by Ben Taylor

President Samia Auluhu Hassan receives the Johnson & Johnson Coronavirus vaccine in Dodoma on July 28th, while urging others to do the same.

Turning a tanker around?
President Samia Suluhu Hassan has continued her efforts to reshape Tanzania’s national response to the Coronavirus, including a number of changes President Magufuli had warned against.

In mid-May, three months after taking office, the scientific advisory committee she formed reported back. The body recommended that the virus’s presence in Tanzania should be publicly acknowledged, that Covid data should be made public, and that Tanzania should join the international effort to supply Covid-19 vaccines to developing countries, Covax.

Most prominently, in June, the President acted on the third of these recommendations and reversed her predecessor’s stance on vaccines. She first allowed international organisations and diplomatic missions to import vaccines for their employees, and shortly after this the country applied to join Covax.

On July 24, the country received a batch of one million Johnson and Johnson single-dose vaccines, donated by the US government. Zanzibar has received doses of the Sinovac vaccine from China. Both vaccines have been approved for use by the World Health Organisation (WHO). Tanzania is also believed to be participating in the African Union’s joint vaccine purchasing programme.

A few days after the US-donated vaccines arrived, the President herself was publicly given one of the first doses. She used the occasion to encourage the public to get vaccinated, pointing out that the country was “not an island” in dealing with the pandemic.

President Hassan wore a mask when receiving her vaccine, as she has done on most public appearances in the past few months. She did not do so right at the start of her Presidency, following the lead of President Magufuli who had shunned both masks and vaccines. And while, under her predecessor, mask wearing was uncommon, it has become much more normal to see leaders and public officials wearing them of late.

The President has also begun allowing some data on case numbers, hospitalisations and fatalities to be released. Specifically, in late June, the Ministry of Health published the first such data in over a year, stating that the “third wave” had thus far led to 100 cases in the country, of which 70 had required oxygen. Four weeks later, the Ministry released more figures, confirming 29 deaths with 176 new coronavirus cases recorded the previous day, and mentioning that the new cases brought the total number of cases in the third wave to 858.

The release of data has been piecemeal, however, with inconsistent figures and formats used. The low official numbers also stand in stark contrast to the hundreds or thousands of new daily cases being identified in neighbouring Kenya and Uganda. Few analysts take the figures seriously, arguing either that the government is still not being honest with the public, or that 12 months of denying the situation has eroded the capacity of public health institutions to deliver a reliable testing regime and to collate accurate statistics.

These data releases provided part fulfilment of a commitment to do so, made to the International Monetary Fund (IMF) in order to access emergency financial support to enable Tanzania to cope with the pandemic. At the start of September, the IMF board approved USD $567m in emergency support to Tanzania to help finance a vaccination campaign and meet the health and social costs of the pandemic.

More broadly, and of particular significance when it comes to the vaccination campaign, the situation is complicated by the continued denialism of some of President Magufuli’s supporters. Most notably, the prominent evangelical preacher and Member of Parliament, Bishop Josephat Gwajima, has claimed without evidence that vaccines can interfere with human DNA.

“Are we that brainless? Doctors, professors: have you decided to put your brains in your pockets?” he asked his congregation. “People taking the vaccines risk becoming mentally challenged or monitored by computers from the West,” he added.

In a sign both that the previous President’s views no longer hold sway and that his methods may be harder to shake off, the government in response ordered the police and anti-corruption authorities to arrest and interrogate Bishop Gwajima to substantiate his statements against Covid-19 vaccines.

Doctors, however, have cautiously welcomed President Hassan’s changes. It has allowed them to work more freely, diagnose patients and treat them without fear of repercussions from the authorities, said Shadrack Mwaibambe, Head of the Tanzanian Medical Association. He did note, however, that the government continued to support – though no longer to encourage – the use of “remedies” with no scientific support, including steam inhalation. He argued that the authorities should not be talking of such things now they have decided to follow the science.

While critics of President Magufuli’s approach to the pandemic remain frustrated that the new President has not gone as far as they would like, other commentators are more understanding of her position.

“Misinformation [about COVID-19 vaccines] is widespread,” said one doctor, who asked to remain anonymous, “and unfortunately it came from official sources.”

“Things changed so suddenly. I know many people who are still trying to reconcile themselves to the government’s new COVID approach,” says Herrieth Makwetta, a health reporter for Mwananchi newspaper.

Another medic, Dr. Shindo Kilawa, of Muhimbili National Hospital, says the government faces a tough task ahead in promoting the vaccines. “To break away from the past, psychologically, I see the need for a massive awareness campaign, mainly targeting the general public. Otherwise we could end up with many unused stocks of vaccines,” he said.

Government figures are personally trying to navigate a tricky change of direction. In February, Health Minister Dr Dorothy Gwajima had been publicly and vocally sceptical of masks and vaccines, preferring instead to promote various herbal concoctions. She now wears a mask in public, and is urging the public to come forward for vaccinations. Similarly, Hamisi Kigwangala, a medical doctor and prominent MP, publicly spoke against Covid-19 vaccines in February but has lately made a U-turn. He was filmed in July receiving a Covid-19 vaccine and has started a social media awareness campaign to encourage greater take-up. “The vaccine is the only sure way we have for now to remain safe, so if one gets a chance, they should take it without wasting time,’’ he told a reporter for the US broadcaster, NPR.

While such course corrections may be awkward and embarrassing for individual politicians, they are emblematic of the challenge the President faces. A widely-beloved President told the country one thing, in emphatic terms. The new President now has the task of telling them this was wrong, ideally without appearing to criticise the source of the falsehoods. This is made even harder by the fact that confidence in science has always been low in Tanzania.

Convincing a sceptical nation to wear masks, maintain good hygiene and distancing practices, and to seek medical help when needed will be difficult. Convincing people to get vaccinated will be even more so.

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