South Africa's Proposed Health Care Reform

South Africa is spending 8.5% of her GDP on healthcare expenditures and continue to have inequity health system, plagued with inefficiency. Their health care system has been described as "unsustainable, destructive, very costly, and highly curative". They are expected to live seven years shorter than Tanzanians, despite the fact that Tanzania's expenditures in healthcare is much less comparable to SA's. This is not a surprise; the legacy of Apartheid is the creation of one of the most en-equal society in the world.

To that end, it seems like folks in SA Ministry of Health are parting ways with donors influenced disease control programs and are overhauling the entire system. Their plan is ambitious, with some unanswered questions--but it is a bold and much welcomed change. Details of the proposed reforms are outlined in this 59 pager policy paper released by SA-MOH. Quick reforms that stands out--

• Creation of National Health Insurance (NHI) modelled from UK's NIH (what Americans call socialism ). NHI will be the sole provider and payer of health expenditure in SA. It will make sure everybody has access to a defined "comprehensive package of healthcare services'". NHI will definitely help control the escalation of cost and there will be rationing of care as well. NHI eventually will transform the way health services are provided, managed, and increase priority towards primary health care.
• Ideally, NIH being the sole funder--will be able to pool and reallocate the funds in a more egalitarian fashion, and revitalize public health sector that will vastly improve access, and will regulate for the higher quality of care.
• Foreign students, tourists, and visitors will be required to show health insurance prior to entry in SA. (potential impact on tourism industry?)
• Re-engineered primary healthcare system focusing on community outreach with an eye on health promotion and preventive measures. They need to look at Ethiopia's Health Extension Workers, who are attributed to a revolutionized rural health in Ethiopia.
• School health services. This is a simple and effective way to improve child hood health.
• Over 14-year implementation period, the overhaul will cost $17 billion (Same price US spend in Afghanistan in 8 months). It will be funded by taxes--which raise concerns for a country with 24% unemployment. It might be regressive to bombard the tiny middle class with extra taxes. I wonder how rich folks feel about that.

You can check out the rest of the proposal on the link above. I think it is the right direction towards improving health systems in low-mid income countries. We have to get away from the PEPFARs and the Global Funds and tackle the problem at its core--which is the messed up system. Tanzania should pay close attention on how this thing is being implemented, we need our own reform. Besides, healthcare is one of the few industries that continue to add jobs in this economic climate. It makes sense to reform now.

Another Edition of Good Reads

It has been the culture of this blog to post what we think might be good reads (books) for the readers of this space. In this edition we have one book that might challenge the dogmatists view economics of poverty (Easterly-Moyo Vs. Sachs-ProBonos). And the other book has enabled liberals and conservative to embrace "libertarian paternalism" view and argue that we are all choice architects at one point. The contents of these books are valuable for public policy makers who are bold and are looking for different ways to achieve their causes. The reviews that are posted below have been borrowed (without permission) from various credible book reviewers. Enjoy!

Poor Economics: A Radical Rethinking of the Way to Fight Global Poverty. By Abhijit Banerjee and Esther Duflo. PublicAffairs; 336 pages; $26.99. (The Economist Review)--One of the Author (Esther Dufflo) was also featured in this blog sometime in the past.

“Poor Economics” should appease some of their critics. It draws on a variety of evidence, not limiting itself to the results of randomised trials, as if they are the only route to truth. And the authors’ interest is not confined to “what works”, but also to how and why it works. Indeed, Ms Duflo and Mr Banerjee, perhaps more than some of their disciples, are able theorists as well as thoroughgoing empiricists.

They are fascinated by the way the poor think and make decisions. Poor people are not stupid, but they can be misinformed or overwhelmed by circumstance, struggling to do what even they recognise is in their best interests. The authors recount (with grudging admiration) how nurses in rural Rajasthan outwitted the two professors’ efforts to stop them skiving off work. They also describe how borrowers in south India exploited a contractual loophole to avoid taking out health insurance, which their microlender insisted they buy for their own good.

The poor, like anyone else, can also succumb to inertia, procrastination and self-sabotage. The authors discovered it was quite normal for poor women in the Indian city of Hyderabad to take out a microloan charging 24% interest only to deposit it in a savings account that paid 4%. This seems mad, except that the obligation to repay the loan ensured the women did not squander the money. Farmers in western Kenya miss out on the benefits of fertiliser because, by the time the planting season arrives they have often spent their earnings from the previous harvest. But farmers far-sighted enough to buy the fertiliser straight after the harvest, when they do have money, do not sell it, despite facing all the same demands on their resources. In other words, farmers cannot save the money to buy fertiliser, but they can save the physical fertiliser itself.

Poverty is often linked in the public mind with dependency. But, as the authors point out, the poor bear more responsibility for their lives than the rich, who coast along, enjoying chlorinated water, drawing a regular salary, paid directly into a bank account, perhaps with contributions to their pension and health care automatically deducted. The rich can indulge their weakness for cigarettes and alcohol without fear of financial ruin. The poor, in contrast, have to watch every cup of sugary tea. Mr Banerjee and Ms Duflo recommend a variety of nudges, props and subsidies that will make it as easy for poor people to make the right decisions as it is already for the rich.

If it is a mistake to equate poverty and dependency, it is equally mistaken to believe the poor will lift themselves up by their bootstraps. The book crosses swords with the business gurus and philanthropists who project their own enthusiasm for Promethean entrepreneurship onto the poor. Yes, the poor are more likely to run their own business than the rest of us. But that is because they have no other choice. When asked, most of them aspire to a government post or a factory job. Developing countries are not full of billions of budding entrepreneurs; they are full of billions of budding salarymen. Read the rest here.

Improving Decisions About Health, Wealth, and Happiness By Richard H. Thaler and Cass R. Sunstein. 293 pp. Yale University Press. $26

As a result, Thaler and Sunstein argue, many of the familiar arguments for why people should simply be left to make choices on their own, and especially for why government should stay strictly out of the way, have little practical force. In many important areas of choice that matter both to the individual and to the rest of us (for example, when overuse of medical care drives up our insurance premiums and our taxes), the operative question is not whether to bias people’s decisions, but in which direction.

Thaler, a professor of economics at the University of Chicago, and Sunstein, a law professor formerly at Chicago but now at Harvard, apply this line of argument to a wide array of familiar areas: saving, borrowing, energy consumption,smoking, teenage pregnancy and many others. Along the way they present fascinating findings about how people actually make decisions, together with lots of personal advice: save more, diversify your investments, don’t invest much in your employer’s stock, don’t pay points on mortgages, buy insurance with the biggest deductible you can afford, don’t pay for extended warranties. But their main objective is to reshape public policy (Sunstein is an informal adviser to Barack Obama, who has advanced some “Nudge”-like policy ideas), and it’s clear that the suggestions they care most about apply to ways in which governments can do a better job of guiding the choices made by their citizens. The goal, in part, is to nudge people toward healthier, safer, more prosperous lives while also addressing pressing issues like environmental damage and the rising cost of health care.

If all this sounds paternalistic, that’s because it is. Thaler and Sunstein adopt the deliberately oxymoronic label “libertarian paternalism” to describe their general approach. It’s libertarian in that people retain the right to make their own choices: they’re free to select the savings plan with the lowest projected return if that’s what they really want. But the govern­ment — or an employer, or the person in charge of laying out the food in the cafeteria — is nonetheless nudging people in the direction that somebody thinks will make them better off.

