release, confined use, contained use, transit and placing on the market of GMOs and their products". ²⁶² It does not address synthesized DNA. Similarly, the Human DNA Regulation Act, 2009 enacts the "management and regulation of collection, packing, transportation, storage, analysis and disposal of sample for Human DNA". (preface, n.p.) However, synthesized DNA is not mentioned. ²⁶³

There is also no evidence of regulations requiring the screening of synthesized DNA before it is sold on the websites of the Tanzania Ministry of Health, Ministry of Agriculture, Ministry of Defence and the Ministry of Works. ²⁶⁴²⁶⁵²⁶⁶²⁶⁷

No evidence is also found from a review of the Joint External Evaluation of the International Health Regulations (IHR) Core Capacities of the United Republic of Tanzania, conducted 14-18 August 2023, or the Joint External Evaluation of the IHR Core Capacities of Tanzania-Zanzibar, conducted 21-25 August 2023. ²⁶⁸²⁶⁹

The VERTIC BWC Legislation Database does not list any law addressing synthesized DNA. ²⁷⁰ No corresponding evidence is found on the websites of the Ministry of Health or Ministry of Agriculture for Tanzania-Zanzibar. ²⁷¹²⁷²

1.6 Immunization

1.6.1 Vaccination rates

1.6.1a Immunization rate for humans (measles/MCV2)

Score: 50

1.6.1b Availability of vaccination figures for livestock (FMD) through OIE database

Score: 100

There are official foot-and-mouth disease (FMD) vaccination figures for livestock publicly available through the WAHIS database for Tanzania. In 2022, 332793 livestock animals were vaccinated for FMD. Vaccinations in Zanzibar are included in this number. ²⁷³

1.6.1c Equitablenature of national immunization strategy/plan

Score: 100

There is evidence that Tanzania and Tanzania-Zanzibar have national immunization plans.

According to the Joint External Evaluation (JEE) of the International Health Regulations (IHR) Core Capacities of the United Republic of Tanzania, conducted 14-18 August 2023, "there is a well-established immunization programme integrated within the primary healthcare system." (p.25) ²⁷⁴ In particular, the JEE references a 'National Immunization Strategy Plan 2021-2025'. However, a broad search of the internet of the Ministry of Health, shows no evidence of this document being publicly available. ²⁷⁵ The 'Immunization and Vaccine Development Programme 2016-2020 comprehensive multi year plan' is publicly available, and provides standardized guidance to promote appropriate immunization services. (p.ii) ²⁷⁶ The 2016-2020 plan does not contain information on equity strategies. The JEE indicates that Tanzania is able to provide most of its population with vaccines, for example "the United Republic of Tanzania has attained coverage of 90-95% of the country's 12-month-old population with at least one dose of measles-containing vaccines (MCV)". (p.25) ²⁷⁷

The Joint External Evaluation (JEE) of the International Health Regulations (IHR) Core Capacities of the United Republic of Tanzania-Zanzibar, conducted 21-25 August 2023, indicates that Zanzibar has an Expanded Programme on Immunization (EPI). (p.28) ²⁷⁸ In general there is a high coverage of vaccination and routine immunization outreach is available. However, immunization may be lacking in hard-to-reach areas due to human resources shortages. (p.29) ²⁷⁹ The JEE does not mention socioeconomic inequalities, gender barriers, or cultural/linguistic differences. The Expanded Programme on Immunization is not available through the Ministry of Health of Tanzania-Zanzibar. ²⁸⁰

1.6.1d Vaccine hesitancy and build public trust coverage in vaccines in national immunization strategy/plans

Score: 0

There is no evidence that the national immunization strategy of Tanzania and Tanzania-Zanzibar includes measures to address vaccine hesitancy and build public trust in vaccines.

In particular, the JEE references a 'National Immunization Strategy Plan 2021-2025'. However, a broad search of the internet of the Ministry of Health, shows no evidence of this document being publicly available. ²⁸² The 'Immunization and Vaccine Development Programme 2016-2020 comprehensive multi year plan' is publicly available, and provides standardized guidance to promote appropriate immunization services. (p.ii) ²⁸³ The 2016-2020 plan does not contain information on building public trust in vaccines or vaccine hesitancy.

1.6.1e National advisory group for immunization strategy/plan

Score: 0

There is evidence that Tanzania has a national advisory group that provides technical guidance and advice on the immunization strategy to the government, however it is unclear if Tanzania-Zanzibar also has an advisory group.

"The Tanzania Immunization Technical Advisory Group (TITAG) was established by the Ministry of Health in November 2016 and finally, members were appointed officially by Minister for Health on 20th January 2017". ²⁸⁶ TITAG is a technical resource as well as a group that provides scientific evidence-based recommendations regarding immunization issues. ²⁸⁷ Tanzania-Zanzibar is not mentioned in this context.

According to the Joint External Evaluation (JEE) of the International Health Regulations (IHR) Core Capacities of the United Republic of Tanzania, conducted 14-18 August 2023, Tanzania has functional advisory technical committees. (p.29) ²⁸⁸ The JEE does not expand on the responsibilities of the technical committees. The 'Immunization and Vaccine Development Programme 2016-2020 comprehensive multi year plan' by the Ministry of Health, does not mention advisory groups that provide technical guidance. ²⁸⁹

There is no further information available through the Ministry of Health. ²⁹⁰

The Joint External Evaluation (JEE) of the International Health Regulations (IHR) Core Capacities of the United Republic of Tanzania-Zanzibar, conducted 21-25 August 2023, does not cover advisory groups in its section on immunization. ²⁹¹ The Expanded Programme on Immunization, mentioned in the JEE, is not publicly available through the Ministry of Health of Tanzania-Zanzibar.²⁹²

1.6.1f Presence of an immunization programme for influenza

Score: 0

There is no evidence that Tanzania and Tanzania-Zanzibar have an immunization programme for influenza.

The Joint External Evaluation (JEE) of the International Health Regulations (IHR) Core Capacities of the United Republic of Tanzania-Zanzibar, conducted 21-25 August 2023, indicates that Zanzibar has an Expanded Programme on Immunization (EPI). (p.28) ²⁹⁶ In general there is a high coverage of vaccination and routine immunization outreach is available. However, vaccines targeting influenza are not mentioned by the JEE ²⁹⁷ The Expanded Programme on Immunization is not available through the Ministry of Health of Tanzania-Zanzibar. ²⁹⁸

The World Health Organization (WHO) has a website addressing influenza vaccination coverage, there is no data available on Tanzania. ²⁹⁹ There if no evidence available through the Ministries of Health of Tanzania and Tanzania-Zanzibar. ³⁰⁰³⁰¹

1.7 Climate change adaptation and vector transmission

1.7.1 Health system resilience

1.7.1a Strategy/plan for resilience of health system

Score: 100

There is evidence that Tanzania and Tanzania-Zanzibar have a strategy or plan to develop a health system that is resilient to the challenges that climate change and changing seasonal weather patterns pose, that includes the threat of infectious diseases.

The Ministry of Health has published the Health – National Adaptation Plan (HNAP) to Climate Change in Tanzania 2018-2023. ³⁰² The HNAP enables Tanzania's health system to become more resilient to climate change through key objectives, such as reducing vulnerabilities, facilitating climate adaptation and guiding health practitioners. (p.iv-v) ³⁰³ The HNAP focusses on mainland Tanzania, but also mentions Tanzania-Zanzibar.

The National Climate Change Response Strategy 2021-2026 by the United Republic of Tanzania, has a section that covers health. (p.51-53) ³⁰⁴ "Despite the presence of linkage between climate change and climate sensitive diseases in the country, there is no system to track down prevalence of such diseases despite the presence of health information management system. In addition, there is inadequate utilization of information released by TMA regarding weather changes such as excessive rains and diseases preparedness and response." (p.51) The Strategy does not provide further evidence regarding the development of a health system that is resilient to the challenges that climate change pose.

The National One Health Strategic Plan 2022-2027 by the Prime Minister's Office of the United Republic of Tanzania, includes a section on climate change health threats. (p.8) ³⁰⁵ Stating that "climate variability is associated with the geographical distribution and reproduction of vectors responsible for a number of diseases". (p.8) ³⁰⁶ While this strategic plan acknowledges the challenges that climate change can pose for infectious diseases, it does not provide actions that could be taken to counter its effects. (p.23) ³⁰⁷

Furthermore, in 2020 the Ministry of Health published the All-Hazard Public Health Emergency Response Plan. ³⁰⁸ "This plan addresses emergency response across health system in events of all hazards. It will guide coordination of response activities at different levels and integration of activities by different stakeholders to avoid vertical approach. "(p. 6) ³⁰⁹ The plan briefly mentions climate change, but does not provide any details. (p.6) ³¹⁰

Finally, the National Disaster Management Strategy, 2022-2027 by the Prime Minister's Office of the United Republic of Tanzania, includes sections on both climate change and epidemics. (p. 11-13 and p.7-8 respectively) ³¹¹ However, this topics are not connected.

There is no further evidence available through the Joint External Evaluation of the International Health Regulations (2005) core capacities of the United Republic of Tanzania, conducted 14-18 August 2023, or the website of the Tanzanian Ministry of Health. ³¹²³¹³

In 2025, the Revolutionary Government of Zanzibar published the 'Zanzibar Disaster Risk Financing and Insurance Assessment Report'. ³¹⁴ Whilst this report does include information on both epidemics and climate change, the report mostly focuses on disaster risk financing as opposed to emergency responses. (p.18)

In 2013, the Revolutionary Government of Zanzibar published Zanzibar's Climate Change Strategy. Health and diseases are not covered in this document. ³¹⁵

No further evidence was found through the Joint External Evaluation of the International Health Regulations (2005) core capacities of the United Republic of Tanzania – Zanzibar, conducted 21-25 August 2023, and the website of the Zanzibar Ministry of Health. ³¹⁶³¹⁷

Early Detection

2.1 Laboratory systems strength and quality

2.1.1 Lab capacity for detecting priority diseases

2.1.1a Capacity of national lab system to conduct 5 or more WHO core tests

Score: 0

There is insufficient evidence to suggest that Tanzania and Tanzania-Zanzibar's national laboratory systems have the capacity to conduct diagnostic tests for at least 5 of the 10 WHO-defined core tests.

The Joint External Evaluation (JEE) of the International Health Regulations (2005) core capacities of the United Republic of Tanzania, conducted 14-18 August 2023, states that: "the country has reasonable testing capabilities in both human and animal health laboratories to routinely test the priority diseases as outlined in the national IDSR [Integrated Disease Surveillance and Response] guidelines, third edition, including measles, viral haemorrhagic fevers (Ebola, Marburg), anthrax, brucellosis and cholera, among others. However, it should be noted that testing for certain diseases such as acute flaccid paralysis and aflatoxin in human blood presents challenges." (p.33) ³¹⁸ However the JEE does not indicate what testing methods are available and what can be understood as 'reasonable testing capabilities'. (p.33-34)

No further evidence was found through the National One Health Strategic Plan or the websites of the Ministry of Health and the Ministry of Agriculture. ³¹⁹³²⁰³²¹

In Tanzania-Zanzibar Polymerase Chain Reaction (PCR) and sequencing is possible in the human health sector. ³²² However, the Joint External Evaluation of the International Health Regulations (2005) core capacities of the United Republic of Tanzania – Zanzibar, conducted 21-25 August 2023, does not provide further information on the types of illnesses that these methods can be used on. (p.34) ³²³

Zanzibar has an integrated HIV, TB, and Leprosy Program (ZIHTLP), however it remains unclear what kinds of methods are used for testing. ³²⁴

There is no evidence found on the websites of the Zanzibar Ministry of Health and Ministry of Agriculture. ³²⁵³²⁶

2.1.1b Plan to conduct testing during a public health emergency

Score: 0

There is no evidence that Tanzania and Tanzania-Zanzibar have a national plan, strategy or similar document for conducting
testing during a public health emergency, which includes considerations for testing for novel pathogens, scaling capacity, and defining goals for testing.

The National Disaster Management Strategy (2022-2027) by the Prime Minister's Office of the United Republic of Tanzania does not mention testing during public health emergencies. ³²⁷ Similarly, the National One Health Strategic Plan, also by the Prime Minister's Office of the United Republic of Tanzania, does not link testing and health emergencies. ³²⁸ However, the strategic plan does indicate that it aims to strengthen laboratory diagnostic capacity. (p.36)

There is no evidence found in the Joint External Evaluation of the International Health Regulations (2005) core capacities of the United Republic of Tanzania, conducted 14-18 August 2023, or on the websites of the Ministry of Health and the Ministry of Agriculture. ³²⁹³³⁰³³¹

According to the Joint External Evaluation of the International Health Regulations (2005) core capacities of the United Republic of Tanzania – Zanzibar, conducted 21-25 August 2023, the island has district emergency preparedness and response plan (DEPRD) 2022-2027 available. (p.44) ³³² However, a broad search of the internet only provided older and possibly outdated versions of these plans. ³³³ The Wete District Emergency Preparedness and Response Plan 2012 by the Revolutionary Government of Zanzibar, does not mention testing. ³³⁴

There is no further evidence available through the websites of the Zanzibar Ministry of the Health and the Ministry of Agriculture. ³³⁵³³⁶

2.1.2 Laboratory quality systems

2.1.2a Existence of an accredited national lab serving as a reference facility

Score: 100

There is evidence that Tanzania and Tanzania-Zanzibar's national laboratory that serves as a reference facility is accredited (e.g., International Organization for Standardization [ISO] 15189:2003, U.S. Clinical Laboratory Improvement Amendments [CLIA]).

According to Joint External Evaluation of the International Health Regulations (2005) core capacities of the United Republic of Tanzania, conducted 14-18 august 2023, there are three national laboratories that have the ISO15189 international accreditation. ³³⁷ "Additionally, 58 other zonal, regional and private health laboratories have attained ISO 15189:2012 accreditation, further enhancing the quality of laboratory services". (p.33) ³³⁸ All accreditations are provided by the Southern African Development Community Accreditation Services (SADCAS). ³³⁹

According to the Joint External Evaluation of the International Health Regulations (2005) core capacities of the United Republic of Tanzania-Zanzibar, conducted 21-25 August 2023, the pathology laboratory at the Mnazi Mmoja Referral Hospital used to be SADCAS accredited with ISO:15189. ³⁴⁰ However, this accreditation has since expired. Nowaday Zanzibar uses the National Public Health Laboratory in mainland Tanzania as the national reference laboratory. (p.32) ³⁴¹

2.1.2b External quality assurance of a national lab serving as a reference facility

Score: 100

There is evidence that Tanzania and Tanzania-Zanzibar's national reference laboratories are subjected to external quality assurance (EQU) review.

The National Public Health Laboratory (NPHL) undergoes EQA as part of its ISO:15189:2012 accreditation for both quality and laboratory competency. ³⁴²³⁴³ The accreditation was provided by the Southern African Development Community Accreditation Services (SADCAS). ³⁴⁴³⁴⁵ The NPHL is the reference laboratory for both mainland Tanzania and Tanzania-Zanzibar. ³⁴⁶³⁴⁷ Tanzania-Zanzibar used to have its own national reference laboratory, however it's accreditation has expired. (p.32)³⁴⁸

According to Joint External Evaluation of the International Health Regulations (2005) core capacities of the United Republic of Tanzania, conducted 14-18 august 2023, "the National Public Health Laboratory has been designated to oversee the distribution of proficiency testing/external quality assessment materials across human health laboratories […]. All laboratories have actively enrolled in the external quality assessment programme. " (p.34)³⁴⁹

2.2 Laboratory supply chains

2.2.1 Specimen referral and transport system

2.2.1a Nationwide specimen transport system

Score: 100

There is evidence that Tanzania and Tanzania-Zanzibar have a specimen transport system.

The Joint External Evaluation of the International Health Regulations (2005) core capacities of the United Republic of Tanzania, conducted 14-18 August 2023, states that mainland Tanzania has a contractual agreement between the United Republic Tanzania Posts Corporation and the Ministry of Health for the transport of specimen. (p.34) ³⁵⁰ Tracking services connecting the courier to the laboratories are available. Furthermore, there are national guidelines available for the sample referral system. ³⁵¹³⁵²

Furthermore, the National Public Health Laboratory states that: "We have a government courier system (EMS) which we normally use for routine, surveillance and referral specimen transport system which is well distributed countrywide to up-country." ³⁵³

In Tanzania-Zanzibar specimen transport is organized for some priority diseases (Malaria, TB, and HIV), but may be restricted at intermediate and/or national levels or within districts. (p.33) ³⁵⁴ Furthermore, the Joint External Evaluation of the International Health Regulations (2005) core capacities of the United Republic of Tanzania-Zanzibar indicates that "there are no guidelines or framework for the referral and transport system". (p.34)³⁵⁵

2.2.2 Laboratory cooperation and coordination

2.2.2a Plan to rapidly authorize/license laboratories to scale-up testing during an outbreak

Score: 0

There is no evidence of a plan in place for Tanzania or Tanzania-Zanzibar to rapidly authorize or license laboratories to supplement the capacity of the national public health laboratory system to scale-up testing during an outbreak.

There is no evidence of such a plan or any mention of authorizing laboratories in the Joint External Evaluation of the International Health Regulations (2005) core capacities of the United Republic of Tanzania, conducted 14-18 August 2023, or the Joint External Evaluation (JEE) of the International Health Regulations (2005) core capacities of the United Republic of Tanzania-Zanzibar, conducted 21-25 August 2023. ³⁵⁶³⁵⁷

There is no other evidence of authorizing or licensing laboratories to supplement the national public health laboratory system capacity on the websites of the Tanzania Ministry of Health or the Ministry of Agriculture. ³⁵⁸³⁵⁹

Neither is there evidence of authorizing laboratories on the websites of the Tanzania-Zanzibar Ministry of Health and Ministry of Agriculture. ³⁶⁰³⁶¹ No other evidence was found of such a plan through a general media search.

2.3 Real-time surveillance and reporting

2.3.1 Indicator and event-based surveillance and reporting systems

2.3.1a Evidence of ongoing event-based and indicator-based surveillance and analysis

Score: 50

There is evidence that Tanzania and Tanzania-Zanzibar conduct ongoing event-based and indicator-based surveillance, but there is no evidence that the data are being analyzed on a daily basis.

