The pattern and challenges to multisectoral HIV/AIDS coordination in Tanzania

Abstract

Multisectoral coordination of HIV/AIDS work has been the leading governance strategy for most sub-Saharan African countries since the early 2000s, institutionalized with national multisectoral coordinating bodies within the central government. This article reveals how such efforts have been practiced in Tanzania. An assessment framework based on theoretical elements from organization theory and elements central to aid coordination/global health coordination policy and strategy literature serves as the basis for data collection and structures the presentation of findings. The article finds that the pattern and challenges to coordination in Tanzania can be summed up as a politics of coordination, with priorities determined by global health initiatives while the national AIDS commission lacks political authority. Together with other factors, such a situation presents severe challenges to multisectoral coordination.

Point for practitioners

Successful multisectoral coordination of HIV/AIDS/global health in aid-dependent countries requires careful consideration of labour divisions and coordination initiatives among involved actors, including the central government, bilateral/multilateral donors, and NGOs.

Ensuring horizontal-internal and vertical-internal as well as external coordination of a cross-sectoral issue requires the highest office of government to provide continuous political support to the coordinating bodies; otherwise, ministries will not give priority to cross-sectoral issues, resulting in failure. Moreover, understanding the larger political economy of the sector within which coordination takes place is pertinent to explain why multisectoral coordination faces severe challenges in Tanzania.