The conceptual argument is powerful, and most of the authors’ suggestions are common sense at its best: Set up 401(k) programs so that employees have to opt out if they want, rather than making them opt in. (At present, roughly 30 percent of employees eligible for 401(k)’s don’t sign up, despite the enticement of employer matching contributions.) Do the same for organ donation. Make credit card companies offer an automatic full-payment option. Offer investment vehicles that provide automatic portfolio rebalancing. Most of these ideas work because of the human tendency, widely documented, toward what Thaler and Sunstein call “inertia.” Most of us just call it laziness.

In the end, however, “Nudge” is somewhat thin on practical ideas for public policy that follow from the authors’ core insight. Many of the suggestions Thaler and Sunstein make, in contexts like savings and mortgages and credit cards, amount to calls for greater disclosure (what did all of those credit card fees total last year?) or for presenting information in a clearer way (to make price comparisons for mortgages easier). Surely no one except the companies making the profits would oppose more disclosure and clearer information. But we don’t need behavioral economics, or libertarian paternalism, to think such proposals might be helpful.

And the authors occasionally strike a false note. Their recommendation to allow patients to sign away the right to sue doctors for malpractice, for example — presumably in return for lower medical bills — doesn’t resemble the argumentation elsewhere in the book. The threat of lawsuits, they reason, gives doctors little incentive to be more careful because malpractice insurance isn’t “experience rated”; in other words, the premium charged doesn’t depend on the doctor’s past record as it does for, say, drivers. (Oddly, they accept the seemingly conflicting view that the threat of lawsuit is expensive because it leads doctors to prescribe unnecessary tests.) Why don’t they suggest that malpractice insurance be experience rated too? Read The Rest Here.

The Legacy of Jakaya and Beyond 2015

I should start by declaring that two of my family members were directly appointees of Jakaya in his first term of presidency. To that end, I have indirectly become a benefactor of his presidency, and this fact might persuade some readers to delegitimize the contents of this document. Also, I have spent not more than 90 days in Tanzania throughout his presidency; education and work assignments have kept me outside of my homeland for a long time. I might not be the best judge of his performance. But as every other African will tell you, Tanzanians love their country—and I have been keeping tabs of the state of our politics throughout my adulthood.

We have had 4 presidents so far in our infant country, and these gentlemen brought different style of leadership. But Jakaya is probably the most criticized for rather deserving or undeserving reasons. You see, we Tanzanians are luckly. Nyerere presided a nation with a clear vision to empower and create independent thinkers out of Tanzanians. He pushed education in its empowering version—not to accumulate knowledge, but to become the means of livelihoods. This foundation had enabled our transition towards democracy much easier and more meaningful. Democracy is useless, and can be an authoritative tool if the mass is misinformed. However, during Benjamin’s (who I regard as an intellectual) presidency he did treat Tanzanians as children. There was a free press that was fearful of the state and you can say that Benjamin was not comfortable enough to be ripped (or his government) in the press daily. This had resulted into fewer leaks and fewer scandals being presented to the press. It doesn’t mean that there were no scandals.

Jakaya is massively criticized because Tanzanians are being aware of how the government is functioning, and we do have an awful ineffective bureaucracy (this is not new). Contrary to Benjamin, Jakaya truly believe that Tanzanians deserve to know everything. He is comfortable enough to be ridiculed in the press because he understands that is how a democratic system should work. Nowadays, we complain about the press being too free that they write upuuzi. From Tanzania Daima, MwanaHalisi, Raia Mwema, to name few dailies and weeklies that make a living ripping this government. To me this is one of his biggest achievements, trusting the people to know everything, and make their decisions on the ballot accordingly. He has had his disappointments (umeme & corruption), and his triumphs (hardcore part of education and infrastructure) but I do commend him for allowing us to talk sh!t about him freely.

Moving forward, Tanzania is on the cusp of taking off. We have this great foundation in place, we just need a reformer and visionary at helm to steer us the right way. Unfortunately (or fortunately), this is our generation challenge. Anybody who was alive during independence shall not attempt to run for presidency in 2015. You have the wrong mentality. We are free already. We just need a leader who is blind of 1961 euphoria, who understand the global dynamics and can negotiate with global leaders without feeling inferior to them. In mean time, let us scrutinize these politicians regardless of their party affiliations—and question the authenticity of the dubious journalism, because the well-being of our republic depends on an informed citizen. At our inner core, Tanzanians are independent and moderate, it is the way we have been engineered. We cannot afford to lose this trait now, as the future has never been so bright.

Random Rant: Classless Barcelona

If Barcelona wants a player who is under contract--then they should pay up. These guys want to buy a world class mid-fielder at only 24 for peanut price. Just because Cesc has loyalty with them, does not make his price any cheaper. Now, they are holding Arsenal hostage because of the unwillingness to pay up. And if the deal doesn't fall through, Arsenal can't count on Fabregas because his loyalty in in Barca. You would expect Barcelona to have more class than what they are doing now.

Looking forward to another season of Gunners football. Competition just got a whole lot tougher, but I think this is a year we can finally win something. Before all that, Barca need to show a little class and pay up the right price for Fabregas.

Waiting on South Sudan's Big Day

I have been in South Sudan for the last 3 weeks (my second stint) now in different areas of the country. It has hard to be here and not being inspired by the magnitude of the events that will take place on July 9th. This is the place where the forgotten war was fought for decades and only World War II killed more people than the Sudan civil war in the modern era. The devastation of that conflict can be seen on daily activities here, you might spend 4 hours driving 50 KMs or stumble into healthcare facility that has neither skilled workers nor essential medicines. There sheer amount of poverty and suffering is unprecedented-- while the acres and acres of virgin land that is stuffed with landmines reminds one that this was once a battle-field. As it is, the entire population is divided into two halves, you are either a former soldier or a former refugee.

But South Sudanese are beaming with unspeakable joy right now. Either you are a Nuer, or a Dinka. A Madi or Acholi. Whether you are a former refugee or a former soldier--the people here seems to put all their bitter ethnic rivalry on the side and celebrate on the big day. There are parties arranged in almost every household, some are planning to slaughter a bull, some a goat, some a chicken--but it is clear that July 9th is shaped up to be the biggest day for this neonatal country. The have all the rights to celebrate, the sacrifices that they took for the right to be a free people are immeasurable. That is why July 9th will be a somber celebration, so many South Sudanese have perished during the fight for freedom. John Garang's name will be echoed throughout the next coming days. This new nation would have used his leadership skills now more than ever--It is unfortunate that he never lived to see this day, but his presence will truly be felt.

Now, Juba is bracing itself for hosting head of states and a lot of "important" global leaders. This is a town that was literally a village three years ago, and an airport that was just handled over yesterday (July 5th). There has been a massive crack-down on security this last week. We were waken up by SPLA soldiers conducting household weapons search, and stop and search check-points all over Juba. Nobody will be allowed to enter or exit Juba starting July 7th, and the airport will be closed from July 7 to 10. The boda boda are not even allowed to use the main roads and Juba will come to a complete shut down when the big day approach. The security crack-down is understandable, not everybody is happy with South Sudan independence. There have been "rebel" militia attacks in different areas of South Sudan who are rumoured to be bankrolled by the other Sudan government. And there is The Abyei showdown, and a crisis in South Khordofan . The situation here is getting tense as the big day is approaching, because nobody know what the other side will do. Interestingly, I just ran (July 5) in huge convoy of Uganda soldiers heading to Juba. It seems like South Sudan is starting to align itself with East Africa and M7 is making himself some friends.