The Joint External Evaluation (JEE) of the International Health Regulations (2005) core capacities of the United Republic of Tanzania, conducted 14-18 August 2023, indicates that Tanzania has both event-based surveillance (EBS) as well as indicator-based surveillance (IBS). (p.39) ³⁶² Tanzania has adopted the Integrated Disease Surveillance and Response Guidelines (IDSR), third edition, by the World Health Organization (WHO) which includes surveillance on notifiable diseases and events. (p.30) ³⁶³ According to the JEE, IDSR reports, including EBS and IBS, are produced on a weekly, monthly and quarterly basis. (p.38) ³⁶⁴ There is no evidence that suggests that data are being analysed on a daily basis.

Tanzania-Zanzibar has similarly adopted the third edition of the IDSR. (p.36) ³⁶⁵ According to the Joint External Evaluation (JEE) of the International Health Regulations (2005) core capacities of the United Republic of Tanzania-Zanzibar, conducted 21-25 August 2023, "Zanzibar has made significant strides in enhancing its surveillance capabilities. Zanzibar has demonstrated key strengths in several areas, including the establishment of a robust early warning surveillance system at national, district, health facility and community levels. This early warning surveillance system is inclusive of the indicator-based surveillance (IBS) and EBS that incorporate various types of EBS […]". (p.36) ³⁶⁶ Weekly reports are available.

The National One Health Strategic Plan 2022-2027 by the Prime Minister's Office, mentioned EBS and IBS once in regards to need to train public and animal health staff to enhance integrated surveillance. (p.70) ³⁶⁷

There is no further evidence available through the websites of the Ministries of Health of both Tanzania and Tanzania-Zanzibar. ³⁶⁸³⁶⁹

2.3.1b Evidence of a mechanism (such as IHR focal point) for reporting notifiable diseases to the WHO within the set timeline

Score: 100

There is evidence available that Tanzania has mechanism for reporting notifiable diseases to the World Health Organization (WHO), however timelines are not mentioned.

In August 2024 the WHO declared an Mpox outbreak as a public health emergency of international concern (PHEIC). ³⁷⁰ In March 2025 Tanzania confirmed its first cases of Mpox virus disease. According to an article by the WHO "the country’s response efforts include the activation of the Public Health Emergency Operations Center which will coordinate response interventions in line with WHO guidelines and recommendations for managing Mpox outbreaks." ³⁷¹

Chapter four of the '2021 Standard Treatment Guidelines and National Essential Medicines List for Tanzania Mainland' by the The United Republic of Tanzania – Ministry of Health, discusses notifiable diseases, and prescribes the requirement to immediately notify public health authorities in the case of conditions and events that pose great threats to public health. (p.77) ³⁷²

While Tanzania regularly reports notifiable diseases to the WHO, there is no evidence of a timeline being used. ³⁷³³⁷⁴³⁷⁵

2.3.2 Interoperable, interconnected, electronic real-time reporting systems

2.3.2a Electronic national and sub-national reporting surveillance system

Score: 100

There is evidence that Tanzania and Tanzania-Zanzibar have an electronic reporting surveillance system at both the national and sub-national level.

Tanzania-Zanzibar has also adopted and implemented the 3rd edition of the WHO IDSR guidelines, which includes protocols for 44 diseases. (p.36)³⁷⁹ The Ministry of Health Zanzibar has introduced a comprehensive electronic IDSR (eIDSR) which aligns the IDSR with c. ³⁸⁰ According to the Joint External Evaluation of the International Health Regulations (2005) core capacities of the United Republic of Tanzania – Zanzibar, conducted 21-25 August 2023, has introduced event-based surveillance, indicator-based surveillance as well as community-based surveillance. (p.37) ³⁸¹

2.3.2b Collection of ongoing/real-time lab data by electronic surveillance system

Score: 50

There is evidence that both Tanzania and Tanzania-Zanzibar have an electronic reporting surveillance system collecting ongoing or real-time laboratory data. In Tanzania data can be disaggregated and analysed by age, ethnicity, etc, however there is no evidence that this is also possible in Tanzania-Zanzibar.

According to Joint External Evaluation (JEE) of the International Health Regulations (2005) core capacities of the United Republic of Tanzania, conduct 14-18 August 2023, the United Republic of Tanzania has adapted the 3rd edition of the Integrated Disease Surveillance and Response (IDSR) guidelines by the World Health Organization (WHO) (p.39). ³⁸² "The IDSR system aims to integrate surveillance functions at all levels of the health system". ³⁸³ According to the JEE, Tanzania uses multiple surveillance systems, such as multiple laboratory systems, indicator-based surveillance, and sentinel surveillance. However, linking these systems into IDSR has turned out to be a challenge (p. 38-40). ³⁸⁴ Nevertheless, "there are IDSR reports, produced weekly, monthly and quarterly. These reports collects aggregated data with sex, age and geographical location. For immediately reportable diseases, the collected data also include demographic information such as sex, age, geographical location, occupation, outcome information, laboratory results, etc. However, there is no formal mechanism to share this data widely with stakeholders." (p.38) ³⁸⁵

There is no further evidence available on the website of the Ministry of Health. ³⁸⁶

Tanzania-Zanzibar has also adopted and implemented the 3rd edition of the WHO IDSR guidelines, which includes protocols for 44 diseases. (p.36)³⁸⁷ The Ministry of Health Zanzibar has introduced a comprehensive electronic IDSR (eIDSR) which aligns the IDSR with Zanzibar's Digital Health Strategy for 2020-2025. ³⁸⁸ According to the Joint External Evaluation of the International Health Regulations (2005) core capacities of the United Republic of Tanzania – Zanzibar, conducted 21-25 August 2023, eIDSR provides weekly reports that contain aggregated data. (p.37) ³⁸⁹

2.3.3 Wastewater surveillance

2.3.3a National wastewater surveillance programme or initiative

Score: 100

There is evidence that Tanzania has ongoing national wastewater or environmental surveillance programmes.

Tanzania introduced environmental surveillance in 2019, which, in addition to the sensitive AFP surveillance, ensures the country's polio surveillance system remains robust. ³⁹⁰

In 2026, the Government of the United Republic of Tanzania launched a subnational polio vaccination campaign in the Lake Zone targeting over 6.7 million in children the country. This was in response to the detection of a circulating vaccine-derived poliovirus (cVDPV) through environmental surveillance. In preparation for the campaign, the Ministry of Health and Regional Administrative Secretariats have strengthened Acute Flaccid Paralysis (AFP) and environmental surveillance, increasing sampling frequency in high-risk districts.³⁹¹

Tanzania is among six African countries participating in Project Stellar, a pilot initiative funded by the Global Fund and implemented via the Association of Public Health Laboratories (APHL). The project tests the feasibility of wastewater-based surveillance (WWBS) for molecular detection and whole-genome sequencing of SARS‑CoV‑2, and leaves room for future expansion to include other pathogens. ³⁹² However, the programme ended in 2024 with no sign of continuation.

Moreover, in September 2024, a workshop under the ODIN Wastewater Surveillance Project was held in Dar es Salaam. Participants – including staff from the National Public Health Laboratory (NPHL) and the National Institute for Medical Research (NIMR) – were trained in sample collection, microbiological protocols, molecular workflows (qPCR, metagenomics), and culturing techniques. Samples were taken from seven locations across the city for pathogens like Vibrio cholerae, Salmonella Typhi, E. coli, Klebsiella pneumoniae, and enterococci – with detection of ESBL and carbapenemase activity. ³⁹³ In November 2023, a Wastewater Surveillance Stakeholder Engagement Workshop explored environmental surveillance of pathogens and AMR in Tanzania. Organized by institutions like NIMR, WHO, the Ministry of Health, and international partners (e.g., IHI, UCT, Oxford), it helped identify priority pathogens, sampling strategies, and gaps in surveillance and infrastructure. ³⁹⁴

2.4 Surveillance data accessibility and transparency

2.4.1 Coverage and use of electronic health records

2.4.1a Common usage of electronic health records

Score: 50

There is evidence showing electronic health records are in use in some facilities in Tanzania, however there is no evidence that they are commonly in use.

The final draft of the National Digital Health Strategy 2019-2024 by the United Republic of Tanzania – Ministry of Health aims to "accelerate increased access to and improved quality of effective and efficient healthcare to all Tanzanians through digitally enabled transformation of the health system". (p.1) ³⁹⁵ This strategy acknowledges that the implementation of digital health structures at all levels is still inadequate. Inadequate skills, personel, and funds are listed as possible reasons for this. (p.9) Still, according to Kessy, Kibusi, and Ntwenya (2024) Tanzania has improved the use and adoption of an electronic medical record (EMR). ³⁹⁶ However, not all healthcare managers are able or willing to use data generated by EMR systems in their decision making. ³⁹⁷

Mwogosi and Mambile (2024) also indicate an improved usage of the EMR system. ³⁹⁸ According to their research the Government of Tanzania Hospital Management Information System (GOTHOMIS), launched in 2015, was one of the reasons for the improved use of electronic records. ³⁹⁹ Still power outages and inadequate infrastructure still prove to be challenges for the effective implementation of a EMR system.

A 2025 Data Management Report by the Ministry of Health states that the usage of EMR systems has expanded, and these systems are now used in over 3.000 primary healthcare facilities. (p.v) ⁴⁰⁰

Finally, no evidence is found via the websites of the Tanzania-Zanzibar Ministry of Health and Ministry of Agriculture. ⁴⁰¹⁴⁰² There is no mention of electronic health records in the Joint External Evaluation of the International Health Regulations (IHR) Core Capacities of the United Republic of Tanzania, conducted 14-18 August 2023, or in the Joint External Evaluation of IHR Core Capacities of Tanzania-Zanzibar, conducted 21-25 August 2023. ⁴⁰³⁴⁰⁴

2.4.1b Public health system access to individual electronic health records

Score: 100

There is evidence showing electronic health records are in use in some facilities in Tanzania.

The final draft of the National Digital Health Strategy 2019-2024 by the United Republic of Tanzania – Ministry of Health aims to "accelerate increased access to and improved quality of effective and efficient healthcare to all Tanzanians through digitally enabled transformation of the health system". (p.1) ⁴⁰⁵ This strategy acknowledges that the implementation of digital health structures at all levels is still inadequate. Inadequate skills, personel, and funds are listed as possible reasons for this. (p.9) Still, according to Kessy, Kibusi, and Ntwenya (2024) Tanzania has improved the use and adoption of an electronic medical record (EMR). ⁴⁰⁶ However, there is no evidence that the electronic health records can be accessed through the national public health system.

Mwogosi and Mambile (2024) also indicate an improved usage of the EMR system. ⁴⁰⁷ According to their research the Government of Tanzania Hospital Management Information System (GOTHOMIS), launched in 2015, was one of the reasons for the improved use of electronic records. ⁴⁰⁸ Still power outages and inadequate infrastructure still prove to be challenges for the effective implementation of a EMR system.

A 2025 Data Management Report by the Ministry of Health states that the usage of EMR systems has expanded, and these systems are now used in over 3.000 primary healthcare facilities. (p.v) ⁴⁰⁹

Finally, no evidence is found via the websites of the Tanzania-Zanzibar Ministry of Health and Ministry of Agriculture. ⁴¹⁰⁴¹¹ There is no mention of electronic health records in the Joint External Evaluation of the International Health Regulations (IHR) Core Capacities of the United Republic of Tanzania, conducted 14-18 August 2023, or in the Joint External Evaluation of IHR Core Capacities of Tanzania-Zanzibar, conducted 21-25 August 2023. ⁴¹²⁴¹³

2.4.1c Existence of data standards for health record data comparability

Score: 0

There is evidence showing electronic health records are in use in some facilities in Tanzania, however there is insufficient evidence to show the use of data standards to ensure data is comparable (e.g., ISO standards).

The final draft of the National Digital Health Strategy 2019-2024 by the United Republic of Tanzania – Ministry of Health aims to "accelerate increased access to and improved quality of effective and efficient healthcare to all Tanzanians through digitally enabled transformation of the health system". (p.1) ⁴¹⁴ This strategy acknowledges that the implementation of digital health structures at all levels is still inadequate. Inadequate skills, personel, and funds are listed as possible reasons for this. Furthermore, the strategy establishes that seamless and secure information sharing as a priority, as data standards across the health sector are still inadequate. (p.9-10) ⁴¹⁵ Still, according to Kessy, Kibusi, and Ntwenya (2024) Tanzania has improved the use and adoption of an electronic medical record (EMR). ⁴¹⁶

Mwogosi and Mambile (2024) also indicate an improved usage of the EMR system. ⁴¹⁷ According to their research the Government of Tanzania Hospital Management Information System (GOTHOMIS), launched in 2015, was one of the reasons for the improved use of electronic records. ⁴¹⁸ Still power outages and inadequate infrastructure still prove to be challenges for the effective implementation of a EMR system.

Finally, no evidence is found via the websites of the Tanzania-Zanzibar Ministry of Health and Ministry of Agriculture. ⁴¹⁹⁴²⁰ There is no mention of electronic health records and data standards in the Joint External Evaluation of the International Health Regulations (IHR) Core Capacities of the United Republic of Tanzania, conducted 14-18 August 2023, or in the Joint External Evaluation of IHR Core Capacities of Tanzania-Zanzibar, conducted 21-25 August 2023. ⁴²¹⁴²²

2.4.2 Data integration between human, animal and environmental health sectors

2.4.2a Data sharing mechanisms

Score: 0

There is evidence that Tanzania has established mechanisms at the relevant ministries responsible for animal, human, and wildlife surveillance to share data, however there is no evidence of such a mechanism in Tanzania-Zanzibar.

The Joint External Evaluation of the International Health Regulations (2005) core capacities of the United Republic of Tanzania, conducted 14-18 August 2023, notes that "there is limited integration between multiple surveillance systems both in the human and animal health sectors". (p.40) ⁴²³ The Ministry of Health, through the 2019 Health Information System Guidelines (HISG), acknowledges that data sharing is essential and provides guidelines on data-sharing agreements and data sharing between government agencies/ministries. However, this information is limited to topics such as sharing data on births, deaths, and causes of deaths. (p.38-44) ⁴²⁴

The National One Health Strategic Plan states that: "After the RVF outbreak, Tanzania authorities worked to institutionalize OH approach in order to facilitate the coordination of appropriate interventions that would either prevent future outbreaks or reduce the burden of diseases to humans. This decision led to the establishment of One Health Coordination Desk (OHCD) under the Disaster 11Management Division in Prime Minister’s Office in 2018 and development of One Health Strategic Plan for 2015–2020. OHCD was mandated to coordinate activities of technical working groups (training, advocacy and communication; preparedness and response; research and development; surveillance and a national multisectoral one health technical committee comprised of directors from core oh sector ministries (human health, animal health (livestock and wildlife), and the environment) in order to enable appropriate interventions and information sharing across health sectors to minimize outbreaks and save lives". (p.11-12) ⁴²⁵ At the same time the Strategic Plan acknowledges that intersectoral data sharing is a weakness, that needs to be worked upon. (p.59) ⁴²⁶

No evidence of mechanisms for sharing of surveillance data was found via the Ministry of Health, Ministry of Agriculture or Ministry of Livestock for Tanzania. ⁴²⁷⁴²⁸⁴²⁹

Joint External Evaluation of the International Health Regulations (2005) core capacities of the United Republic of Tanzania – Zanzibar, conducted 21-25 August 2023, notes that surveillance reports are frequently published, but does not indicate whether or not animal, human, and wildlife surveillance data is shared among relevant ministries. (p.36-37) ⁴³⁰

A review of the websites of the Ministry of Health and Ministry of Agriculture of the Revolutionary Government of Zanzibar as well as media reports does not provide evidence of progress in these areas. ⁴³¹⁴³²

2.4.3 Transparency of surveillance data

2.4.3a Availability of de-identified health surveillance data on disease outbreaks

Score: 0

There is no evidence that Tanzania and Tanzania-Zanzibar make de-identified health surveillance data on infectious diseases publicly available via report (or other format) on government websites at least on a weekly basis.

The 2019 Health Information System Guidelines (HISG) by the United Republic of Tanzania – Ministry of Health, indicates that the Ministry of Health should publish reports on statistical figures at least on a yearly basis. (p.1-2) ⁴³³ A review of publications, reports, and other documents on the website of the Ministry of Health does not provide evidence of such data being published. ⁴³⁴ There is some data published on topics such as HIV/AIDS, Malaria, and TB and Leprosy on the Tanzania National Health Portal, however none of the statistics are updated on a weekly basis. ⁴³⁵

A review of publications, reports and other documents on the websites of the Ministry of Agriculture and the Ministry of Livestock of the United Republic of Tanzania, likewise does not provide evidence of such data being published. ⁴³⁶⁴³⁷ For Tanzania-Zanzibar the websites of the Ministry of Health and Ministry of Agriculture do not provide evidence of de-identified health surveillance data on disease outbreaks being made available. ⁴³⁸⁴³⁹

2.4.4 Ethical considerations during surveillance

2.4.4a Confidentiality legislation/regulations for identifiable health information

Score: 100

There is evidence that Tanzania and Tanzania-Zanzibar have laws, regulations, or guidelines that safeguard the confidentiality of identifiable health information for individuals, such as that generated through health surveillance activities.

Tanzania introduced the Personal Data Protection Act in 2023. ⁴⁴⁰ Health data is covered under personal sensitive data (art. 27). The 2019 Health Information System Guidelines (HISG) by the United Republic of Tanzania – Ministry of Health indicates that confidentiality of personal health information must always be protected, and data cannot be passed to unauthorized persons without explicit prior approval. (p.32-35)⁴⁴¹ Aggregated health data and health data that is de-identified is not considered confidential.

