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In March 2019, Princess Zahra Aga Khan and the Prime Minister of Tanzania, Hon. Kassim Majaliwa launched the completion of the second phase of a US$ 79.8 million (TZS 183 billion) expansion of the Aga Khan Hospital in Dar es Salaam, which will enable the institution to serve over one million patients each year. The expansion was funded by a US$ 53.5 million (TZS 134 billion) loan from the French Development Agency (Agence Française de Développement - AFD) and a US$ 26.3 million (TZS 58 billion) contribution from the Aga Khan Development Network (AKDN). In this interview for the AKDN website, Mtanya Matuja, Programme Officer with AFD in Tanzania, explains why the AFD partners with AKDN and why they saw this hospital as such an important project for AFD to support.
1. How does AFD see the partnership between AFD and AKDN ?
AFD group has had longstanding relationships with the AKDN in different sectors such as culture, environment, education, infrastructures, financial services, tourism food security, and the health sector, for more than 15 years. AFD, as the French bilateral development institution, has been one of the key actors of the partnership agreement signed between the French Republic and Aga Khan Development Network (AKDN) in 2008. Last year marked the celebration of the 10th anniversary of the partnership. The strength of the relationship is based on one common ground: a genuine desire to invest in the social uplifting and improving people’s quality of life.

2. What was the reason for AFD to invest in Africa and Tanzania and partner with Aga Khan Health Service, Tanzania on health ?

This partnership in Tanzania came as a continuum of the AFD’s involvement in the financing of the AKDNs global health
strategy. It focuses on the response to non-communicable diseases in developing countries and is also in line with the framework of AKDN’s strategy in health care in East Africa. Specifically in this Region and for the health sector, AFD has provided $108 M in concessional loans to the Aga Khan Development Network in East Africa, accompanied by a 250,000€ grant. The projects realised through this funding includes:

A new Heart and Cancer Centre at the Aga Khan University Hospital in Nairobi.

The extension of health services at the Aga Khan Hospitals in Kisumu and Mombasa, with a network of outreach health facilities.

The recently inaugurated extension of the Aga Khan Hospital in Dar es Salaam from 74 beds to 170 beds capacity and countrywide expansion of AKHS with 24 outreach health centres.

Establishment of a palliative care program in all four Aga Khan Hospitals in Kenya and Tanzania.

The health sector in Tanzania faces critical challenges: life expectancy at birth reaches barely 59 years and the human resources gap is estimated at 40%. The country has been experiencing an epidemiologic transition with a significant increase in non-communicable diseases (diabetes, cancer, and heart diseases), particularly in urban areas. The number of deaths from these diseases is likely to double by 2030. Despite the efforts of the Tanzanian Government, the public health care system struggles to meet the growing demand in health services, both quantitatively and qualitatively. AFD aims at supporting the government for the implementation of its priority projects, defined by the new Five Year Development Plan, in priority sectors: Water and Sanitation, Energy, Transport and Health. In this journey, the private sector has to be taken on board as they play an important role in addressing challenges related to poverty reduction and sustainable development.

3. How does AFD see the Aga Khan Hospital, Dar es Salaam benefitting the people of Tanzania ?

The inauguration of the extension of the Aga Khan Hospital, Dar es Salaam is a testament to the steadfast partnership between the Government of Tanzania, AFD and AKDN to improve the quality, consistency and equitable delivery of healthcare in the country. This project should establish the Aga Khan Hospital, Dar es Salaam as a premier, private not-for-profit integrated and teaching health system. The establishment of the Outreach Health Centres across Tanzania will enable populations across the country to access affordable and quality health care at their doorstep, and will provide a continuum of care with the Aga Khan Hospital. The impact can already be seen with the first 17 outreach centres already active, spread across 11 regions of Tanzania.

Strengthening health services affordability through a Patient Welfare Programme at the Aga Khan Hospital Dar es Salaam for needy patients who may not, on account of financial difficulties, be able to afford the cost of care. At cruising speed the welfare will be in the region of $4 million per year.

Training of post graduate medical specialists in family medicine, surgery and internal medicine (28 residents trained in 4 years) as the key elements of a high quality hospital.

The expansion has also allowed the Aga Khan Hospital to enrol a larger number of interns (increased from 22 to 60) who are all placed by the Ministry of Health, Community Development, Gender, Elderly and Children.
Improving the environmental treatment of clinical waste with the agreement that Aga Khan Hospital will allow the public hospitals of Dar es Salaam to dispose of their clinical waste through the hospital at no cost.

Establishing Aga Khan Outreach Health Centres across the country over several years. These will offer a range of essential Maternal and child health services to increase the accessibility and quality of services for women and children under five in targeted regions.

These agreed social indicators have been decisive in AFD’s decision to participate in the financing of the project. They are aligned with the objectives we constantly pursue: we ensure that the projects we support bear a maximum social impact.

The Agence Française de Développement (AFD) is an inclusive public financial institution and the main actor in France’s development policy. It makes commitments to projects that genuinely improve the everyday lives of people, in developing and emerging countries and in the French overseas territories. Present in Tanzania for more than 10 years, AFD’s actions are on a growth curve (more than 665M€ committed between 2009-2018 including 130M€ in 2018), mostly via sovereign loans in what are several priority sectors for the Tanzanian Government such as water and sanitation, energy, transport, education, and healthcare.

The Aga Khan Development Network was founded by His Highness the Aga Khan as a private, international, non-denominational development organisation. It employs over 80,000 people in more than 30 countries. The network’s agencies address complex development issues, including the provision of quality healthcare and education services, cultural and economic revitalisation, micro-enterprise, entrepreneurship and economic development, the advancement of civil society and the protection of the environment.

The Aga Khan Hospital, Dar es Salaam was established in 1964 as a private, not-for-profit institution that provides primary, secondary and tertiary level health care services in Tanzania. In 2016, the Hospital was internationally recognised for its quality of services when it received the Joint Commission International certification, making it the only hospital in Tanzania to receive this distinction. The hospital is part of the AKDN Health System in twelve countries, which provides community health programmes covering over 500 health facilities, including 20 hospitals that provide quality health care to more than five million patients annually.