The independence day will come and go, but South Sudan government face the huge task of building this country. It remains to be bitterly divided along tribal lines, and a lot of unanswered questions regarding the issue of oil and debt with the Khartoum government. For us who are working here, we are already aware of how difficult is it to achieve meaningful results. The government has to be assertive, and international community have to get away from short-term projects and invest in real people of this country. But many African countries have been free for about 50 years now, South Sudan has the luxury to look at how African leaders built their nations. I will urge them to copy Julius Nyerere's playbook on nation building.

In mean time, we will be partying comes on July 9th and it is a blessing to be a part of this whole thing, and we are looking forward towards helping these guys building their country. It won't be easy, but it is definitely exciting.

Politics and Power Cuts in Tanzania

Erick, a journalist in Dar, asked me "what is the source of power crisis in Tanzania, and how can it be resolved?". I thought, as simple as these questions were, they are the soberest a journalist has ever asked me. And, as such, they deserved reflection and detailed response. Here I write back:

................

Dear Erick,

Thank you for your email - and your good questions. I think the discussion on energy has taken an interesting tone and, as ever, characterized by finger pointing. For me, as an MP and the Chairman of Parliamentary Committee on Energy and Minerals, the most important question is how do we get out of current crisis. But, before that, we need to look at how we got here.

A bit of history.

All tragic stories begin with “once upon a time…”

So, once upon a time, there was no power cuts. Yes, those who were connected to the Grid were relatively few, but had power most the time. Today, those connected to the Grid do not get power most of the time. Question is: what happened? The simple answer is: we did not invest in power generation, and transmission and distribution system to keep up with increasing demand. This is the crux of the matter.

Why did we not invest? I will explain a bit. The critical period in the history of electricity in Tanzania was between 1996 and 2006. In 1996, at the height of privatization fever, we decided that TANESCO should also be privatized. So, it was “specified” i.e. put under the list of companies to be privatized. This meant that no investment was undertaken – in generation, in transmission and transmission systems and in human resource in TANESCO – except for a couple of donor-funded projects that were in the pipeline already.

So, while no major investment was undertaken, the following also took place between 1996-2006:

1. Faster growth of the economy – at an annual average of 7 percent. And the drivers of this growth were big energy consumers – mining, construction and telecoms.

2. Initiation and expansion of the donor-driven rural electrification program.

3. Growth of SME sector which relied on power – garages, salons, etc, and medium industry, including packaging and so forth.

So, by 2002, 5 years after the decision was made, TANESCO was still not ready to be privatized. It was therefore decided to bring a private management company to run TANESCO and prepare it for privatization. Enter NetGroup Solutions from South Africa. The management contract was (initially) to run for two years and was funded by the Swedish government. It was further expanded to two more years until 2006. Whether or not NetGroup delivered per contract, and whether or not the engagement was a good idea, are matters of debate until today. In the provision of the contract, there was a bonus (beyond management fee) to be paid to NetGroup if they improved the financial condition of TANESCO. Of course they did so (and got the bonus) by doing two things: they succeeded in collecting massive amounts of unpaid bills – even from the Army, and other notorious defaulters including many government agencies. They even went after Zanzibar! They also heavily relied on hydro (they went even below allowed Mtera depth) for generation so as to minimize the costs. As a result, TANESCO's balance sheet improved. But the decision to rely entirely on hydro had its costs - some of which we are seeing today.

So, in 2006, the decision on the fate of TANESCO was finally made: we will not privatize it. So, in essence, these were lost 8-9 years. Then, from 2006 – now, we entered a new phase: a phase of emergency power, and politicization of power sector. And this is entirely another story. But, it is worth remembering that, during the last five years (2006 – 2011), we have only managed to put up 145MW of our own generation while the new increased demand per annum is 100-120MW. So, while we need to catch up fast and close the gap, we are still falling behind even on the new demand.

So, this is where we are. A country of 43 million people, with meager 1,117MW installed capacity, and production of 630MW as of today. This is miserable, to say the least.

But, the critical question is: how do we get out of here? And, most importantly, beyond the question of power cuts, how do we bring electricity to majority of Tanzanians who have not had it since the beginning of the earth?

What to do end power cuts TODAY?

There are two components to producing electricity: generators and fuel. While we need and can do with more generators, TODAY the crisis is of fuel: not enough gas to run Symbion plant to capacity; in some cases, TANESCO is asked by gas suppliers to lower generation in its own two gas plants because of low gas pressure; no fuel to run IPTL plant; and no water to run hydro turbines.

So, the immediate solution is to sort the fuel issue. Why: because, even if you are able to airlift a 300MW gas power plant to Dar today, you will get Zero power as there is simply no gas. It is not that there is no gas in the country. It is just that we haven’t planned well to get it (from SongoSongo and Mtwara) to where the generators are at critical moment and/or those foreigners controlling our gas have not allowed for this to happen.

So, we should sort fuel issue. To start with, we need to buy fuel for the IPTL plant. While this is painful, it is necessary. The cost of producing one unit of electricity at IPTL is 32 cents, and TANESCO sells electricity for 10 cents. So, basically we are buying power from IPTL at loss. But then again, for one unit of electricity that is not produced, the cost to the economy is US$1.1. So, the costliest power is still cheaper than not having it at all.

In addition, the government should sort out the gas issue. The situation as it stands today is scandalous. The bottom line is that we have gas in Tanzania but we do not control its production, its transportation, its distribution and its price. We might as well be importing it via tankers from Qatar. If, for instance, today we have just enough gas to produce only 100MW of power, it will not be directed to TANESCO gas plants (where we do not pay capacity charges) but to Songas plant (where we buy power and pay capacity charges). I even worry if the upcoming TANESCO (Jacobsen) gas plant to be commissioned in December 2011 will have gas to run on. If it wont, then this will be a scandal because we contracted it and we knew of its arrival 18 months ago. We will deal with gas issue in detail in our Committee report to the Parliament later next month. We will have to make some bold proposals.

In the interim, to cover for the shortage of gas, the government should compel Songas and Symbion to invest in combine-cycle turbines to produce more power from steam coming out of the current gas turbines – and wasted in the air. In other countries, if you use jet engines (as in Symbion and Songas plants), you are compelled by regulation not to “waste steam” that can produce additional power. (TANESCO's Wartsilla gas plants use piston engines that do not produce sufficient steam/force to enable a combine-cycle system). This is just an issue of government being assertive and change the regulation given the current emergency situation.

In the medium term, we seriously need to look at the tariff structure. We need to decide in this country whether electricity is a business or service. The current tariff is not commercially viable. Full stop. EWURA sets the price of tariff after receiving request from TANESCO. Of course they do a diligent job of looking at the cost and whether they are "prudently incurred". But then they call a public meeting to ask people what they think of the tariff request. Then people and politicians go there and bully everyone into a lower tariff. Of course TANESCO could do better to cut some of its costs so as to produce electricity cheaply, but we have to realize that 36 percent of tariff is a result of capacity charges, which TANESCO can do nothing about (at least for now) and therefore the more we do away with these the better, and the more TANESCO gets power from its own sources the more it is able to sell it cheaply. Even the government knows that the current tariff does not work. That is the reason it is subsidizing to the tune of 5bn shillings per year a private company in Mtwara to sell electricity at a price equal to TANESCO!

Not only does the current tariff hurt TANESCO balance sheet, it also discourages private investment in energy sector, particularly in alternative energy. For instance, for a solar generation to be commercially viable, the tariff has to be in the upwards of 20 cents (mostly because of the heavy initial investment), likewise with wind power. No one will come here – only to sell power to TANESCO at price below 10 cents.