The websites of the Ministry of Constitutional and Legal Affairs and the Ministry of Health in the United Republic of Tanzania do not provide further evidence. ⁴⁴²⁴⁴³ Similarly, there is no evidence found via the websites of the Ministry of Health and Ministry of Agriculture of Zanzibar. ⁴⁴⁴⁴⁴⁵ There is no mention of such regulations in the Joint External Evaluation of the International Health Regulations (IHR) Core Capacities of the United Republic of Tanzania, conducted 14-18 August 2023, or in the Joint External Evaluation of IHR Core Capacities of Tanzania-Zanzibar, conducted 21-25 August 2023. ⁴⁴⁶⁴⁴⁷

2.4.4b Inclusion of cyber protections in health data confidentiality law/regulation

Score: 0

There is no evidence that Tanzania and Tanzania-Zanzibar have laws, regulations, or guidelines that safeguard the confidentiality of identifiable health information for individuals, such as that generated through health surveillance activities, for example protection from cyber attacks.

Tanzania introduced the Personal Data Protection Act in 2023. ⁴⁴⁸ However, this is a general regulation and does not specifically mention the confidentiality of identifiable health information. Cyber-attacks are only mentioned once, in article 27.c. which requires data controller or data processors to conduct processing in a robust manner "to withstand changes, regulatory demands, incidents and cyber-attacks". ⁴⁴⁹

The 2019 Health Information System Guidelines (HISG) by the United Republic of Tanzania – Ministry of Health indicates that confidentiality of personal health information must always be protected, and data cannot be passed to unauthorized persons without explicit prior approval. (p.32-35)⁴⁵⁰ Aggregated health data and health data that is de-identified is not considered confidential. Cyber-attacks and ransomware are not mentioned in these guidelines. ⁴⁵¹

The websites of the Ministry of Constitutional and Legal Affairs and the Ministry of Health in the United Republic of Tanzania do not provide further evidence. ⁴⁵²⁴⁵³ Similarly, there is no evidence found via the websites of the Ministry of Health and Ministry of Agriculture of Zanzibar. ⁴⁵⁴⁴⁵⁵ here is no mention of such regulations in the Joint External Evaluation of the International Health Regulations (IHR) Core Capacities of the United Republic of Tanzania, conducted 14-18 August 2023, or in the Joint External Evaluation of IHR Core Capacities of Tanzania-Zanzibar, conducted 21-25 August 2023. ⁴⁵⁶⁴⁵⁷

2.4.5 International data sharing

2.4.5a Cooperative commitments or agreements within regions

Score: 50

Although there is some evidence that Tanzania and Tanzania-Zanzibar share surveillance data with other countries in the region for one disease, there is no evidence that the government has made a commitment via public statements, legislation and/or a cooperative agreement to share surveillance data for either one or more diseases during a public health emergency with other countries in the region.

Tanzania is a member of the East Africa Public Health Laboratory Network Project, a World Bank funded project whose aim is to "to establish a network of efficient, high quality, accessible public health laboratories for the diagnosis and surveillance of Tuberculosis and other communicable diseases". This includes the East African Integrated Disease Surveillance Network, which aims to harmonize "integrated disease surveillance systems in the region" ⁴⁵⁸⁴⁵⁹.

Both regions are a part of the East African Community (EAC), a regional cooperative group of eight members states aimed at strengthening capacities in various critical areas including disease control and prevention. ⁴⁶⁰⁴⁶¹ As part of this initiative, the East African Integrated Disease Surveillance Network (EAIDSNet) has been established, which among others, has the following objectives: "promote exchange and dissemination of appropriate information on Integrated Disease Surveillance and other disease control activities; strengthen capacity for implementing integrated disease surveillance and control activities; and ensure continuous exchange of expertise and best practices for integrated disease surveillance and control". ⁴⁶² The webpages of the EAC, however, do not mention data sharing during public health emergencies. Tanzania is also a member-state to the International Health Regulations.⁴⁶³

The 2024 National Data Sharing Framework for Science, Technology and Innovation by the United Republic of Tanzania – Ministry of Education, Science and Technology states that "the country has actively participated in collaborative efforts aimed at enhancing data-sharing mechanisms, particularly in fields like health, where data interoperability is crucial for disease surveillance and healthcare delivery." (p.9)⁴⁶⁴ Whether or not data is shared among different countries and/or during public health emergencies is not mentioned in this document.

No further evidence is found via the Joint External Evaluations of IHR Capacities of both Tanzania and Tanzania-Zanzibar (conducted between 14-18 August 2023 and 21-25 August 2023 respectively), or the Ministry of Health nor Ministry of Agricultur for the two countries. ⁴⁶⁵⁴⁶⁶⁴⁶⁷⁴⁶⁸⁴⁶⁹⁴⁷⁰⁴⁷¹

2.5 Case-based investigation

2.5.1 Case investigation and contact tracing

2.5.1a National support to conduct contact tracing in the event of a public health emergency

Score: 50

There is evidence that Tanzania's national system is able to provide support at the sub-national level (e.g. training, metrics standardization and/or financial resources) to conduct contact tracing, but only in the event of a public health emergency.

'The Progress Report for the Implementation of the COVID 19 Response Plan WHO [World Health Organization] Tanzania Country Office January – June 2020' indicates that contact tracing was done at all district and community levels. ⁴⁷² "One hundred and sixty-six (166) health officers were trained as trainer of trainers (ToT) for Community Health Workers. These later trained 612 CHWs in Dar es Salaam with the support of the Benjamin Mkapa Foundation (BMF) through UNICEF funding". (p.19) ⁴⁷³ What kind of system is/was in place to facilitate these trainings, is not discussed in this country report.

Further and more up to date data is not available through the Joint External Evaluation of the International Health Regulations (2005) core capacities of the United Republic of Tanzania, conducted 14-18 August 2023, Joint External Evaluation of the International Health Regulations (2005) core capacities of the United Republic of Tanzania-Zanzibar, conducted 21-24 August 2023, and the Ministries of Health of Tanzania and Tanzania-Zanzibar. ⁴⁷⁴⁴⁷⁵⁴⁷⁶⁴⁷⁷

2.5.1b Provision of wraparound services to enable self-isolation/quarantine as recommended

Score: 0

No evidence was found that Tanzania can provide wraparound services to enable infected people and their contacts to self-isolate or quarantine as recommended, particularly economic support (paycheck, job security) and medical attention. The Joint External Evaluation of International Health Regulations (IHR) Core Capacities of the United Republic of Tanzania, conducted 14-18 August 2023, as well as the Joint External Evaluation of IHR Core Capacities of Tanzania-Zanzibar, conducted 21-25 August 2023, make no mention of wraparound services. ⁴⁷⁸⁴⁷⁹ And no evidence was found of such a system on the websites for the Ministry of Health for Tanzania or for Tanzania-Zanzibar ⁴⁸⁰⁴⁸¹

2.5.2 Point of entry management

2.5.2a Strategy for tracing and quarantining international travelers

Score: 0

There is insufficient evidence that Tanzania and Tanzania-Zanzibar have co operative agreements between the public health system and border control authorities to identify suspected and potential cases in international travelers and trace and quarantine their contact in the event of a public health emergency.

According to the Joint External Evaluation (JEE) of the International Health Regulations (2005) core capacities of the United Republic of Tanzania, conducted 14-18 August 2023, the points of entry (POE) of Tanzania are equipped to screen and manage sick travelers. (p.63) ⁴⁸² Furthermore, "the country has a digitalization of traveller health surveillance system called AfyaMsafiri platform that helps to track a traveller before arrival and subsequently facilitates contact tracing". (p.62) ⁴⁸³ The JEE references documents such as the '2022 port health operational guidelines' and the '2022 standard operating procedures for entry and exit screening of public health events at points of entry'. These documents are not available through the Ministry of Health or the Tanzania Ports Authority. ⁴⁸⁴⁴⁸⁵

No further evidence regarding a co operative agreement is available through the Ministry of Health or the Tanzania Ports Authority. ⁴⁸⁶⁴⁸⁷

The Joint External Evaluation (JEE) of the International Health Regulations (2005) core capacities of the United Republic of Tanzania-Zanzibar, conducted 21-25 August 2023, indicates that "all of the POEs have isolation facilities for suspected travellers; there is also transport available and mechanisms to refer suspected cases to designated health facilities."(p.59) ⁴⁸⁸ However, several POEs are known to have inadequate facilities and staff. (p.59) Furthermore, the JEE Tanzania-Zanzibar references the '2019 Zanzibar port health services regulation'. This document is not publicly accessible through the Ministry of Health. ⁴⁸⁹

The Ministry of Health does not provide further evidence regarding a co operative agreement between the public health system and border control authorities. ⁴⁹⁰

2.6 Epidemiology workforce

2.6.1 Existence of applied epidemiology training program such FETP and FETPV

2.6.1a Access to field epidemiology training program in country and/or abroad

Score: 100

There is evidence that both Tanzania and Tanzania-Zanzibar have an applied epidemiology training program.

According to the Joint External Evaluation (JEE) of the International Health Regulations (2005) core capacities of the United Republic of Tanzania, conducted 14-18 August 2023, training programmes are available for both field epidemiology and laboratory training. (p.43) ⁴⁹¹ Trainings are available at the basic, intermediate, and advanced level, and often provided through accredited institutions. ⁴⁹²

TEPHINET (Training Programs in Epidemiology and Public Health Interventions Network) indicates that the Tanzania Field Epidemiology and Laboratory Training Program (TFELTP) was established in 2008. ⁴⁹³ Since than 745 individuals have graduated from this program.

The Joint External Evaluation (JEE) of the International Health Regulations (2005) core capacities of the United Republic of Tanzania-Zanzibar, conducted 21-25 August 2023, also shows that field epidemiology training programmes (FETP) are available, and are conducted at the basic, intermediate and advanced level. (p.40) ⁴⁹⁴

2.6.1b Existence of field epidemiology training for animal health professionals

Score: 100

There is evidence that Tanzania and Tanzania-Zanzibar have field epidemiology training programmes in place, which are inclusive of animal health professionals.

According to the Joint External Evaluation of the International Health Regulations (2005) core capacities of the United Republic of Tanzania, conducted 14-18 August 2023, 75 livestock professionals have trained in the Service Applied Veterinary Epidemiology Training (ISAVET). (p.42) ⁴⁹⁵ The Food and Agriculture Organization of the United Nations (FAO), which has developed the ISAVET training, indicates that "frontline ISAVET strengthens field level preparedness, early detection and rapid effective response to transboundary animal diseases, emerging infectious diseases and antimicrobial resistance within an integrative One Health Approach."⁴⁹⁶ The United Republic of Tanzania, including Tanzania-Zanzibar, has partnered with the FAO in this programme. ⁴⁹⁷

The Joint External Evaluation of the International Health Regulations (2005) core capacities of the United Republic of Tanzania – Zanzibar, conducted 21-25 August 2023, mentions a field epidemiology training programme (FETP), however training for animal health professionals is not specifically mentioned. (p.40)⁴⁹⁸

2.6.2 Epidemiology workforce capacity

2.6.2a Evidence of at least 1 trained field epidemiologist per 200,000 people

Score: 100

There is public evidence that Tanzania and Tanzania-Zanzibar has at least 1 trained field epidemiologist per 200,000 people.

According to the World Bank Tanzania had 66,62 million inhabitants in 2023. ⁴⁹⁹ According to the Tanzania Field Epidemiology and Laboratory Training Program 745 people have graduated from their program. ⁵⁰⁰ Meaning that around 2,23 trained field epidemiologists are available per 200,000 people.

Rapid Response

3.1 Emergency preparedness and response planning

3.1.1 National public health emergency preparedness and response plan

3.1.1a National emergency response plan for diseases with pandemic potential

Score: 0

There is evidence that Tanzania has an overarching public health emergency response plans in place which address planning for multiple communicable diseases with epidemic or pandemic potential. There is no evidence that Tanzania-Zanzibar has an overarching public health emergency response plan.

In 2020 the Ministry of Health published the All-Hazard Public Health Emergency Response Plan. ⁵⁰¹ "This plan addresses emergency response across health system in events of all hazards. It will guide coordination of response activities at different levels and integration of activities by different stakeholders to avoid vertical approach. "(p. 6) ⁵⁰² Furthermore, it recommends actions such as early warning systems and rapid response guidelines. This plan does not mention budgets.

Furthermore, the National Disaster Management Strategy, 2022-2027 by the Prime Minister's Office of the United Republic of Tanzania, includes epidemics and zoonotic diseases in their broad discussion on planning for emergencies. (p.7-8) ⁵⁰³ Similarly, the United Republic of Tanzania Disaster Management Act of 2015 discusses emergency situations broadly, without touching upon public health situations. ⁵⁰⁴

Besides the broader strategy, contingency plans for a few diseases such as Ebola virus disease have been developed. ⁵⁰⁵⁵⁰⁶ The 2019 Revised National Ebola Viral Disease Preparedness and Response Contingency Plan by the United Republic of Tanzania – Ministry of Health provides guidelines for the coordination of mitigating measures, preparedness, and response measures for Ebola epidemics. (p.7-14) ⁵⁰⁷ The plan does not link to broader epidemics.

In 2025, the Revolutionary Government of Zanzibar published the 'Zanzibar Disaster Risk Financing and Insurance Assessment Report'. ⁵¹⁰ Whilst this report does include information on epidemic and disease outbreak, the report mostly focusses on disaster risk financing as opposed to emergency responses. (p.18) Furthermore, multipe threat types are not mentioned.

3.1.1b National public health emergency response plan published in past 3 years

Score: 0

There is no evidence that Tanzania and Tanzania-Zanzibar have overarching public health emergency response plans in place.

The National Disaster Management Strategy, 2022-2027 by the Prime Minister's Office of the United Republic of Tanzania, includes epidemics and zoonotic diseases in their broad discussion on planning for emergencies. (p.7-8) ⁵¹³ Similarly, the United Republic of Tanzania Disaster Management Act of 2015 discusses emergency situations broadly, without touching upon public health situations. ⁵¹⁴

Furthermore, in 2020 the Ministry of Health published the All-Hazard Public Health Emergency Response Plan. ⁵¹⁵ "This plan addresses emergency response across health system in events of all hazards. It will guide coordination of response activities at different levels and integration of activities by different stakeholders to avoid vertical approach. "(p. 6) ⁵¹⁶ While this plan mentions epidemics in a broad sense, it does not include information on how the country will respond to communicable diseases. ⁵¹⁷

Besides the broader strategy, contingency plans for a few diseases such as Ebola virus disease have been developed. ⁵¹⁸⁵¹⁹ The 2019 Revised National Ebola Viral Disease Preparedness and Response Contingency Plan by the United Republic of Tanzania – Ministry of Health provides guidelines for the coordination of mitigating measures, preparedness, and response measures for Ebola epidemics. (p.7-14) ⁵²⁰ The plan does not link to broader epidemics.

In 2025, the Revolutionary Government of Zanzibar published the 'Zanzibar Disaster Risk Financing and Insurance Assessment Report'. ⁵²³ Whilst this report does include information on epidemic and disease outbreak, the report mostly focusses on disaster risk financing as opposed to emergency responses. (p.18) Furthermore, multipe threat types are not mentioned.

3.1.1c One health principles by covering multiple threat types

Score: 0

There is no evidence that Tanzania and Tanzania-Zanzibar have national public health emergency response plans in place which cover multiple threat types.

The National Disaster Management Strategy, 2022-2027 by the Prime Minister's Office of the United Republic of Tanzania, includes epidemics and zoonotic diseases in their broad discussion on planning for emergencies. (p.7-8) ⁵²⁶ However, multiple and specific threat types such as antimicrobial resistance, zoonotic disease spillover, biological accidents and/or deliberate acts are not mentioned in this strategy. Similarly, the United Republic of Tanzania Disaster Management Act of 2015 discusses emergency situations broadly, without touching upon public health situations. ⁵²⁷

Furthermore, in 2020 the Ministry of Health published the All-Hazard Public Health Emergency Response Plan. ⁵²⁸ "This plan addresses emergency response across health system in events of all hazards. It will guide coordination of response activities at different levels and integration of activities by different stakeholders to avoid vertical approach. "(p. 6) ⁵²⁹ While this plan mentions epidemics in a broad sense, it does not include information on how the country will respond to communicable diseases. ⁵³⁰

Besides the broader strategy, contingency plans for a few diseases such as Ebola virus disease have been developed. ⁵³¹⁵³² The 2019 Revised National Ebola Viral Disease Preparedness and Response Contingency Plan by the United Republic of Tanzania – Ministry of Health provides guidelines for the coordination of mitigating measures, preparedness, and response measures for Ebola epidemics. (p.7-14) ⁵³³ The plan does not link to broader epidemics.

In 2025, the Revolutionary Government of Zanzibar published the 'Zanzibar Disaster Risk Financing and Insurance Assessment Report'. ⁵³⁶ Whilst this report does include information on epidemic and disease outbreak, the report mostly focusses on disaster risk financing as opposed to emergency responses. (p.18) Furthermore, multipe threat types are not mentioned.

3.1.1d Vulnerable populations in national public health emergency response plan

Score: 0

There is no evidence that Tanzania and Tanzania-Zanzibar have overarching public health emergency response plans in place which address planning for multiple communicable diseases with epidemic or pandemic potential.

The National Disaster Management Strategy, 2022-2027 by the Prime Minister's Office of the United Republic of Tanzania, includes epidemics and zoonotic diseases in their broad discussion on planning for emergencies. (p.7-8) ⁵³⁹ Similarly, the United Republic of Tanzania Disaster Management Act of 2015 discusses emergency situations broadly, without touching upon public health situations. ⁵⁴⁰

Furthermore, in 2020 the Ministry of Health published the All-Hazard Public Health Emergency Response Plan. ⁵⁴¹ "This plan addresses emergency response across health system in events of all hazards. It will guide coordination of response activities at different levels and integration of activities by different stakeholders to avoid vertical approach. "(p. 6) ⁵⁴² While this plan mentions epidemics in a broad sense, it does not include information on how the country will respond to communicable diseases. ⁵⁴³

Besides the broader strategy, contingency plans for a few diseases such as Ebola virus disease have been developed. ⁵⁴⁴⁵⁴⁵ The 2019 Revised National Ebola Viral Disease Preparedness and Response Contingency Plan by the United Republic of Tanzania – Ministry of Health provides guidelines for the coordination of mitigating measures, preparedness, and response measures for Ebola epidemics. (p.7-14) ⁵⁴⁶ The plan does not link to broader epidemics.

