The Journal of Modern African Studies

Between the state and civil society: medical discipline in Tanzania

John A. Harrington a1 1
a1 School of Law, University of Warwick, Coventry CV4 7AL, England UK


This article seeks to examine the status of the medical profession in Tanzania, in the context of political and economic developments since independence. It demonstrates that doctors have maintained a relatively privileged position within the health care system and in the wider society from the colonial period, through the early years of indpendence, to the present. This has been achieved by a variety of means. During the 1970s and early 1980s the profession was closely associated with the developmentalist project of the state. Because of economic restructuring since then it has had to adopt the rhetoric and techniques of accountability, to distance itself from the state and position itself in the notional realm of civil society. Recent cases of the Medical Council are used to demonstrate this trend. Renewed legitimation is most significant as a means of maintaining the profession's links with its international counterparts, and with foreign donors who support the health care system in Tanzania.


1 I wish to express my gratitude to Upendra Baxi, Paul Havemann, Ambreena Manji, Christian Mukoyogo, Paul Street and the anonymous reviewers for critical comment and advice. Thanks are also due to Gwakisa Mlawa for invaluable research assistance. I am indebted to Albert Mallya, registrar of the Medical Council of Tanganyika, Dr Yohana J. S. Mashalla, vice-president of the Medical Association of Tanzania, Mr Chiliko of the Ministry of Health, and the council of Chama Cha Waganga (Tanzanian Traditional Healers Association) for agreeing to be interviewed and for providing me with much information on the topics discussed here. All views expressed and any errors are, of course, my own.