People may say that it is impossible for poor people to afford higher tariff. I don’t believe so. Look at how much poor people are spending on phone airtime. And the tariff structure is such that TANESCO sells power at the same rate be it to a barber shop in Namanga or Barrick Gold Mine in North Mara. The tariff should be dynamic and flexible given the volatility in the fuel prices and different capacities of TANESCO customers. There are those who will be willing to pay higher tariff as long as power is steady and reliable. With industries, power, even at higher price, feature very insignificantly to the cost of production but when it is NOT available it is a very significant contribution to losses. For me, for the poor, the prohibitive cost is the electricity connection cost – at 500,000 shillings at a go, most rural people can’t afford it. If the tariff will continue to not reflect the cost of producing power, TANESCO will continue to underperform and investors will be less inclined to come (recently TANESCO announced a tender and the most competitive bidder offered to sell power to TANESCO at 1,028 shillings while TANESCO sells power for 157 shillings!) or will seek to make money off capacity charges.

Now, as we look for solutions to the power crisis, we also need to look at TANESCO (as our sole power producer and distributor at the moment) itself. What do we need to do to it? What is its cost structure? On the ground, and given the assets it owns, this company should be the pride of Tanzania. Last year, it sold power worth about 500bn shillings. Few companies in Tanzania can match that kind of revenue. And it has assets worth $1bn (more than 1.5 trillion shillings) and more than 5,000 employee. It has the potential to triple the assets and revenue in 5 years if the right decisions are made. But, what are those and why aren’t they being made. I will not dwell much on this as this thing will be longer (and will go beyond the issue of power cuts) and I will let my friend Zitto whose Committee deal with parastatal finances to chip in on this. But, suffice it to say that, we have a sleeping giant in TANESCO, and people ought to be much more thoughtful in their calls for its split and/or privatization.

But I agree that TANESCO has to do better. At the moment, it spends 70 percent of its revenue buying electricity from Songas – which only has about 15 percent of installed capacity. This is painful, and needs to change. Also, while it is required by best [utility] industry practice to spend 12 percent of revenue on Repair and Maintenance, TANESCO spent only 2.8 percent of its revenue on R and M between 2005-2008 – and result is lots of broken transformers and service lines and a huge amount of lost electricity. TANESCO needs to invest in transmission and distribution system as part of the solution to the current power crisis. Last year, mainly because of poor transmission and distribution infrastructure, TANESCO lost 21 percent of power it produced and/or bought. This lost electricity amounted to more than 1,200 GWhr – which is more than all electricity used in factories and businessplaces for the entire year, and amounted to about 75 percent of all electricity bought from Songas in the entire year. These are massive losses – which, if curbed, in themselves would have helped with the power situation.

I want to wind up as I am just on a roll – and can’t seem to finish. But last point: we need to manage better private [prospective] investors in energy sector. There is a lot of bureaucracy and red tape within government where people come in with project plans and proposals and end up going in circles in government offices and end up being captured by middlemen and influence peddlers - and eventually corruption kicks in. There are projects that should have been in the pipeline now but were delayed because of bureaucracy and our incapacity to deal with their complexity. Also, we need to be serious on how we handle energy projects. Most energy investors dedicate a team of around 20 people in a single project – lawyers, finance people, etc. Power projects are very complex. I feel that we in government aren’t looking at them as such. We assign 4 or 5 people who already have other tasks in the Ministry to look at these projects and engage these guys. There ought to be a full time project management team at the Ministry that will live and breath power projects everyday and how to get them executed faster and to the benefit of the country. And I also think that there are many clever energy financing avenues that we haven’t explored thoroughly, and have been stuck in the traditional grants, loans and treasury guarantees.

Finally, the government has plans to do 2,780MW by 2015. This is quite an ambition, and will go long way towards covering the gap and catching up with the demand. I like it when we think big and attempt big things. But to achieve it, we need to do better than business as usual.

So, these are some of my thoughts. You also asked me clarify on my comment on Minister Ngeleja. I didn’t want to dwell on people and personalities. As you can see, there are enough issues to fill many paragraphs. As a Member of Parliament, I will continue to ask these questions and advice the government to make the right decisions and policies. As MPs, we will hold the government (via Minister responsible) accountable for its promises in the Parliament, and we will demand answers (including answer to my letter), and the appointing authority will have to judge on his Ministers' performance. But to say that the Minister is a source of power crisis in Tanzania is being simplistic. And I am not one to jump into simple answers. I have realized that part of my problem as a politician is that I am probably too nuanced, and should probably have chosen academia. But I believe that we can do better as a people to embrace nuance and complexity.

As Chairman of Parliamentary Committee on Energy and Minerals, people always ask me when will these power cuts end? In my PERSONAL view, intermittent power cuts will continue until 2013. And this is being optimistic. Leaders will have to be honest that it may be impossible to completely end the current phase of power cuts before the end of the year.

Call me if you have further questions,

Best regards,

January Makamba (MP)
Chairman of the Parliamentary Committee on Energy and Minerals
Dodoma
June 29th, 2011

PS: The views in this email are my own, not Committee's.

Paine's Perspectives on Religion.

From Thomas Paine's Age of Reason. I will put some snippets here and you can read the whole thing right here. In light of the religious squabbles that are brewing in Tanzania's internet blogs and from some of irresponsible media, we could all use some common sense!

I believe in one God, and no more; and I hope for happiness beyond this life.

I believe in the equality of man; and I believe that religious duties consist in doing justice, loving mercy, and endeavoring to make our fellow-creatures happy.

But, lest it should be supposed that I believe in many other things in addition to these, I shall, in the progress of this work, declare the things I do not believe, and my reasons for not believing them.

I do not believe in the creed professed by the Jewish church, by the Roman church, by the Greek church, by the Turkish church, by the Protestant church, nor by any church that I know of. My own mind is my own church.

All national institutions of churches, whether Jewish, Christian or Turkish, appear to me no other than human inventions, set up to terrify and enslave mankind, and monopolize power and profit.

I do not mean by this declaration to condemn those who believe otherwise; they have the same right to their belief as I have to mine. But it is necessary to the happiness of man, that he be mentally faithful to himself. Infidelity does not consist in believing, or in disbelieving; it consists in professing to believe what he does not believe................

Each of those churches show certain books, which they call revelation, or the word of God. The Jews say, that their word of God was given by God to Moses, face to face; the Christians say, that their word of God came by divine inspiration: and the Turks say, that their word of God (the Koran) was brought by an angel from Heaven. Each of those churches accuse the other of unbelief; and for my own part, I disbelieve them all...................................

When the Church Mythologists established their system, they collected all the writings they could find, and managed them as they pleased. It is a matter altogether of uncertainty to us whether such of the writings as now appear under the name of the Old and New Testament are in the same state in which those collectors say they found them, or whether they added, altered, abridged, or dressed them up.

Be this as it may, they decided by vote which of the books out of the collection they had made should be the WORD OF GOD, and which should not. They rejected several; they voted others to be doubtful, such as the books called the Apocrypha; and those books which had a majority of votes, were voted to be the word of God. Had they voted otherwise, all the people, since calling themselves Christians, had believed otherwise — for the belief of the one comes from the vote of the other. Who the people were that did all this, we know nothing of; they called themselves by the general name of the Church, and this is all we know of the matter.............................................