In 2025, the Revolutionary Government of Zanzibar published the 'Zanzibar Disaster Risk Financing and Insurance Assessment Report'. ⁵⁴⁹ Whilst this report does include information on epidemic and disease outbreak, the report mostly focusses on disaster risk financing as opposed to emergency responses. (p.18) Furthermore, multipe threat types are not mentioned.

3.1.2 Private sector involvement in response planning

3.1.2a Mechanism to engage private sector in outbreak preparedness/response

Score: 0

There is some evidence that Tanzania has a specific mechanism(s) for engaging with the private sector to assist with outbreak emergency preparedness and response. However, there is no evidence for such a mechanism existing in Tanzania-Zanzibar.

The National Disaster Management Strategy, 2022-2027 by the Prime Minister's Office of the United Republic of Tanzania, mentions a "private sector alliance for disaster resilience in line with the global Private Alliance for Disaster Resilient Societies (ARISE)". (p.31) ⁵⁵² However, the strategy does not clarify how this alliance will be implemented and how this should assist with emergency outbeak preparedness and response.

Furthermore, "the World Bank and the Global Facility for Disaster Reduction and Recovery (GFDRR), in collaboration with a range of development partners, have worked closely with the Government of Tanzania to deepen the country’s understanding of risk, enable better planning and financing to reduce that risk across sectors, and advance transformative investments for urban resilience". Projects supported through the GFDRR mostly took part in Tanzania's capital, Dar es Salaam. ⁵⁵³

The United Republic of Tanzania's Disaster Management Act of 2015 discusses emergency situations broadly, without touching upon public health situations and the private sector. ⁵⁵⁴

No further evidence is available through the Joint External Evaluation of the International Health Regulations (2005) core capacities of the United Republic of Tanzania, conducted 14-18 August 2023, or the website of the Prime Minister's Office. ⁵⁵⁵⁵⁵⁶

In 2025, the Revolutionary Government of Zanzibar published the 'Zanzibar Disaster Risk Financing and Insurance Assessment Report'. ⁵⁵⁷ Whilst this report does include information on the private sector this is mostly linked to financial risks and not emergency preparedness. (p.vii) ⁵⁵⁸

3.1.3 Non-pharmaceutical interventions planning

3.1.3a Policy/plan/guidelines in place to implement non-pharmaceutical interventions (NPIs)

Score: 0

There is no evidence that Tanzania or Tanzania-Zanzibar have a policy, plan and/or guidelines in place to implement non-pharmaceutical interventions (NPIs) during an epidemic or pandemic.

No evidence of such a plan is available via the Ministry of Health websites for Tanzania or Tanzania-Zanzibar. ⁵⁶¹⁵⁶² There is no mention of such a plan in either the International Health Regulations (2005) core capacities of the United Republic of Tanzania, conducted 14-18 August 2023, or in the Joint External Evaluation of the International Health Regulations (2005) core capacities of the United Republic of Tanzania – Zanzibar, conducted 21-25 August 2023. ⁵⁶³⁵⁶⁴ No other evidence of an NPI plan was found through a general media search.

3.2 Exercising response plans

3.2.1 Activating response plans

3.2.1a Completion of biological-focused IHR exercise with the WHO in past year

Score: 100

There is no evidence that Tanzania and Tanzania-Zanzibar have national public health emergency response plans and therefore no evidence that it has been activated for an infectious disease outbreak in the past year. There is evidence, however, that Tanzania has completed a national-level biological threat-focused exercise (either with WHO or separately) in the past year.

The National Disaster Management Strategy 2022-2027 by the Prime Minister's Office of the United Republic of Tanzania, includes epidemics and zoonotic diseases in their broad discussion on planning for emergencies. (p.7-8) ⁵⁶⁵ Besides the broader strategy, contingency plans for a few diseases such as the Marbug Virus Disease (MVD) were published. ⁵⁶⁶ The Marburg Virus Disease (MVD) Response Plan was published in January 2025. This plan was activated as MVD outbreak took place in January/February of 2025 by the United Republic of Tanzania – Ministry of Health. ⁵⁶⁷ It is confirmed by the World Health Organization (WHO) that a National Incident Management System was activated. ⁵⁶⁸

In 2025, the Revolutionary Government of Zanzibar published the 'Zanzibar Disaster Risk Financing and Insurance Assessment Report'. ⁵⁷¹ Whilst this report does include information on epidemic and disease outbreak, the report mostly focusses on disaster risk financing as opposed to emergency responses. (p.19) Furthermore, multipe threat types are not mentioned.

3.2.1b Evidence of bio-focused exercise to identify gaps/best practices

Score: 0

There is no evidence that Tanzania and Tanzania-Zanzibar have undergone an exercise to identify a list of gaps and best practices through either an after action review (post emergency response) or a biological threat-focused International Health Regulations (IHR) exercise with the World Health Organization (WHO).

Evidence from the WHO indicates that Tanzania underwent an after-action review after the outbreak of Marburg Virus Disease (MVD) in 2023. ⁵⁷⁴ Challenges such as "late detection of initial cases including index cases, and referral of infectious cases from lower health facilities, limited adherence to contact isolation requirements by the contacts under home quarantine, inadequate space and functionality of the PHEOC [public health emergency operations centre] in Kagera region, limited involvement of other sectors during the response due to lack of interest" were mentioned. ⁵⁷⁵ There is no such review conducted in the past year, and no planned review is listed. ⁵⁷⁶ Since the WHO's definition of Tanzania's scope includes Zanzibar, this applies to Tanzania-Zanzibar as well. ⁵⁷⁷

Tanzania underwent multiple MVD simulations, with the objective to "evaluate and improve the country's preparedness, the World Health Organization (WHO) in collaboration with the Ministry of Health and other partners, organized a tabletop simulation exercise to test the National Multi-Hazard Emergency Response Plan and the National MVD Contingency Plan."⁵⁷⁸⁵⁷⁹ The Marburg Virus Disease (MVD) Response Plan published January 2025 by the United Republic of Tanzania – Ministry of Health, does not mention a list of gaps or best practices. ⁵⁸⁰

3.2.2 Private sector engagement in exercises

3.2.2a Evidence of national-level biological threat-focused exercise that includes private sector

Score: 0

There is no evidence that Tanzania has undergone a national-level biological threat-focused exercise that has included private sector representatives.

During the last year, Tanzania took part in several Mulburg Virus Disease (MVD) related simulations. ⁵⁸¹⁵⁸² In late 2024, a tabletop simulation exercise was held with the World Health Organization (WHO), the Ministry of Health, and other partners. ⁵⁸³ 40 individuals from different sectors were involved in this exercise, however it is unclear if the private sector was included. Similarly, after a MVD outbreak in early 2025 cross-border collaboration was strengthened through another exercise. ⁵⁸⁴ In this case 68 professionals from Kagera, Mwanza, Geita, and Kigoma participated. Again it is not clear whether or not the private sector was included. ⁵⁸⁵

No further evidence of such involvement was available on the Tanzania's Ministry of Health or Ministry of Defence websites or from Tanzania-Zanzibar's Ministry of Health website. ⁵⁸⁶⁵⁸⁷⁵⁸⁸

3.3 Emergency response operation

3.3.1 Emergency response operation

3.3.1a Existence of Emergency Operations Center (EOC)

Score: 100

There is evidence that both Tanzania and Tanzania-Zanzibar have an Emergency Operations Center (EOC).

According to the Joint External Evaluation of the International Health Regulations (2005) core capacities of the United Republic of Tanzania, conducted 14-18 August 2023, Tanzania's national public health emergency operations center (PHEOC) is situated at the Ministry of Health in Dodoma. ⁵⁸⁹ A further six regions have PHEOCs at the intermediate level. (p.47) ⁵⁹⁰

Tanzania-Zanzibar has one subnational EOC located in Pemba. ⁵⁹¹ The Joint External Evaluation of the International Health Regulations (2005) core capacities of the United Republic of Tanzania – Zanzibar, conducted 21-25 August 2023, indicates that the EOC is permanently staffed and supported by the Ministry of Health. (p.44)

3.3.1b Requirement for EOC to conduct/evidence EOC conducts at least annual drills

Score: 0

There is insufficient evidence that the Emergency Operations Center (EOC) in Tanzania and Tanzania-Zanzibar require drills for public health emergency scenarios at least once per year.

According to the Joint External Evaluation (JEE) of the International Health Regulations (2005) core capacities of the United Republic of Tanzania, conducted 14-18 August 2023, Tanzania's national public health emergency operations center (PHEOC) is situated at the Ministry of Health in Dodoma. (p.47) ⁵⁹² The JEE indicates that there is formal training plans are lacking, and "relevant personnel are unable to activate the emergency operations centre in 120 minutes". (p.47) ⁵⁹³ Drills are not specifically mentioned.

The 2017 'Standard Operating Procedures for Emergency Operation and Communication Center (EOCC)'by the Prime Minister's Office of the United Republic of Tanzania, does mention drills, indicating that the EOCC will be used for disaster drills during non disaster times. (p.39) ⁵⁹⁴ These Standard Operating Procedures do not mention whether or not drills are a requirement.

In 2024 Tanzania organized a chemical, biological, radiological and nuclear (CBRN) training. ⁵⁹⁵ "CBRN field exercises are coordinated activities which present potential real-life scenarios under simulated situations that law enforcement officers, emergency services and other response units might face if deployed in case of a CBRN threat." ⁵⁹⁶ It is unclear if EOC participated in this exercise.

Tanzania-Zanzibar has one subnational EOC located in Pemba. ⁵⁹⁷ The Joint External Evaluation of the International Health Regulations (2005) core capacities of the United Republic of Tanzania – Zanzibar, conducted 21-25 August 2023, indicates that there are "inadequate resources for regular simulation exercises". (p.44) ⁵⁹⁸ It is unclear if there is a requirement to conduct drills on at least a yearly basis.

There is no further evidence on the websites of the Ministries of Health of Tanzania and Tanzania-Zanzibar. ⁵⁹⁹⁶⁰⁰

3.3.1c EOC activation within 120 minutes of identification of emergency/scenario

Score: 0

There is evidence that both Tanzania and Tanzania-Zanzibar have emergency response centers, however there is no evidence that Tanzania is capable of responding within 120 minutes of the identification of a public health emergency.

According to Joint External Evaluation (JEE) of the International Health Regulations (2005) core capacities of the United Republic of Tanzania, conducted 14-18 August 2023, mainland Tanzania has several public health emergency operations centers (PHEOC) at both the national and intermediate level. ⁶⁰¹ However, the JEE report indicates that staff is "unable to activate the emergency operations centre in 120 minutes". (p.47) ⁶⁰² There is no evidence available on the website of the Ministry of Health that counters this statement. ⁶⁰³

The Joint External Evaluation of the International Health Regulations (2005) core capacities of the United Republic of Tanzania – Zanzibar , conducted 21-25 August 2023, indicates that a EOC is located in Pemba Zanzibar and that the "EOC can be activated by an executive order within 120 minutes of receiving an alert. In addition, the subnational level has electronically linked alert desks that play the role of the EOC". (p.44)⁶⁰⁴ There is no evidence on the Zanzibar Ministry of Health that coordinated emergency responses took place within the last year, and that these were activated within 120 minutes. ⁶⁰⁵

3.4 Linking public health and security authorities

3.4.1 Public health and security authorities linked for a biological event

3.4.1a Joint exercise/procedures for potential deliberate biological events

Score: 0

There is no evidence that the public health and national security authorities have carried out an exercise to respond to a potential deliberate biological event (i.e., bioterrorism attack), and there is no evidence that there exist standard operating procedures, guidelines, memorandums of understanding (MOUs), or other agreements between the public health and security authorities to respond to a potential deliberate biological event (i.e., bioterrorism attack).

In 2024, Tanzania organized a simulation exercise to enhance preparedness for Marburg Virus Disease (MVD). ⁶⁰⁶ "The exercise saw the participation of 40 individuals from various sectors involved in emergency response at the national, regional, and district levels." It is unclear who exactly participated, and if this included participants from the animal health sector or the private sector. In 2019, simulations regarding Ebola and Rift Valley Fever took place. ⁶⁰⁷⁶⁰⁸ It was unclear who took part in the Ebola simulation. ⁶⁰⁹ However, the cross-border field simulation exercise between Kenya and Tanzania on Rift Valley Fever included 300 participants from "Ministries of East African Affairs, Health, Agriculture, Tourism, Trade, Environment and Defence; from tourism, trade and business; public laboratories and health facilities; slaughter houses; Ports of Entry; community and religious leaders; as well as East African public health experts who fought the Ebola epidemic in West Africa". (p.16) ⁶¹⁰ Deliberate attacks were not covered in this exercise.

According to the Joint External Evaluation (JEE) of the International Health Regulations (2005) core capacities of the United Republic of Tanzania, conducted 14-18 August 2023, "legislation, relationships, protocols, MoUs or agreements between public health and security authority entities exist". (p.51) ⁶¹¹ Furthermore, the National Disaster Preparedness and Response Plan 2022, by the Prime Minister's Office, outlines "actions and procedures to be taken by Government institutions, multilateral and aid organizations, NGOs, volunteer organizations, and relevant stakeholders in relation to disaster management and to mitigate the impact on the public. (p.50) ⁶¹² The animal health sector is not mentioned in the National Disaster Preparedness and Response Plan. ⁶¹³

In 2024 Tanzania organized a chemical, biological, radiological and nuclear (CBRN) training. ⁶¹⁴ "CBRN field exercises are coordinated activities which present potential real-life scenarios under simulated situations that law enforcement officers, emergency services and other response units might face if deployed in case of a CBRN threat." ⁶¹⁵ The exercise seems to have focussed on chemical and radiological release at the Port of Dar es Salaam, as opposed to a deliberate biological event. ⁶¹⁶

There is no evidence available via the Ministry of Health or the Ministry of Agriculture. ⁶¹⁷⁶¹⁸

The Joint External Evaluation of the International Health Regulations (2005) core capacities of the United Republic of Tanzania – Zanzibar , conducted 21-25 August 2023, indicates that the 2021 Zanzibar Emergency Preparedness and Response Plan (ZEPRP) outlines the responsibilities of law enforcement during major disasters. (p.47) ⁶¹⁹The ZEPRP is not publicly available through the Tanzania-Zanzibar Ministry of Health or Ministry of Agriculture. ⁶²⁰⁶²¹

There is no further evidence available on the websites of Ministry of Health or the Ministry of Agriculture of Tanzania-Zanzibar. ⁶²²⁶²³

3.5 Risk communication

3.5.1 Risk communication planning

3.5.1a Risk communication plan for specific use during a public health emergency

Score: 100

There is evidence that both Tanzania and Tanzania-Zanzibar have risk communications plans in place that can be used or are intended specifically to address public health emergencies.

The Prime Minister's Office of the United Republic of Tanzania has published a multi-hazard risk communication strategy in place, the Tanzania Disaster Communication Strategy (TDCS) 2012. ⁶²⁴ The TDCS outlines responsibilities, direction and control, as well as administration and logistics. (p.10)⁶²⁵ The East African Community, of which Tanzania is a member, also had the 'One Health Regional Risk and Crisis Communication Strategy (2018/2019 – 2022/2023)'. ⁶²⁶ According to this report Tanzania also has a National Communication Guidelines for Public Health Risks and Emergencies. (p.15) ⁶²⁷ Based on the Ministry of Health and a broad search of the web, the guideline does not appear to be publically available. ⁶²⁸

In 2011, the Revolutionary Government of Zanzibar published the 'Zanzibar Disaster Communication Strategy (ZDCZ)', which "outlines the organization, operational concepts, responsibilities, and procedures to accomplish emergency communications requirements", with public health emergencies included within the scope of the document. (p.iii) ⁶²⁹ The ZDCZ does not include a specific communication structure for public health emergencies. Nonetheless, the ZDCZ establishes an Emergency Communication Centre (ECC) which will receive instructions from the Director of Public health to disseminate information when emergency situations arise and also states that the Department of Preventive and Public Health Services would be involved in the communication. (p.13) ⁶³⁰

There is no further information found on the Tanzania-Zanzibar websites for the Ministry of Health and Ministry of Agriculture. ⁶³¹⁶³²

3.5.1b Inclusion of different population & sector needs in risk communication plan

Score: 0

There is no evidence that risk communication plans in either Tanzania or Tanzania-Zanzibar outline how messages will reach populations and sectors with different communications needs.

The Prime Minister's Office of the United Republic of Tanzania has published a multi-hazard risk communication strategy in place, the Tanzania Disaster Communication Strategy (TDCS) 2012. ⁶³³ The plan outlines responsibilities, direction and control, as well as administration and logistics. (p.10) ⁶³⁴ Different communication needs for certain populations or sectors, are not mentioned. The East African Community, of which Tanzania is a member, also had the 'One Health Regional Risk and Crisis Communication Strategy (2018/2019 – 2022/2023)'. ⁶³⁵ According to this report Tanzania also has a National Communication Guidelines for Public Health Risks and Emergencies. (p.15) ⁶³⁶ Based on the Ministry of Health and a broad search of the web, the guideline does not appear to be publically available. ⁶³⁷

In 2011, the Revolutionary Government of Zanzibar published the 'Zanzibar Disaster Communication Strategy (ZDCZ)', which "outlines the organization, operational concepts, responsibilities, and procedures to accomplish emergency communications requirements", with public health emergencies included within the scope of the document. (p.iii) ⁶³⁸ The strategy does not include a specific communication structure for populations and sectors that may have different needs. Nonetheless, the plan establishes an Emergency Communication Centre (ECC) which will receive instructions from the Director of Public health to disseminate information when emergency situations arise and also states that the Department of Preventive and Public Health Services would be involved in the communication. (p.13) ⁶³⁹

There is no further information found on the Tanzania-Zanzibar websites for the Ministry of Health and Ministry of Agriculture. ⁶⁴⁰⁶⁴¹

3.5.1c Designation of a specific government spokesperson during a public health emergency

Score: 100

There is evidence that both Tanzania and Tanzania-Zanzibar have risk communications plans in place that designate a specific position within the government to serve as the primary spokesperson to the public during a public health emergency.

