key: cord-0898265-fyq5or92 authors: Mfinanga, Sayoki G; Mnyambwa, Nicholaus P; Minja, Daniel T; Ntinginya, Nyanda Elias; Ngadaya, Esther; Makani, Julie; Makubi, Abel N title: Tanzania's position on the COVID-19 pandemic date: 2021-04-14 journal: Lancet DOI: 10.1016/s0140-6736(21)00678-4 sha: aab6941e201f2168121d2bc1bc8df69862c933c9 doc_id: 898265 cord_uid: fyq5or92 nan In a World Report about COVID-19 vaccine use in Tanzania, 1 local context was not sufficiently considered to fully understand the country's position on the COVID-19 pandemic and its use of COVID-19 vaccines. We maintain that the late President John Magufuli understood the severity of the COVID-19 pandemic, which merits joint and coordinated global efforts. In the early months of the pandemic, between February and April, 2020, the Tanzanian Government quickly implemented various WHO-recommended measures, and, as of Feb 27, 2021, the Ministry of Health has issued 15 guidelines. The government decided not to implement a lockdown because that would have restricted public access to health services, especially for patients with chronic conditions like tuberculosis and HIV infection, which, in settings like Tanzania with large burdens of infectious and non-infectious disease, would have had severe effects. Lockdown might have also prevented citizens from working, affecting households' ability to afford food or health care, pushing more people into poverty. In February, 2021, the government reissued guidelines insisting on WHO-recommended measures and built local capacity to produce personal protective equipment. The government has also adopted complementary traditional remedies that are thought to boost immunity. Tanzania harbours a rich diversity of valuable medicinal plants and has plans to build capacity to intensify research on alternative remedies against COVID-19; such efforts are also supported by WHO. 2 However, such efforts have been misinterpreted as undermining control measures against COVID-19. The suspended use of the Oxford-AstraZeneca COVID-19 vaccine in South Africa and emerging SARS-CoV-2 variants raised concerns in Tanzania. 3 President Magufuli urged the Ministry of Health to conduct a robust evaluation before accepting the use of vaccines in the country. In an interview with the BBC, the government's chief spokesperson Hassan Abbas reiterated that "we would like to see the accuracy [efficacy] of these vaccines first. Tanzania is not in denial of the vaccines, but we think that it is not the right time for now...at some point, yes, once they [the vaccines] have been clinically approved". 4 Tanzania embraces vaccination programmes and consistently shows high im mun isa tion coverage for infants younger than 5 years. 5 We uphold the spirit of working collaboratively with local and international agencies in the fight against the COVID-19 pandemic. ANM is employed by the Tanzanian Ministry of Health. All other authors declare no competing interests. SGM and NPM contributed equally. 2 WHO. WHO supports scientifically-proven traditional medicine Covid-19: South Africa pauses use of Oxford vaccine after study casts doubt on efficacy against variant Covid-19 vaccines: Tanzanian government says the country has "controlled" the virus United States Agency for International Development. Immunization. MCSP Tanzania program brief For the Tanzanian Minstry of Health COVID-19 guidelines see