As to the theology that is now studied in its place, it is the study of human opinions and of human fancies concerning God. It is not the study of God himself in the works that he has made, but in the works or writings that man has made; and it is not among the least of the mischiefs that the Christian system has done to the world, that it has abandoned the original and beautiful system of theology, like a beautiful innocent, to distress and reproach, to make room for the hag of superstition.

The very nature and design of religion, if I may so express it, prove even to demonstration that it must be free from everything of mystery, and unencumbered with everything that is mysterious. Religion, considered as a duty, is incumbent upon every living soul alike, and, therefore, must be on a level with the understanding and comprehension of all. Man does not learn religion as he learns the secrets and mysteries of a trade. He learns the theory of religion by reflection. It arises out of the action of his own mind upon the things which he sees, or upon what he may happen to hear or to read, and the practice joins itself thereto.

When men, whether from policy or pious fraud, set up systems of religion incompatible with the word or works of God in the creation, and not only above, but repugnant to human comprehension, they were under the necessity of inventing or adopting a word that should serve as a bar to all questions, inquiries and speculation. The word mystery answered this purpose, and thus it has happened that religion, which is in itself without mystery, has been corrupted into a fog of mysteries....

On Tanzania's Growing Population

On Tanzania's Growing Population

By Thuwein Y. Makamba

This is where we are at today. Each woman in Tanzania is averaging 5.4 children during her lifetime, and that would project our population to grow up to 109 million by year 2050. Only 27% of Women have access to modern contraceptive methods.

Women in our country are forbidden the choice to abort their pregnancies, so they either throw the infants away (we often read of this in our news) or seeks unsafe abortions--which happens a lot on makeshift clinics. Now, 42% of under-5 yrs old have stunted growth which have implications on their intellectual abilities. Furthermore we have 88% of secondary school graduates virtually failed their examinations.

We are a nation of young, unemployed, and uneducated people in an economy growing in unequal way with non-existent middle class. But we continue to produce offsprings that we either do not need or we can not take care of (as a parent and as a nation). Our culture used to view children quantitatively, that a family needs a man power for farming and livestock keeping. But the mechanization of labor has changed that mentality. And Children are valued qualitatively. The parents with 2 children that have at least bachelor degree is better off than one with 6 children, half of them malnourished. The parents with 6 children in 20 years, are better off than the ones with 3 children in two years. The issue is not necessarily to limit the number of children, but to have a quality pool of offsprings. Moreover, the direction of global labor market is to favor only those skilled workers. Engineers, and ICT wonks. The companies will invest only to those countries that have wide pool of these kind of workers.

It is in everybody's interest to scale up Reproductive Health and Family Planning services to majority of Tanzanians, and should be included in the package for essential health services for every single health facility in our land. Obviously this will not be easy, and other will argue that development is the best contraceptive, but the pace of development is so slow that we can not wait. Currently we have 43 million folks, and only 15% households have rationed electricity. There is famine scare if we miss 3 months of rain, and we need USAID + Irish money to feed our own children. Now, imagine what would happen if there is 100 million of us. It would be a disaster.

Population issues are never without controversies, and currently we have religious leaders who think of themselves as bigger as ever. But RH/FP is about child spacing and empowering women more than anything, because development is synonymous with equality. Including gender equity, with a known fact that women are thee large, untapped resource that we have. So, this is not about "killing babies" it is about giving our children a chance to become a competent people. And allowing Women to use the magic of child rearing skills for other facets of our society.

That is why when Roe V. Wade (legalized abortion) was passed in 1973, it had effect with the significant reduction of crime in early America's 90s. This is because folks where given the chance to have children that they could take care of. And China's one child policy has created a generation of skilled pool of worker unrivalled by any country on earth. They all want to go back to China to build their nation.

Our time is now, and policy makers can can choose to ignore RH because it is not as popular as banning "posho" but the great law of neccesity is so obvious that warned the states from allowing increasing of population beyond the food it can produce or acquire.

An Insane Economic System

United States currently has a record number of homeless people, and a record number of foreclosures homes. In a way, there is bunch of folks sleeping outside staring at bunch of empty houses.

Isn't that crazy? Whatever happened to commonsense policy making? and maybe a little less greed from the elites.

Irresponsibility of Some of Tanzania's Media

In Tanzania we have been enjoying free of speech unparalleled by many countries in this planet. However, there has been a trend of gross irresponsibility by our journalists and the public have been constantly fed by ridiculously articles. I ran into this piece published by RAIA MWEMA on June 1st, 2010, that demonstrated the sheer negligence of professionalism and ethics of fine journalism. Somebody, should get Jenerali Ulimwengu (whom I greatly respect) to read the articles that his affiliated newspaper is publishing.

Here is the piece and some comments that I inserted.

Kikwete na Porojo za Kujivua Gamba

Na Mwandishi Maalumu (You can not publish article with this amount of allegations without revealing the author)

NI vigumu kuamini kwamba rais wa nchi anaweza kuhusika na mchezo mchafu kama huu wa kuwabagua wananchi wake kwa misingi ya dini zao, lakini matukio ya hivi karibuni yanathibitisha hilo.( How? Show us the causality)

Baada ya uchaguzi mwaka jana na hasa tukio la Arusha la Watanzania kupigwa na polisi kwenye maandamano ya Chama cha Demokrasia na Maendeleo (CHADEMA), na kisha harufu ya udini kuibuka, baadhi ya Waislamu wachache wenye mtazamo mkali walianza kuzunguka nchi nzima wakitoa mahubiri ya chuki. (Dates, Names, what exactly did they say? At least have a source)

Mkutano mmoja ulifanyika kwenye ukumbi wa Diamond Jubilee jijini Dar es Salaam na inadaiwa ulipata baraka za Kikwete (How can we believe u?). Baadhi ya mikutano hiyo ilijadili masuala tata, na baadhi ikaibuka hata na mapendekezo ya ajabu ukiachilia yale ya muda mrefu kama vile kudai Mahakama ya Kadhi na Tanzania kuingia kwenye Jumuiya ya Kiislamu Duniani (OIC).

Madai mengine yalihusu malalamiko kwamba Wakristo wamekuwa wakipendelewa tangu enzi za ukoloni na kwamba ingawa Waislamu ni wengi zaidi Tanzania, lakini hawana nafasi nyingi za madaraka.

Madai mengine yaliyotolewa ni kwamba Wakristo wana shule na mahospitali lakini Waislamu hawana, na kwamba serikali hutoa fedha kuzisaidia hospitali za Wakristo na walimu wa kufundisha shule za Wakristo, lakini Waislamu wanaachwa hivi hivi tu.

Baadhi walifikia hata hatua ya kumlaani Mwalimu Nyerere na kusema kwamba hastahili kuitwa Baba wa Taifa; bali anastahili kuitwa Baba wa Kanisa Katoliki. Baadhi yao, akiwemo kigogo wetu, hawamwiti Mwalimu Nyerere kwa hadhi yake iliyozoeleka ya Baba wa Taifa, na badala yake humwita Mzee Nyerere.( We need dates of the events, and names of attendees. At least a background interview. You can’t just throw allegations with NO evidence. WaTanzania sio wajinga hivyo).

Kwa ufupi, kuna imani kubwa miongoni mwa Watanzania kwamba utawala wa Rais Kikwete unalea udini (Do u have a scientific poll to back this up? ), na asipokuwa makini nyufa hii yenye msingi wa kidini inaweza kupanuka na kuutia dosari umoja wa kitaifa tulionao ambao misingi yake si udini.