The Prime Minister's Office of the United Republic of Tanzania has published a multi-hazard risk communication strategy in place, the Tanzania Disaster Communication Strategy (TDCS) 2012. ⁶⁴² The plan outlines responsibilities, direction and control, as well as administration and logistics. (p.10) ⁶⁴³ Different communication needs for certain populations or sectors, are not mentioned. The East African Community, of which Tanzania is a member, also had the 'One Health Regional Risk and Crisis Communication Strategy (2018/2019 – 2022/2023)'. ⁶⁴⁴ According to this report Tanzania also has a National Communication Guidelines for Public Health Risks and Emergencies. (p.15) ⁶⁴⁵ Based on the Ministry of Health and a broad search of the web, the guideline does not appear to be publically available. ⁶⁴⁶

In 2011, the Revolutionary Government of Zanzibar published the 'Zanzibar Disaster Communication Strategy (ZDCZ)', which "outlines the organization, operational concepts, responsibilities, and procedures to accomplish emergency communications requirements", with public health emergencies included within the scope of the document. (p.iii) ⁶⁴⁷The strategy specifies that the communication coordinator under the director of the Disaster Management Department (DMD) is in charge of the Emergency Communication Center (ECC) and its activities.⁶⁴⁸ The plan establishes an ECC which than receive instructions from the Director of Public health to disseminate information when emergency situations arise and also states that the Department of Preventive and Public Health Services would be involved in the communication. (p.13) ⁶⁴⁹

There is no further information found on the Tanzania-Zanzibar websites for the Ministry of Health and Ministry of Agriculture. ⁶⁵⁰⁶⁵¹

3.5.2 Public health systems communication

3.5.2a Government use of media platforms to share info on public health emergencies

Score: 0

There is no evidence that in the past year, the public health system of Tanzania and Tanzania-Zanzibar has actively shared messages via online media platforms to inform the public about ongoing public health concerns.

A review of publications, reports and other documents on the websites of the Tanzania Ministry of Health do not provide evidence of such data being published. ⁶⁵² The Ministry of Health has a public facebook and X account. ⁶⁵³⁶⁵⁴ The facebook account was last used in May 2025 to announce that the secretary of the Ministry of Health has taken a tour of healthcare facilities. ⁶⁵⁵ The X account was last used in May 2025, after a hiatus of 5 years, to announce that Professor Mohammed Janabi was elected as the Director of the World Health Organization Africa Region. ⁶⁵⁶ There is no indication that these channels have been used to dispel rumors or discus ongoing public health concerns in the last year.

The Ministry of Health in Tanzania-Zanzibar actively uses a facebook account, posts cover topics such as performance of medical officers and the participation of the Ministry of Health in research sessions. ⁶⁵⁷ The website of the Ministry of Health also has a section on the latest news. ⁶⁵⁸ There is no evidence that this section has been used to dispel rumors.

The publishing language of all social media accounts as well as the news section of the Ministry of Health for both Tanzania and Tanzania-Zanzibar is Kiswahili.

3.5.2b Evidence that senior leaders have shared mis/disinformation on infectious diseases

Score: 100

There is no evidence that senior leaders in Tanzania and Tanzania-Zanzibar has shared misinformation on infectious diseases in the past two years.

In 2025, the President of Tanzania, Samia Suluhu Hassan, has announced the outbreak of the Marburg Virus Disease (MVD). ⁶⁵⁹ Whilst declaring the outbreak the president thanked the World Health Organization for its swift attention and stated that "the government took several measures including the investigation of suspected individuals and the deployment of emergency response teams". ⁶⁶⁰ Furthermore, the Daily News of Tanzania, indicated that the health sector has significantly improved under the leadership of President Hassan. ⁶⁶¹ Health Ministry Ummy Mwalimu listed achievements such as an increased number in health service delivery facilities and increased diagnostic and disease detection equipment. ⁶⁶²

Similarly, the President of Zanzibar Dr Hussein Ali Mwinya "has expressed satisfaction with the successful establishment of the Zanzibar Health Services Fund (ZHSF), while praising setting up medical camps for delivering specialized treatment to many ordinary people". ⁶⁶³ Furthermore, the Zanzibar President has affirmed his and his administration's commitment to improving the healchare sector. ⁶⁶⁴

3.6 Access to communications infrastructure

3.6.1 Internet users

3.6.1a Percentage of households with Internet

Score: 29.74

3.6.2 Mobile subscribers

3.6.2a Mobile-cellular telephone subscriptions per 100 inhabitants

Score: 57

3.6.3 Female access to a mobile phone

3.6.3a Gender gap in access to a mobile phone (percentage points)

Score: 60

3.6.4 Female access to the Internet

3.6.4a Gender gap in access to the Internet (percentage points)

Score: 37.5

3.7 Trade and travel restrictions

3.7.1 Trade restrictions

3.7.1a Restrictions on export/import of medical goods due to an infectious disease outbreak

Score: 100

There is no evidence that Tanzania has issued restrictions on the export/import of medical goods due to an infectious disease outbreak.

In January 2025, a Marburg Virus Disease (MVD) outbreak was declared. The World Health Organization (WHO), writing about the outbreak, the public health response, and providing advice, does not mentioned restrictions on the importing or exporting of medical goods nor does it recommend that restrictions take place. ⁶⁶⁵

There is no information on restrictions of medical goods on the websites of the Tanzania Ministry of Health or the Tanzania-Zanzibar Ministry of Health. ⁶⁶⁶⁶⁶⁷

3.7.1b Restrictions on movement and/or exports/imports due to disease outbreak

Score: 100

There is no evidence that Tanzania has issued restrictions on the export/import of non-medical goods due to an infectious disease outbreak.

In January 2025, a Marburg Virus Disease (MVD) outbreak was declared. The World Health Organization (WHO), writing about the outbreak, the public health response, and providing advice, does not mentioned restrictions on the importing or exporting of non-medical goods nor does it recommend that restrictions take place. ⁶⁶⁸ In fact, the WHO "advises against any travel and trade restrictions with the United Republic of Tanzania". ⁶⁶⁹

There is no information on restrictions of non-medical goods on the websites of the Tanzania Ministry of Health or the Tanzania-Zanzibar Ministry of Health. ⁶⁷⁰⁶⁷¹

3.7.2 Travel restrictions

3.7.2a Evidence of travel ban due to an infectious disease outbreak

Score: 100

There is no evidence that Tanzania has implemented a ban on travelers arriving from a specific country or countries due to an infectious disease outbreak.

Between January and March 2025 the United Republic of Tanzania suffered from a Marburg Virus Disease (MVD) outbreak in the Kagera region, in the North-Western part of the country. ⁶⁷²⁶⁷³ The Ministry of Health published the 'travel advisory NO.15 of 21st January 2025, outlining measures for both local and international travellers. ⁶⁷⁴ Measures include filling out an online from, checking body temperature at points of entry, and providing a toll-free number to enable self-monitoring and self-reporting. ⁶⁷⁵ Neither inbound nor outbound travel was restricted. This stance is supported by the World Health Organization (WHO), which "advises against any travel and trade restrictions with the United Republic of Tanzania". ⁶⁷⁶ The WHO bases this statement on their own risk assessment.

There is no evidence on the websites of the Tanzanian Ministry of Health and the Tanzania-Zanzibar Ministry of Health that other travel restrictions were imposed during the past year. ⁶⁷⁷⁶⁷⁸

3.7.2b Risk-based approach to international travel-related measures

Score: 0

There is insufficient evidence that Tanzania uses a risk-based approach to international travel-related measures.

Between January and March 2025 the United Republic of Tanzania suffered from a Marburg Virus Disease (MVD) outbreak in the Kagera region, in the North-Western part of the country. ⁶⁷⁹⁶⁸⁰ The Ministry of Health published the 'travel advisory NO.15 of 21st January 2025, outlining measures for both local and international travellers. ⁶⁸¹ Measures include filling out an online from, checking body temperature at points of entry, and providing a toll-free number to enable self-monitoring and self-reporting. ⁶⁸² The travel advisory does not indicate that a risk-based approach was used.

The World Health Organization (WHO) "advises against any travel and trade restrictions with the United Republic of Tanzania". ⁶⁸³ The WHO bases this statement on their own risk assessment. The travel advisory from the Tanzanian government does not refer to the WHO advise. ⁶⁸⁴

Health System

4.1 Health capacity in clinics, hospitals and community care centers

4.1.1 Available human resources for the broader healthcare system

4.1.1a Doctors per 100,000 people

Score: 1.46

4.1.1b Nurses and midwives per 100,000 people

Score: 6.15

4.1.1c Updated health workforce strategy to address human resource shortfalls

Score: 0

There is evidence that Tanzania has a health workforce strategy in place, updated in the past five years, that identifies fields where there is an insufficient workforce and strategies to address these shortcomings. However, there is insufficient evidence that Tanzania-Zanzibar has a health workforce strategy in place.

According to the Joint External Evaluation of the International Health Regulations (2005) core capacities of the United Republic of Tanzania, conducted 14-18 August 2023, "the Ministry of Health as developed a well-articulated workforce strategy that is ending in 2026 that puts into consideration avenues for developing a robust health workforce for public health emergencies." (p.41)⁶⁸⁷ The Health Sector Strategic Plan July 2021 – June 2026 (HSSP V) by the United Republic of Tanzania – Ministry of Health, indicates that the country strives for a "competent health workforce with adequate and updated competencies in adequate numbers available". (p.45) ⁶⁸⁸ Trainings will be established to fill gaps in knowledge, availability of trainers, equipment, and infrastructure will be improved, and quality assurance will be enhanced. (p.45) ⁶⁸⁹

The Zanzibar Development Plan (ZADEP) 2021-2026 by the Revolutionary Government of Zanzibar, includes a brief section on human capital and the health sector. However, aspirations moreso cover an accessible and reliable healthcare sector than the goal to improve its workforce. (p. 55-57)⁶⁹⁰ Similarly, the Joint External Evaluation of the International Health Regulations (2005) core capacities of the United Republic of Tanzania – Zanzibar, conducted 21-25 August 2023, provides no further information. ⁶⁹¹

4.1.1d Health system capacity for essential health services

Score: 0

There is no evidence that Tanzania and Tanzania-Zanzibar has sufficient capacity within the health system to deliver essential health services.

According to the Human Resources for Health – Tanzania Mainland Country Profile by the United Republic of Tanzania – Ministry of Health, states that: "The health sector was found to have 1 doctor per 8,882 population and 1 nurse per 1,289 population. This represents 10,171 doctors and nurses per 10,000 population, which is significantly less than the WHO [World Health Organization] recommendation of 439 (22.8) doctors, nurses and midwives per 10,000 population." (p.7)⁶⁹² In a similar vein, the World Bank reported that Tanzania had fewer health professionals than its neighbouring countries. (p.6) ⁶⁹³

The Joint External Evaluation of the International Health Regulations (2005) core capacities of the United Republic of Tanzania, conducted 14-18 August 2023, indicates that while Tanzania has a strong capability of training public health staff, it has trouble retaining these people due to retirement, termination, death, and resignation. (p.41) ⁶⁹⁴ The March 2025, Human Resources for Health Report (Mid-Term Review (MTR) of the Health Sector Strategic Plan V (HSSP v)) by the United Republic of Tanzania, does show that recent retention initiatives have proved successful and reached 128,000 health workers. (p.iii) ⁶⁹⁵

In Tanzania-Zanzibar, the government is committed to transition community health volunteers to a professional community health workforce. ⁶⁹⁶ Furthermore, the Zanzibar Development Plan (ZADEP) 2021-2026 by the Revolutionary Government of Zanzibar aspires to create a "resilient healthcare system with adequate contingency plans to maintain the high coverage of essential services in crisis situations". (p.56) ⁶⁹⁷ The Joint External Evaluation of the International Health Regulations (2005) core capacities of the United Republic of Tanzania – Zanzibar, conducted 21-25 August 2023, provides no information on the capacity of the healthcare system in Tanzania-Zanzibar. ⁶⁹⁸

4.1.1e Essential health services continuity plan for public health emergencies

Score: 0

There is evidence that Tanzania has a plan to ensure continuity of essential health services during a public health emergency. However, there is no evidence that Tanzania-Zanzibar has a plan to ensure continuity of essential health services during a public health emergency.

According to the Joint External Evaluation of the International Health Regulations (2005) core capacities of the United Republic of Tanzania, conducted 14-18 August 2023, "the Ministry of Health as developed a well-articulated workforce strategy that is ending in 2026 that puts into consideration avenues for developing a robust health workforce for public health emergencies." (p.41)⁶⁹⁹ The Health Sector Strategic Plan July 2021 – June 2026 (HSSP V) by the United Republic of Tanzania – Ministry of Health, indicates that the government is responsible for emergency preparedness, en will ensure that necessary medicines and equipment are available to emergency and post-emergency services. ⁷⁰⁰ "Lessons learned from Ebola and COVID-19 show that even more people can suffer from this “collateral damage” than from the emergency itself. The emergency response therefore includes maintaining regular services as much as possible". (p.35) ⁷⁰¹

The Zanzibar Development Plan (ZADEP) 2021-2026 by the Revolutionary Government of Zanzibar, includes information on human capital and the health sector, but does not indicate whether or not continuity of essential health services are guaranteed during public health emergencies. (p. 55-57)⁷⁰² Similarly, the Joint External Evaluation of the International Health Regulations (2005) core capacities of the United Republic of Tanzania – Zanzibar, conducted 21-25 August 2023, provides no further information. ⁷⁰³

4.1.2 Facilities capacity

4.1.2a Hospital beds per 100,000 people

Score: 12.42

4.1.2b In-country capacity to isolate patients with highly communicable diseases

Score: 0

There is evidence that Tanzania has the capacity to isolate patients with highly communicable diseases in a biocontainment patient care unit. There is insufficient evidence that the same applies to Tanzania-Zanzibar.

The Muhimbili National Hospital, one of the largest hospitals in Tanzania has two isolation beds with negative pressure air control available in the medical intensive unit and another two isolation beds in the surgical intensive care unit.⁷⁰⁴ Furthermore, in 2024 the World Health Organization (WHO) and the United States Agency for International Development (USAID) handed over a isolation unit in Mutukula, in the Kagera region. ⁷⁰⁵ The isolation unit replaces a tent that was temporarily used to isolate patients. It is unclear how many patients the new unit can hold.

According to the Joint Evaluation of the International Health Regulations (2005) core capacities of the United Republic of Tanzania-Zanzibar, conducted in 21-25 August 2023, Zanzibar has isolation facilities at all points of entry. (p.59) ⁷⁰⁶ However, these are often times inadequate. Furthermore, there are no isolation units for highly infectious diseases in health facilities. (p.54) ⁷⁰⁷

There is no further evidence on isolation units on the Tanzanian-Zanzibar Ministry of Health. ⁷⁰⁸

4.1.2c Demonstrated capacity / evidence of plan to expand isolation capacity

Score: 0

There is no evidence that Tanzania or Tanzania-Zanzibar have demonstrated the capacity to expand isolation capacity in response to an infectious disease outbreak or that the country has developed, updated or tested a plan to expand isolation capacity in response to an infectious disease outbreak in the past two years.

There is no evidence found via the Tanzania Ministry of Health. ⁷⁰⁹ The Muhimbili National Hospital, one of the largest hospitals in Tanzania has two isolation beds with negative pressure air control available in the medical intensive unit and another two isolation beds in the surgical intensive care unit. ⁷¹⁰ It is unclear if this number was recently expanded or will be expanded upon in the future. ⁷¹¹

The Joint External Evaluation of the International Health Regulations (2005) core capacities of the United Republic of Tanzania, conducted 14-18 August 2023, does not mention isolation capacity in regards to healthcare facilities.⁷¹² However, the report states that isolation facilities are non-existent at entry points into the country. (p.62) ⁷¹³

The Joint External Evaluation of the International Health Regulations (2005) core capacities of the United Republic of Tanzania – Zanzibar, conducted 21-25 August 2023, indicates that "there are holding facilities for the isolation of suspect/ill travellers". However, there are also airports, such as the Pemba airport, that do not have these facilities. (p.60) ⁷¹⁴ There is no evidence found through the website of the Zanzibar Ministry of Health. ⁷¹⁵

4.2 Supply chain for health system and healthcare workers

4.2.1 Routine health care and laboratory system supply

4.2.1a National procurement protocol for the acquisition of routine laboratory/medical supplies

Score: 100

There is evidence that Tanzania and Tanzania-Zanzibar have national procurement protocols in place which can be utilized by the Ministries of Health and Agriculture for the acquisition of laboratory supplies (such as equipment, reagents and media) and medical supplies (equipment, PPE) for routine needs.

Public procurement in Tanzania is regulated by the Public Procurement Act NO.10 of 2023 which provides for the standards of equity and the duties of procuring entities. Article 2 indicates that this act expressly applies to all types of public procurement. ⁷¹⁶The Public Procurement Regulatory Authority (PPRA) is charged with overseeing these regulations and it runs a tenders portal as well as a national e-procurement system, from which both laboratory and medical supplies can be purchased. ⁷¹⁷⁷¹⁸ These systems also include the Tanzanian Ministry of Health and Ministry of Agriculture in their list of procuring entities. ⁷¹⁹

In Tanzania-Zanzibar public procurement is regulated by the 'An act to repeal the public procurement and disposal of public assets act, NO.11 of 2016 and enact the public procurement act to provide comprehensive provisions to regulate and control public procurements and other matters related thereto' of 2025. ⁷²⁰ Article 2 states that the act applies to all public procurement. ⁷²¹ The Zanzibar Public Procurement Regulatory Authority (ZPPRA) is charged with overseeing this regulation ⁷²² Unfortunately, some of the links on the website of the ZPPRA do not appear to work. Hence a list of procuring entities is not available. ⁷²³

4.2.2 Stockpiling for emergencies

4.2.2a Stockpile of medical supplies for national use during a public health emergency

Score: 0

There is some evidence that Tanzania has a stockpile of medical supplies for national use during a public health emergency. There is no evidence that Tanzania-Zanzibar maintains a stockpile of medical supplies for national use during a public health emergency. Furthermore, the country does not have overarching national public health emergency response plans in place, and other relevant plans make no mention of stockpiles or equitable distribution.

