Tanzania health act poses opportunities and challenges

Significance The scheme was born out of the populist politics of former President John Magufuli (2015-21) but its realisation under Samia reflects a combination of the president’s own conviction to make health services widely accessible and her political calculations ahead of local and presidential elections in 2024 and 2025 respectively. Impacts The poor handling of the existing National Health Insurance Fund may dissuade some private employers from backing the new scheme. Delivering affordable healthcare to low-income Tanzanians would boost Samia’s profile ahead of 2024-25 elections. If the scheme succeeds, it would become one of Samia’s key legacy issues.