Geresha ya kujivua gamba

Pamoja na kubadili safu ya uongozi mjini Dodoma, CCM pia ilitangaza kwamba wanachama wake watatu wanaotuhumiwa kwa ufisadi wajiondoe wenyewe; la sivyo wataondolewa kwa nguvu. Wanachama hao wanatajwa kuwa ni Waziri Mkuu aliyejiuzulu, Edward Lowassa, na wabunge wawili, Andrew Chenge na Rostam Aziz. Ni kweli matajiri hawa hawapendwi na Watanzania wengi isipokuwa pengine wa majimboni mwao tu.

Lakini pia watu hawa watatu wana sifa nyingine: Kwamba ndio tishio pekee na la kweli dhidi ya mpango wa Kikwete wa kusaka mgombea urais wa mwaka 2015 ambaye ni Mwislamu (This is unprecedented. You are accusing the head of state of being mdini, but you are not telling us readers how u have arrived to this conclusion?)Wanaotaka kumweka Lowassa kwenye urais mwaka 2015, si tu wanakwamishwa na tuhuma hizi zinazomwandama na hatihati hii ya kung’olewa CCM, lakini pia wanakwazwa na Kikwete mwenyewe. Inadaiwa kwamba, kwenye mbio za urais za 2015, tatizo la Kikwete kuhusu Lowassa si kwamba anakabiliwa na tuhuma za ufisadi; bali kwamba si Mwislamu. (You are supposed to quote your sources on this sentence. How can we believe u?)

Kundi hili la kina Lowassa inaaminika lina urafiki wa karibu na Makamba ambaye inadaiwa kuwa agenda yake kubwa kwa mwaka 2015 haikuwa udini; licha ya kuwa naye amesikika mara kadhaa akilumbana na maaskofu (Disagreeing with Maaskofu does not make one Mdini); bali yeye (Makamba) ana ndoto ya mwanae (January) aje kuachiwa urais mwaka 2025 na kundi hili(Now you can read people’s dreams too? How can a respectable news as Raia Mwema publish this nonsense?). Makamba hutamba kwamba mwanae anafaa kuwa kiongozi, na hakuna ubishi kwamba alihakikisha mwanae anapata ubunge, uenyekiti wa kamati ya Bunge, na kisha kuingia kwenye Sekretarieti ya CCM.

Aidha, mtoto huyo wa Makamba pia anaelezwa kuwemo kwenye kundi linalowaunga mkono watuhumiwa hawa wa ufisadi ambalo lina idadi kubwa ya wabunge na viongozi wa CCM wa ngazi za wilaya, mikoa na taifa. Hii ndiyo sababu tangu CCM ilipoanza kushambulia mafisadi hadharani, yeye amepotea jukwaani!( Have u reach to him and ask for him to comment? That is how professional journalists operates. You just made up your own reasons as if January do not exist.)

Kimsingi, kuna kutofautiana kati ya Makamba na Kikwete kuhusiana na nani awe rais mwaka 2015 na kuhusu nini wafanyiwe hawa watuhumiwa wa ufisadi. Hivyo; tangazo la kujivua gamba pamoja na kutajwa kwa watuhumiwa hao ambao Kikwete mwenyewe aliwapigia kampeni mwaka jana kwenye uchaguzi wa wabunge, ni geresha tu. Ukweli ni kwamba Kikwete alikuwa anaunda timu itakayomrithi mwaka 2015.

Kimsingi, hadi sasa Kikwete ameshawaacha ‘wabaya’ wake wote nje ya Kamati Kuu ambao ‘dhambi’ yao kuu ni kuutaka urais wa mwaka 2015. Watu hao ni pamoja na Membe na Andrew Chenge ambaye anamtaka Lowassa. Kwa ufupi, janja hii ya Mwenyekiti Kikwete ya “kujivua gamba” ililenga katika kuwaengua wale wote wanaoweza kumsumbua kwenye suala la urais wa mwaka 2015; ingawa pia ni kweli kwamba ukiuangalia juujuu utaona kuwa mpango huo wa “CCM kujivua gamba” unalenga katika kupunguza nguvu za CHADEMA kwa kuirejeshea CCM mvuto wake wa zamani.

Vyovyote vile; hakuna ushujaa wala maamuzi magumu yaliyofanyika Dodoma. Ulikuwa ni ‘usanii’ tu, na ndiyo sababu hakuna kiongozi wa CCM anayepigia kelele kung’olewa chamani mafisadi zaidi ya kijana Nape na Katibu Mkuu mpya, Wilson Mukama ambao, hata hivyo, nao wamefungwa “gavana” hivi karibuni kuhusu kulipigia debe suala hilo. Hata Chiligati aliyejitokeza mwanzoni kuhubiri nia ya kuwavua uongozi wa CCM kina Lowassa, Rostam Aziz na Andrew Chenge, sasa naye ameingia mitini!( Sources?)

Kauli ya Joseph Butiku

Labda nigusie pia kidogo kuhusu malalamiko ya Joseph Butiku aliyoyatoa katika mahojiano na gazeti la Raia Mwema, hivi karibuni, kwamba viongozi wa CCM wamemwachia Mwenyekiti Kikwete mzigo wa kupambana na mafisadi.

Mimi nadhani madai hayo ya Butiku ameyatoa bila kujua ukweli wa mambo. CCM haiko kwenye mapambano na mafisadi; bali Mwenyekiti Kikwete ndiye anapambana na maadui zake kwenye kinyang’anyiro cha kutafuta mrithi wake kwenye Uchaguzi Mkuu wa mwaka 2015; ila tu amepata bahati kwamba watu hao hao ndio wanaolalamikiwa kwa ufisadi. Ni bahati tu ya mtende iliyotoa fursa ya ‘usanii’ huu kuchezwa! (Last election was a referendum on corruption more than anything. But you seem to disagree. You argument is “luck”. You know we can reach conclusion to every issue by attributing it on luck)

Aidha, kelele za CCM kupitia kwa Nape kwamba kuna vyombo vya habari, viongozi wa Upinzani na viongozi wa dini ambao wamepangwa kuwatetea mafisadi na kuishambulia familia ya Kikwete, ni janja ya kuwatangulia mbele ili wakisema jambo, wananchi waambiwe: “Si tulisema, mnaona sasa!?”

Hata hivyo, inafahamika kuwa makundi haya matatu ndiyo yako mstari wa mbele kupinga ufisadi na udini unaosambazwa na Kikwete na watu wake, hivyo lolote litakalosemwa halitakuwa geni; bali ni muendelezo unaofahamika. Pengine CCM haijui kuwa wananchi wanajua kinachoendelea. (WaTanzania are not stupid, ofcourse they know what is going on. You writing this piece betting on fact that WaTanzania hatujui kinachoendelea. You are betting on our ignorance)

Wagombea wa Kikwete 2015

Kwa kufuatilia mambo ya kisiasa yanavyokwenda na jinsi Rais Kikwete anavyoendesha mambo yake, kuna majina mawili ya watu wanaotajwa ambao angependa wachukue urais na umakamu wa rais wa Muungano mwaka 2015. Hii inatokana pia na imani yake kwamba Katiba mpya haitabadili mfumo wa sasa. (Now you can also predict people’s beliefs. Sources mzee, at least one source to come on the record. How can we believe u)

Sababu kubwa ni mbili: Kwanza, kutekeleza ahadi yake ya siri kwamba hawezi kuacha nchi kwa Mkristo (This is very dangerous. You are being irresponsible with your words throwing allegations like this one. SOURCES??) na pili, kuhakikisha uongozi mpya unamlinda yeye na familia yake dhidi ya misukosuko ya hapa na pale ambayo kawaida kote duniani hutokea mtu akishaacha urais. Hakika, naye hatapenda kushambuliwa kama inavyotokea kwa Mkapa.