In the case of Tanzania-Zanzibar, the Joint External Evaluation (JEE) of the International Health Regulations (2005) core capacities of the United Republic of Tanzania-Zanzibar, conducted 21-25 August 2023, states that "the Ministry of Health has a fully functional logistics and supply chain mechanism but occasionally experiences some stock-outs and delays in dispatches of supplies to the field". (p.43) ⁷²⁷

Neither Tanzania nor Tanzania-Zanzibar have a overarching national public health emergency response plan. Plans and/or strategies that do cover public health response such as the National Disaster Management Strategy 2022-2027 (by the United Government of Tanzania), All-Hazard Public Health Emergency Response Plan (2020, by the United Republic of Tanzania), and the Zanzibar Disaster Risk Financing and Insurance Assessment Report (2025, by the Revolutionary Government of Zanzibar), make no mention of stockpiles or equitable distribution. ⁷²⁸⁷²⁹⁷³⁰

There is no evidence available through the Tanzania Ministry of Health and the Tanzania-Zanzibar Ministry of Health. ⁷³¹⁷³²

4.2.2b Stockpile of laboratory supplies for national use during a public health emergency

Score: 0

There is insufficient evidence that Tanzania has a stockpile of laboratory supplies for national use during a public health emergency. There is no evidence that Tanzania-Zanzibar maintains a stockpile of laboratory supplies for national use during a public health emergency. Furthermore, the country does not have overarching national public health emergency response plans in place, and other relevant plans make no mention of stockpiles.

There is no evidence available through the Tanzania Ministry of Health and the Tanzania-Zanzibar Ministry of Health. ⁷⁴⁰⁷⁴¹

4.2.2c Annual review of national stockpile to ensure sufficient supply

Score: 0

There is no evidence that Tanzania and Tanzania-Zanzibar requires an annual review of the national stockpile to ensure the supply is sufficient for a public health emergency.

There is no evidence available through the Tanzania Ministry of Health and the Tanzania-Zanzibar Ministry of Health. ⁷⁴⁹⁷⁵⁰

4.2.3 Manufacturing and procurement for emergencies

4.2.3a Plan/agreement to produce/procure medical supplies during a public health emergency

Score: 0

There is insufficient evidence that Tanzania and Tanzania-Zanzibar have a plan/agreement to leverage domestic manufacturing capacity to produce or to procure medical supplies (e.g. MCMs, medicines, vaccines, equipment, PPE) for national use during a public health emergency.

According to the Joint External Evaluation (JEE) of the International Health Regulations (2005) core capacities of the United Republic of Tanzania, conducted 14-18 August 2023, there is "a Medical Stores Department [MSD] with ten zonal warehouses in the country, with existing procedures for management of medical equipment and supplies during emergencies". (p.46) However, the JEE also recognizes that delays in accessing emergency medical supplies may be caused by prolonged processes. Furthermore, both medical supplies and personal equipment has been found as inadequate. (p.46) ⁷⁵¹ "MSD procures medicines, medical supplies, and laboratory reagents on behalf of public health facilities". ⁷⁵² However, the website of the MSD does not cover emergency procurement. ⁷⁵³ The website of the Public Procurement Regulatory Authority (PPRA) has a guideline for carrying out emergency procurement (2017), which allows for some flexibility during the procurement process. ⁷⁵⁴ For example, procurement processes may be shortened and the requirement for tender advertisement may be waived. (p.4) However, this guideline does not mention leveraging public and/or private sectors nor does it include points of entry.

In Tanzania-Zanzibar public procurement is regulated by the 'An act to repeal the public procurement and disposal of public assets act, NO.11 of 2016 and enact the public procurement act to provide comprehensive provisions to regulate and control public procurements and other matters related thereto' of 2025. ⁷⁵⁵ Article 2 states that this act applies to all public procurement. ⁷⁵⁶ The Zanzibar Public Procurement Regulatory Authority (ZPPRA) is charged with overseeing this regulation ⁷⁵⁷ Unfortunately, some of the links on the website of the ZPPRA do not appear to work. Hence it is unclear if Tanzania-Zanzibar has the capacity to produce or to procure medical supplies for national use during a public health emergency.

4.2.3b Plan/agreement to produce/procure lab supplies during a public health emergency

Score: 0

There is insufficient evidence that Tanzania and Tanzania-Zanzibar have a plan/agreement to leverage domestic manufacturing capacity to produce or to procure laboratory supplies (e.g. reagents, media) for national use during a public health emergency.

According to the Joint External Evaluation (JEE) of the International Health Regulations (2005) core capacities of the United Republic of Tanzania, conducted 14-18 August 2023, there is "a Medical Stores Department [MSD] with ten zonal warehouses in the country, with existing procedures for management of medical equipment and supplies during emergencies". (p.46) ⁷⁵⁸ However, the JEE also recognizes that delays in accessing emergency medical and laboratory supplies may be caused by prolonged processes. "MSD procures medicines, medical supplies, and laboratory reagents on behalf of public health facilities". ⁷⁵⁹ The MSD imports 100% of laboratory supplies from different countries world wide. However, the website of the MSD does not cover emergency procurement. ⁷⁶⁰ The website of the Public Procurement Regulatory Authority (PPRA) has a guideline for carrying out emergency procurement (2017), which allows for some flexibility during the procurement process. ⁷⁶¹ For example, procurement processes may be shortened and the requirement for tender advertisement may be waived. (p.4) However, this guideline does not mention leveraging public and/or private sectors nor does it include points of entry.

In Tanzania-Zanzibar public procurement is regulated by the 'An act to repeal the public procurement and disposal of public assets act, NO.11 of 2016 and enact the public procurement act to provide comprehensive provisions to regulate and control public procurements and other matters related thereto' of 2025. ⁷⁶² Article 2 states that this act applies to all public procurement. ⁷⁶³ The Zanzibar Public Procurement Regulatory Authority (ZPPRA) is charged with overseeing this regulation ⁷⁶⁴ Unfortunately, some of the links on the website of the ZPPRA do not appear to work. Hence it is unclear if Tanzania-Zanzibar has the capacity to produce or to procure laboratory supplies for national use during a public health emergency.

4.2.3c Mechanism emergency logistics and supply chain management

Score: 0

There is insufficient evidence that Tanzania or Tanzania-Zanzibar has a system for national and subnational levels for emergency logistics and supply chain management.

According to the Joint External Evaluation (JEE) of the International Health Regulations (2005) core capacities of the United Republic of Tanzania, conducted 14-18 August 2023, there is "a Medical Stores Department [MSD] with ten zonal warehouses in the country, with existing procedures for management of medical equipment and supplies during emergencies". (p.48) ⁷⁶⁵ However, the JEE also recognizes that delays in accessing emergency supplies may be caused by prolonged processes. Furthermore, there is inadequate storage space in the MSD warehouses to store emergency stock. (p.48)⁷⁶⁶ "MSD procures medicines, medical supplies, and laboratory reagents on behalf of public health facilities". ⁷⁶⁷ However, the website of the MSD does not cover emergency procurement. ⁷⁶⁸The website of the Public Procurement Regulatory Authority (PPRA) has a guideline for carrying out emergency procurement (2017), which allows for some flexibility during the procurement process. ⁷⁶⁹ For example, procurement processes may be shortened and the requirement for tender advertisement may be waived. (p.4) However, this guideline does not mention leveraging public and/or private sectors nor does it include cold chain management for vaccines. ⁷⁷⁰

In Tanzania-Zanzibar public procurement is regulated by the 'An act to repeal the public procurement and disposal of public assets act, NO.11 of 2016 and enact the public procurement act to provide comprehensive provisions to regulate and control public procurements and other matters related thereto' of 2025. ⁷⁷¹ Acticle 2 states that this act applies to all public procurement. ⁷⁷² The Zanzibar Public Procurement Regulatory Authority (ZPPRA) is charged with overseeing this regulation ⁷⁷³ Unfortunately, some of the links on the website of the ZPPRA do not appear to work. Hence it is unclear if Tanzania-Zanzibar has a system for national and subnational levels for emergency logistics and supply chain management.

4.3 Medical countermeasures and personnel deployment

4.3.1 System for dispensing MCMs during a public health emergency

4.3.1a Plan/program/guidelines for dispensing MCMs during a public health emergency

Score: 0

There is insufficient evidence that Tanzania or Tanzania-Zanzibar has a system for national and subnational levels for emergency logistics and supply chain management.

According to the Joint External Evaluation (JEE) of the International Health Regulations (2005) core capacities of the United Republic of Tanzania, conducted 14-18 August 2023, there is "a Medical Stores Department [MSD] with ten zonal warehouses in the country, with existing procedures for management of medical equipment and supplies during emergencies". (p.48) ⁷⁷⁴ However, the JEE also recognizes that delays in accessing emergency supplies may be caused by prolonged processes. Furthermore, there is inadequate storage space in the MSD warehouses to store emergency stock. (p.48)⁷⁷⁵ The website of the MSD indicates that it does deliver medical supplies, medication, and laboratory reagents to over 8.500 health facilities. ⁷⁷⁶ Additionally, cold chain logistics are available. ⁷⁷⁷ Dispensing during public health emergencies are not covered in the JEE or the website of the MSD. ⁷⁷⁸⁷⁷⁹

There is no evidence via the Ministry of Health or the Ministry of Defence and National Services that a plan is in place for dispensing medical countermeasures during public health emergencies. ⁷⁸⁰⁷⁸¹

The Joint External Evaluation (JEE) of the International Health Regulations (2005) core capacities of the United Republic of Tanzania-Zanzibar, conducted 21-25 August 2023, indicates that: "the Ministry of Health has a fully functional logistics and supply chain mechanism but occasionally experiences some stock-outs and delays in dispatches of supplies to the field. There is also limited funding to support response operations. " (p.43) ⁷⁸² Evidence of this mechanism has not been found through the Tanzania-Zanzibar Ministry of Health. ⁷⁸³

No evidence regarding a plan to dispense medical countermeasures during public health emergencies can be found through the website of the Tanzania-Zanzibar Ministry of Health. ⁷⁸⁴

4.3.2 System for receiving foreign health personnel during a public health emergency

4.3.2a Plan to receive foreign health personnel during a public health emergency

Score: 0

There is no evidence that Tanzania and Tanzania-Zanzibar have a plan in place to facilitate workforce surge in an emergency.

According to the Joint External Evaluation of the International Health Regulations (2005) core capacities of the United Republic of Tanzania, conducted 14-18 August 2023, Tanzania promotes strong relations between universities to support training of healthcare professionals, however there are no policy or strategic plans in place for workforce surges. (p.41) ⁷⁸⁵

There is no evidence in the Health Sector Strategic Plan July 2021 – June 2026 (HSSP V), the Human Resources for Health – Tanzania mainland Country Profile, the Human Resources for Health Report (Mid-Term Review (MTR) of the Health Sector Strategic Plan V (HSSP V)), or on the websites of the Ministry of Health and the Ministry of Labour that plans targeting workforce surges in emergencies exist. ⁷⁸⁶⁷⁸⁷⁷⁸⁸⁷⁸⁹⁷⁹⁰

Similarly, neither the Joint External Evaluation of the International Health Regulations (‎2005)‎ core capacities of the United Republic of Tanzania-Zanzibar, conducted 21-25 August 2023, nor the Zanzibar Development Plan (ZADEP) 2021-2026 make mention of workforce surges in relation to Tanzania-Zanzibar. ⁷⁹¹⁷⁹²

4.3.2b Plan to facilitate workforce surge in an emergency

Score: 0

There is no evidence that Tanzania and Tanzania-Zanzibar have a public plan in place to receive health personnel from other countries to respond to a public health emergency.

The Joint External Evaluation (JEE) of the International Health Regulations (2005) core capacities of the United Republic of Tanzania, conducted 14-18 August 2023, states that "despite having mechanisms to support deployment of personnel and equipment in health emergencies, these functional strategies are not formalized; further, there is no national plan that guides the activation and coordination of personnel in emergencies."(p.48) ⁷⁹³ It is unclear if personnel from other countries are included in these mechanisms.

No further evidence of a plan for receiving and deploying health personnel is found via the Ministry of Health or the Ministry of Defence and National Services. ⁷⁹⁴⁷⁹⁵

According to the Joint External Evaluation (JEE) of the International Health Regulations (2005) core capacities of the United Republic of Tanzania-Zanzibar, conducted 21-25 August 2023, Zanzibar does not have standard operating procedures (SOPs) in place. (p.45) ⁷⁹⁶

Again there is no evidence available via the website of the Tanzania-Zanzibar Ministry of Health. ⁷⁹⁷

4.3.2c Plan to redeploy existing health personnel within the country

Score: 0

There is no evidence that there is a public plan in place to redeploy existing health personnel within Tanzania or Tanzania-Zanzibar.

According to the Joint External Evaluation (JEE) of the International Health Regulations (2005) core capacities of the United Republic of Tanzania, conducted 14-18 August 2023, Tanzania has a fairly strong heath workforce that is able to respond to healthcare emergencies. ⁷⁹⁸ However, healthcare shortages and imbalances are common across regions and councils. ⁷⁹⁹ The JEE does not make mention of redeployment, either geographically or role, but does state that "no emergency medical teams that are readily deployable in health emergencies". (p.41)

The Health Sector Strategic Plan July 2021 – June 2026 (HSSP V) by the Ministry of Health does include a section on human resource planning, stating that "the government will expand use of Workload Indicator of Staffing Needs – Prioritisation and Optimisation Analysis (WISN-POA), allocating health workers where they are most needed." (p.46) ⁸⁰⁰ More specific information on redeployment is not provided in this document. ⁸⁰¹

Further documents such as the 2023 Human Resources for Health – Tanzania Mainland Country Profile and 2025 Human Resources for Health Report (Mid-Term Review (MTR) of the Health Sector Strategic Plan V (HSSP V)) both by the Ministry of Health, as well as the websites of the Ministry of Health and the Ministry of Labour make no mention of geographical or role deployment. ⁸⁰²⁸⁰³⁸⁰⁴⁸⁰⁵

The Zanzibar Development Plan (ZADEP) 2021-2026 by the Revolutionary Government of Zanzibar includes a section on human resources in the health sector. Again it does not address redeployment. (p. 55-57) ⁸⁰⁶ The same being true for the Joint External Evaluation of the International Health Regulations (‎2005)‎ core capacities of the United Republic of Tanzania-Zanzibar, conducted 21-25 August 2023. ⁸⁰⁷

4.4 Healthcare access

4.4.1 Access to healthcare

4.4.1a Constitutional guarantee of citizens’ right to medical care

Score: 0

There is no evidence that the right to medical care is explicitly guaranteed in the Tanzanian constitution.

As of 2022, the World Policy Analysis Center indicates that there are no specific provisions that guarantee the right to medical care. ⁸⁰⁸ Similarly, the Constitution of the United Republic of Tanzania, governing mainland Tanzania and Tanzania-Zanzibar, does not mention this right. ⁸⁰⁹

In 2023, the United Republic of Tanzania has signed into law the Universal Health Insurance bill. ⁸¹⁰⁸¹¹ As of June 2025, the bill cannot be accessed through the Ministry of Health or the Ministry of Labour, Youth, Employment and Persons with Disability. ⁸¹²⁸¹³

4.4.1b Access to skilled birth attendants (% of population)

Score: 77.94

4.4.1c Out-of-pocket health expenditures per capita, PPP (current international $)

Score: 97.23

4.4.1d Coverage of essential health services through universal health coverage

Score: 33.33

4.4.1e Total population pushed below a relative poverty line by household health expenditure (60% of media daily per capita consumption or income)

Score: 79.45

4.4.1f Rate of mortality amenable to health care

Score: 70.86

4.4.2 Paid medical leave

4.4.2a Guaranteed paid sick leave

Score: 66.67

There is evidence that workers in Tanzania are guaranteed paid sick leave.

Article 32 of the Employment and Labour Relations Act of 2004 by the United Republic of Tanzania states that employees are entitled to 126 days of sick leave. ⁸¹⁴ Wages will be paid in full for the first 63 days, the second 63 days half the wages will be paid. ⁸¹⁵ Employees must submit a medical certificate to receive paid leave. The Act does not specify whether or not mental health problems are covered.

Paid sick leave is also guaranteed in Tanzania-Zanzibar through the employment act, no. 11 of 2005, article 69. ⁸¹⁶ Employees are entitled to two months of full pay. If a medical board determines that the employee is still incapable of work, the employer shall grant an additional three months of half pay.

4.4.3 Healthcare worker access to healthcare

4.4.3a Government prioritisation of care for healthcare workers during response

Score: 0

There is insufficient evidence that Tanzania has issued a policy to provide prioritized healthcare services to healthcare workers who become sick as a result of responding to a public health emergency. There is no evidence that such a policy exists for Tanzania-Zanzibar.

The Joint External Evaluation (JEE) of the International Health Regulations (2005) core capacities of the United Republic of Tanzania, conducted 14-18 August 2023, indicates that the country has standards and resources in place to establish a safe environment in healthcare spaces. (p.57) ⁸¹⁷ However, the JEE does not indicate that healthcare workers receive prioritized care if they became sick as a result of responding to a public health emergency.

In 2019 the 'National guidelines for workers health and safety in healthcare facilities and emergency responders' were published by the Ministry of Health, which includes a section on prevention and control for health workers (p.41-48) ⁸¹⁸ According to these guidelines, health workers receive vaccinations and boosters pre employment, and may receive post exposure care in the case of exposure to bloodborne pathogens. (p.41) ⁸¹⁹ There is no indication in this guideline that care will be prioritized if healthcare workers fall in as a result of responding to a public health emergency.

The Joint External Evaluation (JEE) of the International Health Regulations (2005) core capacities of the United Republic of Tanzania-Zanzibar, conducted 21-25 August 2023, provides no evidence that healthcare workers receive prioritized care. ⁸²⁰ The JEE also references the 'Zanzibar infection prevention and control standard for Referral and Regional Hospital' and the 2019 ' Zanzibar Guideline for Water, Sanitation and Hygiene in healthcare Facility'. ⁸²¹ However, these documents are not available through the Tanzania-Zanzibar Ministry of Health. ⁸²²

4.5 Communications with healthcare workers during a public health emergency

4.5.1 Communication with healthcare workers

4.5.1a Existence of system for communication during a public health emergency

Score: 0

There is no evidence that suggests that there is a system in place for public health officials and healthcare workers to communicate during a public health emergency.

