Tanzania is rapidly expanding its digital health systems, collecting enormous amounts of information about its citizens. The Ministry of Health uses the District Health Information Software 2 (DHIS2) as part of its health information infrastructure. This platform supports the collection, storage, analysis, reporting and dissemination of health information. The ministry also has a Data Use Partnership (DUP) with PATH, a government-led initiative to strengthen digital health and establish governance bodies.
The DUP was implemented with support from the Bill & Melinda Gates Foundation and PATH. DHIS2 states that countries using the platform operate their own separate instances and retain ownership of their local systems and data. The global DHIS2 team does not have access to local systems or data unless the local system owner grants access. This distinction is crucial, as using foreign-supported technology does not automatically mean foreign organizations own the information stored in it.
Health data includes highly sensitive information about a person's medical history, HIV status, laboratory results, reproductive health, genetic information and other personal details. Once this information moves through digital platforms, databases, cloud infrastructure, technical-support arrangements and data-sharing agreements, questions arise over who determines the purpose of processing, who can access the information, where it is stored and under what circumstances it can be transferred outside the country.
Tanzania's 2026 health cooperation agreement with the United States commits over $1.3 billion to Tanzania's health sector over five years, with Tanzania committing $1.8 billion of its own resources. The agreement focuses on strengthening Tanzania's ability to finance, manage and sustain essential health services. During the signing, Tanzania's Health Minister Mohamed Mchengerwa stated that the agreement did not provide for sharing laboratory specimens with the United States.
The issue of health data governance has become relevant following Kenya's dispute over a $1.6 billion U.S.-Kenya health cooperation agreement. A Kenyan court temporarily suspended the agreement while considering a case concerning the privacy and oversight of citizens' health data. The Consumers Federation of Kenya argued that decisions based on Kenyan health data should be publicly accountable, auditable and subject to joint and independent oversight.
Kenya's Office of the Data Protection Commissioner has warned about risks associated with health-data processing, including unauthorized access, disclosure, cyberattacks and the way technology vendors may use information to which they have access. Its guidance identifies cloud-based systems as presenting challenges, as healthcare institutions may have limited control over the cloud infrastructure and the terms imposed by service providers.
Tanzania has its own personal-data protection framework, but the rapid expansion of digital health means that laws must operate alongside procurement contracts, technology agreements, cloud arrangements, donor agreements and technical-support relationships. The critical issue is whether every partnership leaves Tanzania with stronger permanent control over its own health information, clearly identifying the Tanzanian institution responsible for each data set.
Key points
- The control of Tanzania's health data is a critical issue as the country expands its digital health systems.
- The use of foreign-supported technology does not automatically mean foreign organizations own the information stored in it.
- Health data governance has become a contentious issue in Kenya, with a court temporarily suspending a $1.6 billion U.S.-Kenya health cooperation agreement.