Baada ya kufanikiwa kuwaengua pembeni Lowassa na Membe (Prof. Mwandosya kanusurika?) ni nani, basi, ambaye Kikwete anamtaka kwa urais wa 2015 na atachezaje karata zake kuhakikisha jina la mtu huyo linapeta?

Ili watu hao wawili anaowataka wakubalike, inaaminika kuwa Kikwete atatumia mtindo ule ule wa funika kombe mwanaharamu apite. Atawapendekeza kwa kutumia vigezo vinavyoficha ukweli (Now umekuwa Mnajimu. You can predict the future). Kutokana na hali ya kisiasa itakavyokuwa, anaweza kusema: “Jamani ni zamu ya wanawake sasa, tusitawale akina baba tu, nchi yetu wote.”

Iwapo wazo hili litakwama, basi, Kikwete anaweza kusema hivi: “Jamani sasa wenzetu wa Zanzibar nao, miaka 20 imepita, tuwape nao nafasi jamani.” Msemo huu, hata hivyo, hauna mashiko iwapo Katiba haitakuwa na agizo hilo; kwani upande wa Upinzani unaweza kuweka wagombea wote wa Bara.

Mbinu hiyo Kikwete ameshawahi kuitumia kwenye kujaza nafasi ya Mwenyekiti wa Umoja wa Vijana ambapo alimpendekeza kijana wa Visiwani, na pia aliitumia kwenye kupata jina la mgombea wa uspika. Anaamini kuwa mbinu hiyo itasaidia kufunika hoja yake ya udini isionekane, na hivyo kufanikisha kupata rais Mwislamu.

Asha-Rose Migiro na Dk. Mwinyi

Katika miaka ya karibuni Kikwete amekuwa na mahusiano ya karibu ya kikazi na mwanamama mmoja ambaye kila baada ya miezi michache hufika Ikulu, na kisha picha nyingi hupigwa kuonesha kwamba wawili hao wanaelewana na wanashirikiana kisiasa pia.

Huyu ni mwanamama ambaye ni mmoja wa wanasiasa wachanga waliofaidika na vyeo vya uwaziri wa Kikwete mwaka 2005. Aidha, pale Tanzania ilipopewa mwanya wa kutoa jina la mwanamke wa kushika nafasi ya juu kimataifa, Kikwete hakusita kumtaja mwanamama huyu.

Nafasi hii ilikuwa baada ya Tanzania kufanya kampeni kubwa barani Afrika kuunga mkono jina la Waziri wa Mambo ya Nje wa Korea Kusini, Ban ki-Moon, kwenye kugombea nafasi ya ukatibu mkuu wa Umoja wa Mataifa.

Mwanamama huyo pia ana kisomo kizuri kinachokubalika na kinachoweza kuwaaminisha watu wanaotaka kuuliza maswali kuhusu uwezo wake kiutendaji wa kuiongoza nchi yenye matatizo ya uchumi na yenye mipasuko kibao kama Tanzania. Mwanamama huyo ni Naibu Katibu Mkuu wa Umoja wa Mataifa, Dkt. Asha-Rose Migiro ambaye anaelezwa kuanza kujiandaa kurejea nyumbani Tanzania siku si nyingi.

Kwa upande wa Zanzibar, ni waziri mmoja kijana ambaye urafiki wake na Kikwete huwashangaza viongozi wengine wa Zanzibar; mathalani jinsi wanavyosalimiana kama watoto wa mjini. Katika mtandao wa YouTube Watanzania waliweka picha ya video ya Kikwete akisalimiana ‘kishkaji’ na waziri huyu kwenye Uwanja wa Amani, Zanzibar siku ya Januari 12, mwaka huu. Picha hiyo iliibua gumzo kubwa (What is your point?? What do u want us readers to take away from this useless paragraph? President and his minister wanasilimiana kishkaji, so what?)

Hivi karibuni Waziri huyu alipokabiliwa na msukosuko wa kutakiwa na wananchi kwamba ajiuzulu ambao kimsingi ulisababishwa na utendaji dhaifu wa Jeshi la Wananchi uliochukua maisha ya watu kwenye milipuko ya maghala ya silaha, alikataa na Kikwete hakusema kitu. Huyu ni Waziri wa Ulinzi, Dkt. Hussein Mwinyi.

Hitimisho langu

Inaaminika kuwa hao wawili ndio chaguo la Kikwete katika mbio za urais za 2015, na chaguo lake hilo linachagizwa zaidi na dini zao (How did you arrive to this conclusion? Throughout this piece, you have not convince us readers to buy on your accusation that our President is a religious fanatic) badala ya vigezo vya jumla vya sifa ambazo Watanzania wote tunataka mtu anayetaka kuwania urais kuwa nazo.

Hata hivyo, napenda nieleweke kwamba sina tatizo na rais ajaye kuwa Mwislamu au Mkristo; ilimradi tu awe ni kiongozi hodari, mchapakazi, mwadilifu na mwona mbali. Angalizo langu ni kwamba rais huyo ajaye asitafutwe kwa msingi wa dini yake; bali kwa vigezo hivyo vya ubora.

Nasisitiza hivyo; maana Watanzania katika ujumla wao hawajali dini ya mtu ila uadilifu na uchapakazi tu, lakini viongozi wetu ndio wenye matatizo ya udini. Na kwa hakika, Kikwete analo tatizo hilo.

Nihitimishe kwa kusisitiza kwamba wajibu wa wana-CCM ni kukisafisha chama chao kwa uaminifu na werevu, na kisha kuachia demokrasia iamue nani awe mgombea wa CCM mwaka 2015. CCM na Kikwete wawe waangalifu na dhana hii ya “sasa ni zamu yetu kutawala” ili Tanzania isitumbukie kwenye matatizo yanayosikika kwenye nchi zingine.

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The author and the publisher are being irresponsible and do not take their role in our society seriously. The piece has absolutely no standards to be published and consumed by our society. We are a democracy, but for democracy to work, a people have to be informed--otherwise we will continue to elect useless leaders. But our people can not be informed, if we keep on consuming garbage articles like this one.

Everybody can write, but to publish is a privilege that should be taken seriously.

The Fallacy of Donors' Driven Health Agenda

In Tanzania, like many other low income countries, funds for healthcare activities are largely derived from donors. It can be PEPFAR, USAID, or The Gates. We can not tax our way through providing comprehensive health insurance for everybody in the model of UK's NHS for obvious reasons. And we can not generate funds from Social Insurance Schemes due to largely high levels of unemployment. So, we rely on donors, who in turn get to set the agenda and the priorities on how to spend the money.

This is what we get-- Acute Respiratory Infections only get 3% of funding despite contributing to 25% of disease burden. Shigellosis (some stomach infection) kills 1 million a year, mostly children but receives relatively no fundings. On the other hand HIV despite of its deservingly fame, contribute only 5% of disease burden but it collects 32% of total funds. There is absolutely no infrastructures for cardiovascular and other non communicable diseases, but collectively there is no emphasis to earmark funds onto these categories (because they do not cross borders). This is what happen when a country loose grip of its own agenda.

What is rather surprising is law makers in Kenya have gotten creative and proposes airline levy (like UNTAID is doing) to increase funds for HIV. This is mind boggling, because they could use that money to build up their non-communicable disease infrastructure since they get so much HIV money from other sources.