Tanzania has published a multi-hazard risk communication plan, namely the Tanzania Disaster Communication Strategy (TDCS) 2012. ⁸²³ The TDCS provides information on assigned responsibilities, supporting agencies, and direction and control. (p.12) No information on systems that can be used by healthcare workers during public health emergencies. ⁸²⁴ The TDCS has not been updated since 2012.

The Joint External Evaluation of the International Health Regulations (2005) core capacities of the United Republic of Tanzania, conducted 14-18 August 2023, adds that no infodemic management system is available. (p.59) ⁸²⁵ No further evidence is available via the websites of the Ministry of Health and Ministry of Agriculture of Tanzania as well as the 2012 Tanzania Emergency Response and Preparedness Plan (TEPRP). ⁸²⁶⁸²⁷⁸²⁸

In 2020 the Ministry of Health published the 'All-Hazard Public Health Emergency Response Plan'. ⁸²⁹ "This plan addresses emergency response across health system in events of all hazards. It will guide coordination of response activities at different levels and integration of activities by different stakeholders to avoid vertical approach. "(p. 6) ⁸³⁰ Steps to strengthen risk communication are included, but communication systems are not. (p.13)

Risk communication for Tanzania-Zanzibar is covered through the 2011 Zanzibar Disaster Communication Strategy (ZDCZ), which "outlines the organization, operational concepts, responsibilities, and procedures to accomplish emergency communications requirements". (p.iii) ⁸³¹ This strategy document includes multiple hazards including public health emergencies. (p.2/3) The ZDCZ also does not address communication systems for healthcare workers. ⁸³² No further evidence is found via Tanzania-Zanzibar's Ministry of Health. ⁸³³

The risk communication and community engagement section of the Joint External Evaluation of the International Health Regulations (2005) core capacities of the United Republic of Tanzania-Zanzibar, conducted 21-25 August 2025, does not mention a system for healthcare workers to communicate during public health emergencies. (p.55-57) ⁸³⁴

4.5.1b Inclusion of public and private sector in healthcare communication system

Score: 0

There is no evidence that suggests that there is a system in place for public health officials and healthcare workers to communicate during a public health emergency and therefore it does not encompass healthcare workers in both the public and private sectors.

Tanzania has published a multi-hazard risk communication plan, namely the Tanzania Disaster Communication Strategy (TDCS) 2012. ⁸³⁵ The TDCS provides information on assigned responsibilities, supporting agencies, and direction and control. (p.12) No information is provided on healthcare workers either in the public or private sectors. ⁸³⁶ The TDCS has not been updated since 2012. The Joint External Evaluation of the International Health Regulations (2005) core capacities of the United Republic of Tanzania, conducted 14-18 August 2023, adds that no infodemic management system is available. (p.59) ⁸³⁷ No further evidence is available via the websites of the Ministry of Health and Ministry of Agriculture of Tanzania as well as the 2012 Tanzania Emergency Response and Preparedness Plan (TEPRP). ⁸³⁸⁸³⁹⁸⁴⁰

Risk communication for Tanzania-Zanzibar is covered through the 2011 Zanzibar Disaster Communication Strategy (ZDCZ), which "outlines the organization, operational concepts, responsibilities, and procedures to accomplish emergency communications requirements". (p.iii) ⁸⁴¹ This strategy document includes multiple hazards including public health emergencies. (p.2/3) The ZDCZ also does not address communication between public health officials and healthcare workers. No further evidence is found via Tanzania-Zanzibar's Ministry of Health. ⁸⁴²

4.6 Infection control practices

4.6.1 Healthcare-associated infection (HCAI) monitoring

4.6.1a Evidence of national public health system monitoring and tracking of HCAIs

Score: 0

There is evidence that Tanzania uses the national public health system to monitor for and track the number of healthcare associated infections (HCAI) that take place in healthcare facilities. However, there is no evidence that Tanzania-Zanzibar also tracks HCAI.

According to Joint External Evaluation of the International Health Regulations (2005) core capacities of the United Republic of Tanzania, 14-18 August 2023, Tanzania has a HCAI surveillance programme in place. ⁸⁴³ "There is a core team of trainers of trainees in place from all 26 regional health management teams and 46 referral hospitals trained in the HCAIs surveillance programme and who have started reporting data on surgical site infections in the DHIS2 [District health information software 2]". (p.56)⁸⁴⁴ Similarly, research by Bakar et al. (2024) indicates that data is made public HCAI related topics such as surveillance of device-associated infections, infections caused by multidrug-resistant backteria (MDR), and lack of isolation of pations infected with MDR bacteria. ⁸⁴⁵

In the case of Tanzania-Zanzibar the Joint External Evaluation of the International Health Regulations (2005) core capacities of the United Republic of Tanzania – Zanzibar, 21-25 August 2023, states that "there is no strategic plan for surveillance of HCAIs". (p.53)⁸⁴⁶ A search of the Zanzibar Policy Guidelines for Occupational Health, Safety and Wellbeing of Workers in the Health System, the Zanzibar Action Plan on Antimicrobial Resistance, and the website of the Zanzibar Ministry of Health provides no evidence to indicate that the tracking or monitoring of HCAI take place. ⁸⁴⁷⁸⁴⁸⁸⁴⁹

4.6.1b Infection prevention and control programme

Score: 100

There is evidence that both Tanzania and Tanzania-Zanzibar have infection prevention and control (IPC) programme's in place.

Joint External Evaluation of the International Health Regulations (2005) core capacities of the United Republic of Tanzania, conducted 14-18 August 2023, indicates that the Ministry of Health in combination with other development partners, is in strong support of the implementation and continuous improvement of IPC at all levels of healthcare in Tanzania. (p.55) ⁸⁵⁰ The 2018 National Infection Prevention and Control Guidelines for healthcare Services in Tanzania by the United Republic of Tanzania – Ministry of Health, presents the fundamentals of IPC, such as infectious disease transmission cycle, workers health and safety, and personal protective equipment. (p.5-6) ⁸⁵¹ Other policy plans, such as the National One Health Strategic Plan 2022-2027 and the National Action Plan for AMR (Antimicrobial Resistance) 2023-2028 actively integrated the IPC programme. ⁸⁵²⁸⁵³⁸⁵⁴

In Zanzibar IPC is covered in The Zanzibar Policy Guidelines for Occupational Health, Safety and Wellbeing of Workers in the Health System 2018. ⁸⁵⁵ However, both the Joint External Evaluation of the International Health Regulations (2005) core capacities of the United Republic of Tanzania – Zanzibar, conducted 21-25 August 2023 (p.52) and the Zanzibar Action Plan on Antimicrobial Resistance 2019-2024 (p.17), indicate that work still needs to be done regarding the structural integration of a IPC framework at the national and subnational level. ⁸⁵⁶⁸⁵⁷

4.6.1c National plan to ensure a safe environment in health facilities

Score: 100

There is evidence that Tanzania and Tanzania-Zanzibar has a plan in place to ensure a safe environment in health facilities.

According to the Joint External Evaluation (JEE) of the International Health Regulations (2005) core capacities of the United Republic of Tanzania, conducted 14-18 August 2023, the country has "national standards and resources for safe built environment (e.g. water, sanitation and hygiene (WASH), screening, isolation areas and sterilization services in healthcare facilities) including appropriate infrastructure, materials and equipment for IPC [Infection Prevention and Control]; as well as standards for reduction of overcrowding and optimization of staffing levels in healthcare facilities, according to WHO minimum requirements, exist and are implemented in selected healthcare facilities at a national level according to a national plan; however, it has not been implemented at intermediate levels."(p.57) ⁸⁵⁸

Furthermore, the 2019 'National guidelines for workers health and safety in healthcare facilities and emergency responders' by the Ministry of Health, covers occupational health and safety in health facilities. (p.11) ⁸⁵⁹ These guidelines cover both hazards as well as a minimum of safety that health facilities are required to have. (p. 11-12 and p.28) ⁸⁶⁰ "Workers health and safety in health facilities requires comprehensive integration of OHS related components. These components include water, hygiene and sanitation, healthcare waste management, infection prevention and control, patient safety, quality of care, emergency preparedness and human resource for health."(p.28) ⁸⁶¹

In Tanzania-Zanzibar WASH is also implemented, and the Joint External Evaluation (JEE) of the International Health Regulations (2005) core capacities of the United Republic of Tanzania-Zanzibar, conducted 21-25 August 2023, indicates that a select number of health-care facilities have implemented a safe environment. (p.53) ⁸⁶² The JEE also references the 'Zanzibar infection prevention and control standard for Referral and Regional Hospital' and the 2019 ' Zanzibar Guideline for Water, Sanitation and Hygiene in healthcare Facility'. ⁸⁶³ However, these documents are not available through the Tanzania-Zanzibar Ministry of Health. ⁸⁶⁴

4.7 Capacity to test and approve new medical countermeasures

4.7.1 Regulatory process for clinical trials of unregistered interventions

4.7.1a Requirement for ethical review before beginning a clinical trial

Score: 0

There is evidence that Tanzania has a national requirement for ethical review before beginning a clinical trial, there is insufficient evidence to suggest that this requirement exists for Tanzania-Zanzibar.

According to the website of the National Institute for Medical Research (NIMR) of the United Republic of Tanzania, there is a Medical Research Coordinating Committee (MRCC). "The MRCC has delegated functions of registration, ethical review, approving and monitoring of health research to the National Health Research Ethics sub-Committee (NatHREC), which is hosted by NIMR Headquarters. NatHREC is responsible for overseeing all issues pertaining to data and material transfers. Permission to Publish needs to be granted before publishing any health-related research conducted in Tanzania". ⁸⁶⁵

In 2009, the NatHREC has published 'guidelines of ethics for health research in Tanzania'. This guideline provides health researchers with information on accepted ethical standars and how these should be applied in research. (p.7) ⁸⁶⁶ Tanzania-Zanzibar is not mentioned in this document.

Ethical research in Tanzania-Zanzibar appears to be covered by the Zanzibar Health Research Institute (ZHRI). ⁸⁶⁷ The website of the ZHRI provides checklists for the submission of ethical clearance as well as ethical clearance application forms. ⁸⁶⁸ Some pages by the ZHRI are inaccesible, making it unclear if ethical clearance is always required.

There is no evidence available through the Joint External Evaluation of the IHR Core Capacities of Tanzania-Zanzibar, conducted in 21-25 August 2023, or the website of the Ministry of Health. ⁸⁶⁹⁸⁷⁰

4.7.1b Expedited approval for clinical trials of unregistered MCMs during epidemics

Score: 0

There is no evidence that either Tanzania or Tanzania-Zanzibar has an expedited process for approving clinical trials for unregistered medical countermeasures to treat ongoing pandemics or epidemics.

The Tanzania Food, Drugs and Cosmetics (Clinical Trials Control) Regulations 2013 governs how clinical trials can be conducted. ⁸⁷¹ Part 2, articles 3 through 6, specify how clinical trials are conducted and the conditions for authorization of said trials. Expedited processes are not mentioned.

In the case of Tanzania-Zanzibar, clinical trials are covered under the Zanzibar Food, Drugs and Cosmetics Act, NO.2 of 2006. ⁸⁷² Part 4.c, articles 62 through 73, specifically covers clinical trials in drugs, medical devices, and herbal drugs. Again expedited processes are not mentioned.

No mention of an expedited process for approving clinical trials was made in the Joint External Evaluation of the International Health Regulations (IHR) Core Capacities of the United Republic of Tanzania, conducted 14-18 August 2023, or in the Joint External Evaluation of the IHR Core Capacities of Tanzania-Zanzibar, conducted 21-25 August 2023. ⁸⁷³⁸⁷⁴ The websites of the Ministry of Health for both Tanzania and Tanzania-Zanzibar provide no further information. ⁸⁷⁵⁸⁷⁶

4.7.2 Regulatory process for approving medical countermeasures

4.7.2a Existence of agency responsible for approving new human MCMs

Score: 100

There is evidence that both Tanzania and Tanzania-Zanzibar have agencies responsible for the approving of new medical countermeasures for humans.

The Tanzania Medicines and Medical Devices Authority (TMDA) is the agency responsible for authorization of medicines and medical devices. On their website an extensive list of registered/approved medicines can be accessed. ⁸⁷⁷ In Zanzibar, the equivalent authority is the Zanzibar Food and Drug Agency (ZFDA), which also has a list available on registered medicine products. ⁸⁷⁸

4.7.2b Expedited approval for human MCMs during public health emergencies

Score: 0

There is evidence that Tanzania has an expedited process for approving medical countermeasures for human use during public health emergencies. However, there is no evidence that expedited approval is available in Tanzania-Zanzibar.

In 2025, the Tanzania Medicines and Medical Devices Authority (TMDA) signed memorandum of understanding (MoU) committed to streamlining "application submission and evaluation processes to expedite regulatory processes, reduce costs, and ensure timely regulatory decision-making" of medicines. ⁸⁷⁹ Through this MoU, Tanzania as well as its co-signers will "accelerate access to essential medicines, vaccines and medical devices". ⁸⁸⁰ Tanzania-Zanzibar is not mentioned in regards to the MoU.

The TMDA is the agency responsible for the authorization of medicines and medical devices. ⁸⁸¹ According to the Ministry of Health Guidelines on Processing of applications for Registration of Medicinal Products through Non-Routine Procedure 2023 "section 51 (1) of the Tanzania Medicines and Medical Devices Act, provides TMDA the authority for expedited processing of medicinal product applications for medicines with potential to address unmet medical needs, especially during a national epidemic, a global pandemic or other similar emergency situations." ⁸⁸² However, when reviewing the act, section 51 does not mention expedited processing. ⁸⁸³ There is no further information through the website of the Ministry of Health. ⁸⁸⁴

In Tanzania-Zanzibar, the Zanzibar Food and Drug Agency (ZFDA) is responsible for the approving of medical countermeasures through the Zanzibar Food, Drugs, and Cosmetics Act, No.2 of 2006. ⁸⁸⁵⁸⁸⁶ The act does not include provisions on expedited processing. ⁸⁸⁷

Commitment to International Norms

5.1 IHR reporting compliance and disaster risk reduction

5.1.1 Official IHR reporting

5.1.1a Submission of IHR reports to the WHO in past year

Score: 100

Tanzania has submitted an IHR Self-Assessment Annual Report (SPAR) to the WHO for the last calendar year, with the latest submission in 2024.⁸⁸⁸

5.1.2 Integration of health into disaster risk reduction

5.1.2a Existence of specific risk reduction strategies for epidemics and pandemics

Score: 0

There is evidence that Tanzania has a national risk reduction strategy that includes epidemics, but not pandemics. There is no evidence that Tanzania-Zanzibar has a national risk reduction strategy.

The National Disaster Management Strategy 2022-2027 lists epidemics as a potential disaster. (p.5)⁸⁸⁹ The strategy states that early warning signs are in place for both human and animal epidemics, but that trans-boundary epidemics may cause significant challenges. (p.7-8) Furthermore, the document provides extensive information on risk reduction and prevention, but these strategies or targets tend to be generalized and not specific to just epidemics and/or pandemics. In general, this report does not mention pandemics but does include information on diseases, such as COVID-19, that are generally perceived as pandemics.

The 'Act to Establish Zanzibar Disaster Risk Reduction and Management Act 20165 and other matters connected thereto' does not make mention of epidemics or pandemics. ⁸⁹⁰ The One Health Strategic Plan 2021-2025 of Zanzibar mentions disease surveillance, prention and control but links it mostly tot zoonotic diseases, antimicrobial resistance, and biosecurity. (p.6-10)⁸⁹¹

No other evidence was found through the website of the Ministry of Health (Tanzania-Zanzibar) or through the Joint External Evaluation of the International Health Regulations (‎2005)‎ core capacities of the United Republic of Tanzania-Zanzibar. ⁸⁹²⁸⁹³

5.2 Cross-border agreements on public health and animal health emergency response

5.2.1 Cross-border agreements

5.2.1a Existence of public health emergency agreements with regional neighbors

Score: 50

There is evidence that both Tanzania and Tanzania-Zanzibar have cross-border agreements, protocols, or Memorandum of understandings (MOUs) specifically dealing with public health emergencies, but there is evidence of gaps in implementation.

Both Tanzania and Tanzania-Zanzibar are members of the East African Community (EAC), a regional co operative group of eight members. It's goals are to strengthen capacities regarding disease control and prevention. ⁸⁹⁴⁸⁹⁵ The Disease Prevention and Control Unit of the EAC promotes interventions such as establishing information exchange systems for diseases, promoting supranational and national reference laboratories, and strengthening preventive health services. ⁸⁹⁶ Disease surveillance across borders is also promoted by the EAC and aims to enhance both cross-country and cross-institutional collaboration under the 'One Health' initiative. Furthermore the EAC has published a 'Standard Operating Procedure – Cross-border Surveillance in the EAC Region', which sets thresholds for reporting public health emergencies in cross-border districts. ⁸⁹⁷

The National One Health Strategic Plan 2022-2027 reiterates the improtance of cross-country collaboration, and indicates a desire to "conduct cross-border joint risk assessment focusing on zoonosis diseases, AMR [Antimicrobial Reistance] and other public health events". (p.34)⁸⁹⁸

The Joint External Evaluation of the International Health Regulations (2005) core capacities of the United Republic of Tanzania, 14-18 August 2023, recognizes that cross-border agreements are in place, but indicates that mainland Tanzania faces many challenges due to the "non-existence of examination facilities and isolation facilities, inadequate staff at POE [points of entry], and inadequate equipement […]". (p.62)⁸⁹⁹ Tanzania-Zanzibar similarly has some limitations that prevent full scale operations, such as inadequate staff, equipment, and isolation facilities. (p.59) ⁹⁰⁰

5.2.1b Existence of animal health emergency agreements with regional neighbors

Score: 0

There is no publicly available evidence that Tanzania and Tanzania-Zanzibar have cross-border agreements, protocols or MOUs specifically dealing with animal health emergency response.

Both regions are a part of the East African Community, a regional co operative group of eight members states aimed at strengthening capacities in various critical areas including disease control and prevention. ⁹⁰¹⁹⁰²⁹⁰³ The United Republic of Tanzania (including Zanzibar) together with its neighbours in the East African Community (EAC) issued a joint communique at their 2018 EAC joint heads of state retreat. In the communique, members resolved to strengthen the network of medical reference laboratories and the regional rapid response system in order to protect the region from health threats including pandemics, bio-terrorism and common agents but nothing on animal health emergencies specifically. ⁹⁰⁴ No additional evidence was found from the Ministry of Health or Ministry of Defence and National Services for Tanzania. ⁹⁰⁵⁹⁰⁶

The Joint External Evaluation of the International Health Regulations (2005) core capacities of the United Republic of Tanzania, 14-18 August 2023, reiterates the existance of cross-border agreements, but does not mention animal health emergencies. (p.64) ⁹⁰⁷

The Joint External Evaluation of the International Health Regulations (2005) core capacities of the United Republic of Tanzania-Zanzibar, conducted 21-25 August 2023, states that "cross-border collaboration meetings were held with neighbouring countries to share ideas on public health events, ways to prevent transmission and improvement of coordination and communication". (p.59) ⁹⁰⁸ Again animal health emergencies are not mentioned. There is no further evidence on the websites of the Tanzania-Zanzibar Ministry of Health and Ministry of Agriculture. ⁹⁰⁹⁹¹⁰

5.3 International commitments

5.3.1 Participation in international agreements

5.3.1a Biological and Toxin Weapons Convention status

Score: 100

There is evidence that the United Republic of Tanzania, including both Tanzania and Tanzania-Zanzibar, has signed and ratified the Biological Weapons Convention (BWC).

According to the United Nations Office for Disarmament Affairs Treaties Database, the United Republic of Tanzania signed the BWC on August 16 1972. ⁹¹¹ As of 14 August 2019 the convention is also ratified. ⁹¹²⁹¹³

5.3.1b Submission of CBMs to the Biological and Toxin Weapons Convention

Score: 0

There is no evidence that the United Republic of Tanzania, including both Tanzania and Tanzania-Zanzibar, has submitted confidence building measures for the Biological Weapons Convention (BWC) in the past three years.

According to the United Nations, the United Republic of Tanzania has submitted no reports regarding BWC confidence building. ⁹¹⁴

The Group of the Non-Aligned Movement (NAM) of which the United Republic of Tanzania is a member, regularly submits working papers. "Papers submitted by NAM in 2022 include the following: 'International cooperation, assistance and exchange in the use of biological sciences and technology for peaceful purposes; Proposal for the establishment of a Cooperation Committee' (2022); and 'Proposals for the Final Document of the Ninth Review Conference of the Biological and Toxin Weapons Convention (BTWC): Article by Article' (2022)." ⁹¹⁵⁹¹⁶⁹¹⁷

5.3.1c Submission of UNSCR 1540 reports

Score: 100

There is evidence that the United Republic of Tanzania, including both Tanzania and Tanzania-Zanzibar, have provided the required United Nations Security Council Resolution (UNSCR) 1540 report to the Security Council Committee established pursuant to resolution 1540.

The United Republic of Tanzania has submitted the UNSCR 1540 report on August 29 2005. ⁹¹⁸

5.3.1d Extent of UNSCR 1540 implementation on public health emergencies

Score: 0

5.3.2 Voluntary memberships

5.3.2a Membership in global health security and/or biological weapons agreements

Score: 0

There is no evidence that Tanzania and Tanzania-Zanzibar are members of the Global Partnership Against the Spread of Weapons and Materials of Mass Destruction (GP), the Australia Group (AG), and the Proliferation Security Initiative (PSI). ⁹¹⁹⁹²⁰⁹²¹

5.4 JEE and PVS

5.4.1 Completion and publication of a JEE assessment and gap analysis

5.4.1a Completion and publication of JEE (or GHSA pilot external assessment) report

Score: 100

There is evidence that both Tanzania and Tanzania-Zanzibar have completed a Joint External Evaluation (JEE) and published a full public report in the last five years.

In August 2023 two JEE missions were completed, one in Tanzania and the other in Tanzania-Zanzibar. ⁹²²⁹²³ The reports are publicly available on the website of the World Health Organization (WHO), under the following titles: Joint External Evaluation of the International Health Regulations (2005) core capacities of the United Republic of Tanzania and Joint External Evaluation of the International Health Regulations (‎2005)‎ core capacities of the United Republic of Tanzania-Zanzibar. ⁹²⁴⁹²⁵

5.4.2 Completion and publication of a PVS assessment and gap analysis

5.4.2a Completion and publication of PVS report (past five years)

Score: 0

There is no evidence that Tanzania and/or Tanzania-Zanzibar has completed and published a Performance of Veterinary Services (PVS) assessment in the last five years.

According to the World Organisation for Animal Health (WOAH) Tanzania, including both its mainland and Tanzania-Zanzibar, conducted an initial PVS evaluation in 2008 and did a follow-up evaluation in 2016. ⁹²⁶ No additional evaluations or assessments have taken place since.

5.4.2b Completion and publication of PVS gap analysis (past five years)

Score: 0

There is no evidence that Tanzania and/or Tanzania-Zanzibar has completed and published a Performance of Veterinary Services (PVS) gap analysis in de last five years.

According to the World Organisation for Animal Health (WOAH) Tanzania, including both its mainland and Tanzania-Zanzibar, conducted an initial gap analysis in 2009. ⁹²⁷ This analysis has not been updated since then.

5.5 Financing

5.5.1 National financing for epidemic preparedness

5.5.1a Evidence of allocated national funds to improve capacity to address epidemic threats

Score: 0

There is no evidence that Tanzania and Tanzania-Zanzibar have allocated national funds to improve capacity to address pandemic or epidemic threats within the past three years.

In 2025, the African Epidemic Fund was established by the Africa Centres for Disease Control and Prevention (Africa CDC). ⁹³⁴ There is no evidence on the Africa CDC website that Tanzania or Tanzania-Zanzibar has contributed to this fund. ⁹³⁵

5.5.2 Financing under JEE and PVS reports and gap analyses

5.5.2a National budget to address gaps identified in JEE, NAPHS or GHSA roadmap

Score: 0

There is no evidence that the Joint External Evaluation (JEE) report or the National Action Plan for Health Security (NAPHS) allocates or describes specific funding from the national Tanzanian and Tanzanian-Zanzibar budget to address identified gaps in the past five years.

In the past five years a JEE was published for both Tanzania and Tanzania-Zanzibar. These JEE reports did include sections on financing and budgets, however these were not connected to addressing identified gaps. ⁹³⁶⁹³⁷

The National Action Plan for Health Security (NAPHS) 2017-2021 similarly includes sections on budgetting. (p.34-35) ⁹³⁸ The cost drivers are linked to preventing, detecting, and responding to diseases as well as other International Health Regulations (IHR) related hazards and points of entry. (p.34-35) ⁹³⁹ Overall the main cost drivers are connected to the JEE thematic areas, however identified gaps are not mentioned. In 2024, Tanzania was working on an updated NAPHS for 2024-2028. ⁹⁴⁰ There is no evidence on the websity of the Ministry of Health that the NAPHS is already published. ⁹⁴¹

According to the World Health Organization (WHO) Zanzibar has unveiled a NAPHS in 2024. ⁹⁴² However, there is no evidence on the website of the WHO or the Ministry of Health that the document is publicly available. ⁹⁴³⁹⁴⁴

5.5.2b National budget to address gaps identified in PVS assessment or gap analysis

Score: 0

Tanzania and Tanzania-Zanzibar does not have a Performance of Veterinary Services (PVS) gap analysis or PVS assessment covering the past five years. ⁹⁴⁵

5.5.3 Financing for emergency response

5.5.3a Emergency public financing during a public health emergency

Score: 100

There is a publicly identified special emergency public financing mechanism and funds which Tanzania kan access in the face of a public health emergency.

The United Republic of Tanzania, including both the mainland and Tanzania-Zanzibar, is an International Development Association (IDA)-eligible borrowing country. ⁹⁴⁶ Tanzania can borrow funds under the World Bank Pandemic Financing Facility. ⁹⁴⁷ Furthermore, "the African Epidemic Fund is now operational, providing the Africa Centres for Disease Control and Prevention (Africa CDC) with flexible funding to support countries across the continent in outbreak preparedness and response". ⁹⁴⁸ According to the Africa CDC the fund comes at a crucial time as the continent is challenged by multiple health crises, such as the Marburg outbreak in Tanzania. ⁹⁴⁹ Lastly, Tanzania has received US$25 million from the Pandemic Fund. ⁹⁵⁰ The fund will be used to further develop surveillance systems and enable laboratories to confirm diseases, all of this by 2027. ⁹⁵¹

5.5.4 Accountability for international commitments to address epidemic threats

5.5.4a Commitments to improve domestic or foreign capacity for epidemic threats

Score: 0

There is no evidence that Tanzania and Tanzania-Zanzibar's senior leaders have supported other countries to improve capacity to address pandemic or epidemic threats by providing support or financing. Furthermore, there is insufficient evidence that leadership has improved Tanzania and Tanzania-Zanzibar's domestic capacity to address pandemic threats by expanding financing or requesting support to improve capacity.

A scan of press releases, statements, speeches and notices on the websites of Tanzania's Ministry of Health, Ministry of Agriculture, Ministry of Livestock, and Ministry of Foreign Affairs does not provide evidence of such commitments. ⁹⁵²⁹⁵³⁹⁵⁴⁹⁵⁵ There also does not exist evidence in case of Tanzania-Zanzibar via a review of its Ministry of Health and Ministry of Agriculture websites and media sources. ⁹⁵⁶⁹⁵⁷ Furthermore the Global Health Security Funding Tracking Dashboard indicates that neither Tanzania nor Tanzania-Zanzibar has provided other countries with financing to address pandemic threats. ⁹⁵⁸

During a press briefing on January 20, 2025, The president of the Republic of Tanzania, Samia Suluhu Hassan announced the outbreak of the Marburg Disease Virus (MVD). The president states that "we have demonstrated our ability to contain similar (MVD) outbreaks and are determined to do the same this time". ⁹⁵⁹ The same day the World Health Organization (WHO) indicated that it would provide US$3 million to support Tanzania's response. It is unclear if the president or other leadership requested this support. ⁹⁶⁰⁹⁶¹⁹⁶²⁹⁶³

5.5.4b Investments to improve domestic or foreign capacity for epidemic threats

Score: 100

There is evidence that Tanzania and Tanzania-Zanzibar have invested finances (from donors) to improve their own domestic capacity to address epidemic threats in the past three years. However, there is no evidence that they have provided other countries with financing or technical support to improve capacity to address epidemic threats.

As per the Global Health Security Funding Tracking Dashboard, from 2014 to 2022 Tanzania received US$ 6,5 billion from donor countries to improve its own domestic capacity to detect, respond and address epidemic threats. ⁹⁶⁴ Between 2019 and 2023 Tanzania received US$ 185 million to help counter the effects of COVID-19. ⁹⁶⁵ In 2025 the country also received US$ 3 million from the World Health Organization to combat the Marburg virus outbreak. ⁹⁶⁶ These funds are used to contain the outbreak, to step up surveillance, and to deploy emergency response teams.

There is no evidence that Tanzania and Tanzania-Zanzibar have provided other countries with financing or technical support to improve capacity to address epidemic threats, through a review of the Global Health Security Funding Tracking Dashboard and the Ministry of Health. ⁹⁶⁷⁹⁶⁸⁹⁶⁹

5.5.4c Evidence that the country has fulfilled its full WHO contribution within the past two years

Score: 0

There is no evidence that the United Republic of Tanzania has fulfilled its full contribution to the World Health Organization (WHO) in the past two years.

According to the WHO the United Republic of Tanzania was invoiced US$ 47.850 in 2023. By December 31, US$46.178 was paid, leaving an outstanding balance of US$1.662. ⁹⁷⁰ In both 2024 and 2025 the United Republic of Tanzania will be expected to contribute US$57,420 per year. ⁹⁷¹ At the end of December 2024, Tanzania still had an outstanding balance of US$1.131. ⁹⁷²

5.6 Commitment to sharing of genetic & biological data & specimens

5.6.1 Commitment to share data and specimens in emergency/non-emergency research

5.6.1a Sharing of genetic/biological data and materials beyond influenza

Score: 0

There is no publicly available evidence in Tanzania and Tanzania-Zanzibar of a plan or policy for sharing genetic data, clinical specimens, and/or isolated specimens (biological materials) along with the associated epidemiological data with international organizations and/or other countries that goes beyond influenza.

There is no evidence found in the National Data Sharing Framework for Science, Technology, and Innovation by the Tanzania Commission for Science and Technology or the Health Information System Guidelines. ⁹⁷³⁹⁷⁴ The National Data Sharing Framework specifically targets data sharing but does not make mention of genetic data, clinical specimens, or isolated specimens. ⁹⁷⁵

Broad information on disease surveillance can be found through the East African Integrated Disease Surveillance Network (EAIDSNet), which the United Republic of Tanzania is a member of. EAIDSNet promotes the following objectives: "promote exchange and dissemination of appropriate information on Integrated Disease Surveillance and other disease control activities; strengthen capacity for implementing integrated disease surveillance and control activities; and ensure continuous exchange of expertise and best practices for integrated disease surveillance and control". ⁹⁷⁶ While there is a provision for information sharing, it is not clear whether this includes either of genetic data, epidemiological data, clinical specimens, and/or isolated specimens.

There is no evidence found via the Joint External Evaluation of the International Health Regulations (2005) core capacities of the United Republic of Tanzania, the Joint External Evaluation of the International Health Regulations (‎2005)‎ core capacities of the United Republic of Tanzania-Zanzibar, or the websites of the Ministries of Health. ⁹⁷⁷⁹⁷⁸⁹⁷⁹

5.6.1b Evidence of non-compliance with sample sharing element of PIP framework

Score: 100

There is no public evidence that Tanzania has not shared samples in accordance with the Pandemic Influenza Preparedness (PIP) framework in the past two years. There is no evidence via the World Health Organisation (WHO) or top international and local media outlets of any non-compliance in the past year by Tanzania. [1,2

5.6.1c Evidence of non-sharing of pandemic pathogen samples during an outbreak

Score: 100

There is no public evidence that Tanzania has not shared pandemic pathogen samples during an outbreak in the past two years. There is no suggestion from the World Health Organisation (WHO) report on a Marburg Virus Disease in both 2023 and 2025 that Tanzania failed to share pandemic pathogen samples. ⁹⁸⁰

There is no media reporting in the past two years to suggest that Tanzania has failed to share pathogen samples during an outbreak. No evidence was found via the Ministry of Health, Ministry of Agriculture, and Ministry of Livestock for Tanzania, and no evidence from the Ministry of Health and Ministry of Agriculture for Tanzania-Zanzibar. ⁹⁸¹⁹⁸²⁹⁸³⁹⁸⁴

Risk Environment

6.1 Political and security risk

6.1.1 Government effectiveness

6.1.1a Policy formation

Score: 50

6.1.1b Quality of bureaucracy

Score: 25

6.1.1c Excessive bureaucracy/red tape

Score: 25

6.1.1d Vested interests/cronyism

Score: 25

6.1.1e Corruption

Score: 41

6.1.1f Accountability of public officials

Score: 25

6.1.1g Human rights risk

Score: 50

6.1.2 Orderly transfers of power

6.1.2a Orderly transfers of power

Score: 50

6.1.3 Risk of social unrest

6.1.3a Risk of social unrest

Score: 25

6.1.4 Illicit activities by non-state actors

6.1.4a Risk of terrorism

Score: 50

6.1.4b Level of illicit arms flows within the country

Score: 50

6.1.4c Risk of organized criminal activity

Score: 50

6.1.5 Armed conflict

6.1.5a Presence or risk of armed conflict

Score: 75

6.1.6 Government territorial control

6.1.6a Government territorial control

Score: 100

6.1.7 International tensions

6.1.7a International tensions

Score: 50

6.2 Socio-economic resilience

6.2.1 Literacy

6.2.1a Adult literacy rate (15+ years old, both sexes)

Score: 82.86

6.2.2 Gender equality

6.2.2a UNDP Gender Inequality Index score

Score: 39.41

6.2.3 Social inclusion

6.2.3a Poverty gap at $1.90 a day (2011 PPP) (%)

Score: 36.76

6.2.3b Share of employment in the informal sector

Score: 0

6.2.3c Coverage of social insurance programs (% of population)

Score: 0

6.2.4 Public confidence in government

6.2.4a Public confidence in government

Score: 50

6.2.5 Local media and reporting

6.2.5a Robust, open, diverse local media and reporting

Score: 0

6.2.6 Inequality

6.2.6a Gini coefficient

Score: 59.5

6.3 Infrastructure adequacy

6.3.1 Adequacy of road network

6.3.1a Adequacy of road network

Score: 25

6.3.2 Adequacy of airports

6.3.2a Adequacy of airports

Score: 50

6.3.3 Adequacy of power network

6.3.3a Adequacy of power network

Score: 25

6.4 Environmental risks

6.4.1 Urbanisation

6.4.1a Urban population (% of total population)

Score: 69.83

6.4.2 Land use

6.4.2a Change in forest area (percentage points)

Score: 17.64

6.4.3 Natural disaster risk

6.4.3a Natural disaster risk

Score: 75

6.5 Public health vulnerabilities

6.5.1 Access to quality healthcare

6.5.1a Total life expectancy (years)

Score: 56.85

6.5.1b NCD mortality rate

Score: 79.69

6.5.1c Population aged 65+

Score: 90.52

6.5.1d Tobacco use (% of adults)

Score: 65.49

6.5.1e Level of adult obesity (%)

Score: 79.53

6.5.1f Age-standardised prevalence of mental health disorders (per 100 000 people)

Score: 68.46

6.5.2 Access to potable water and sanitation

6.5.2a Access to potable water

Score: 0

6.5.2b Access to at least basic sanitation facilities

Score: 0

6.5.2c Percentage of health-care facilities with no access to any electricity supply

Score: 64.58

6.5.3 Public healthcare spending levels per capita

6.5.3a Domestic general government health expenditure per capita (PPP)

Score: 2.29

6.5.4 Trust in medical and health advice

6.5.4a Trust medical and health advice from the government

Score: 100

6.5.4b Trust medical and health advice from medical workers

Score: 100

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