We can not improve the health outcomes of our people, if we can not even address the problems that requires our undivided attention. Spending our time and efforts in HIV, TB, and Malaria just because thats what the donors want is a ticking time bomb.

The Positive.

Cornel West on deception of Barack Obama

A very interesting observation of Cornel West on Barack's presidency, which I found it as fair and valid--for those of us outside the veil of presidency. He (West) might have went too far when he said that Barack is afraid of an independent black man. But in most part his criticism is on point. You can't justify electing Larry Summers over Joe Stiglitz unless you want to re-assure very powerful people that you have their backs.

Anyways, here are some quotes--

"“I think my dear brother Barack Obama has a certain fear of free black men,” West says. “It’s understandable. As a young brother who grows up in a white context, brilliant African father, he’s always had to fear being a white man with black skin. All he has known culturally is white. He is just as human as I am, but that is his cultural formation. When he meets an independent black brother, it is frightening. And that’s true for a white brother. When you get a white brother who meets a free, independent black man, they got to be mature to really embrace fully what the brother is saying to them. It’s a tension, given the history. It can be overcome. Obama, coming out of Kansas influence, white, loving grandparents, coming out of Hawaii and Indonesia, when he meets these independent black folk who have a history of slavery, Jim Crow, Jane Crow and so on, he is very apprehensive. He has a certain rootlessness, a deracination. It is understandable.

“He feels most comfortable with upper middle-class white and Jewish men who consider themselves very smart, very savvy and very effective in getting what they want,” he says. “He’s got two homes. He has got his family and whatever challenges go on there, and this other home. Larry Summers blows his mind because he’s so smart. He’s got Establishment connections. He’s embracing me. It is this smartness, this truncated brilliance, that titillates and stimulates brother Barack and makes him feel at home. That is very sad for me."

On Michelle Obama

I can tell her I’m sorry it offended you, but I’m going to speak the truth. She is a Harvard Law graduate, a Princeton graduate, and she deals with child obesity and military families. Why doesn’t she visit a prison? Why not spend some time in the hood? That is where she is, but she can’t do it.

On Barack's economy team

He bitterly describes Obama as “a black mascot of Wall Street oligarchs and a black puppet of corporate plutocrats. And now he has become head of the American killing machine and is proud of it.”........The first announcement of Summers and Geithner I went ballistic. I said, ‘Oh, my God, I have really been misled at a very deep level.’ And the same is true for Dennis Ross and the other neo-imperial elites. I said, ‘I have been thoroughly misled, all this populist language is just a facade. I was under the impression that he might bring in the voices of brother Joseph Stiglitz and brother Paul Krugman"

On Barack's defense, I think governing a 450 million democracy is not easy especially in a country whose political system was designed to frustrate radical changes. Edmund Burke and early thinkers thought this was a way to avoid radicals from creating fresh difficulties in their attempt to re-engineer the society. I think he could do more for progressives and moralists out there (himself is one of them) but he is governing an institution rigged with ideologue that requires compromises to get things done. The Kennedys (Bobby & Jack) were progressive and didn't last very long. Bobby didn't even made it to the presidency, maybe Barack want to enjoy his social security.

and you can read the whole interview here

A Radical Experiment in Empathy

In a wake of Osama's death. A renowned sociologist Sam Richards' timely talk on empathy is challenging you to get outside your skin and attempt to understand the other side.

Many of us still regard Mau Mau movements in fighting for Kenya's independence as heroics, but British viewed them as savaged terrorists. And they set operations to crush them, which was highly supported by majority of British people. When Nelson Mandela and ANC waged terrorist attacks against white South Africa, it was acceptable to a lot of black Africans but himself (Mandela) was viewed as a terrorists by scores of western nations. Malcolm X, infamously said that Black Americans need to speak the same language (of violence) as White Americans during the civil rights movements. And he is viewed as a role model and a hero to a lot of people in our societies.

But our standards of "acceptable violence" took different turn when judging how middle-easterners react to what they perceive as injustice against them. I'm not trying to defend terrorism, but terrorism itself is in relative to who? because Mau Mau weren't terrorist in our eyes--then maybe Hamas or Al-Qaeda aren't terrorists in Palestines' lens. Whenever a society perceive to be treated unfairly, her people will raise up, that is human nature. Social justice and social protection are the cheapest way to avoid violence. Politicians and policy makers ought get their empathy on, if the world will ever try to reduce the amount of violence that is so prevalent.

Malaysia New Economic Model

In an attempt to circumvent away from the "middle-income trap". Malaysia has put together an impressive blue print. Bold and indeed creative on paper. I hope serious politicians in Tanzania can print and read these reports. For the sake of being inspired.

Here is Part One and Part two. They are all PDFs and are downloadable links.

Deadly Collabo?

These two need to make an album together. 20 percent and Afande Sele, it would be just right on point. "Hata tembo akikonda hawezi kuwa kama ndama"..Enjoy kazi yao hapo chini.

Thoughts on Health Inequality

Thoughts on Health Inequality

By Thuwein Y. Makamba

Improving health inequality doesn’t necessarily increase health equity; Sen argued that distribution of wealth in a fashion that will make overall society unhealthy is not the right way to pursue health equity. In many low income countries, the pie is too small to be distributed to everybody, and it is suggested to let economies grow first before implementation of egalitarian social policies. However, in societies like United States where the pie is already big, it is imperative to implement social policies that will improve social determinants of health and provide everybody capabilities to achieve good health. However, policy makers must understand that providing capability for citizens to achieve health doesn’t mean they will achieve good health. This is explained by the idea of “subculture of poverty” brought by anthropologist Oscar Lewis who argued that poor people have sense of dependence, of not belonging, and are marginalized in their own country. These people (poor) are convinced that existing institutions do not serve their interest or needs. In response to this, it is imperative that when improving social determinants of these populations’ health, the behavioral change component should also implemented in parallel with improving education status.

Providing healthcare for all and implementing policies that will improve social conditions for the poor is a moral decision, and decisions in morality are non-uniform amongst politicians and policy makers. United States political ideology (premises of Washington Consensus) is highly influenced by early political thinkers like John Locke who argued that “every man has a property in his own person. This nobody has any right to but himself. The labor of his body, and the work of his hands, we may say are properly his.” This thinking has shaped a society in a way that it is not accepted to distribute one’s income, because the labor is the unquestioned property of the laborer. This explain why more egalitarian social policies are not acceptable in United States, despite the evidence of immense sufferings to those disadvantageous social groups. And the fact that the idea of ‘unquestioned property of the laborer” is only valid when there was the same level of equality to begin with. The critics of equal social policies are negating the notion of accident of birth, which it was not in poor people choosing to be born in conditions with poor determinants of health.

Those who disputes ideas of equality often say that “it is better that some should be unhappy than that none should be happy”. Although this thinking is flawed because equality can also means that everyone should be happy. Also, it also known that wherever health inequalities are greatest the overall health status of the population is lower. Therefore it is in everybody interest to adopt the policies that would improve health equity of the society. The only inequality that should be allowed is that if it would benefit those who are least well-off, argued by John Rawls in his Difference Principle. But this Rawls’ accepted inequality would only be tolerated if it will improve equity rather than bringing everybody down.

The marker for moral excellence in our society should be based on how we can avoid premature deaths, and needless illness. We have signed a social contract with our governing institutions to pursue equal justice for all and this include giving everybody the chance to pursuit of healthiness regardless of their social status or income.