ACT Wazalendo has questioned the pace and effectiveness of the government’s implementation of its 100-day healthcare pledges, particularly the rollout of Universal Health Insurance.
The opposition party says the government’s reported progress should be measured not only by the number of people registered for health insurance, but also by whether citizens can actually access medicines, diagnostic services, specialist treatment and healthcare workers when they need them.
ACT Wazalendo said campaign commitments included launching Universal Health Insurance within 100 days, providing full coverage for specialist treatment and diagnostic services for vulnerable patients with chronic illnesses, recruiting 5,000 health workers and ending the withholding of bodies of deceased patients over unpaid medical bills.
According to figures cited by ACT Wazalendo from the 2025 Household Income and Expenditure Survey, about 16.56 million people on Mainland Tanzania live below the poverty line.
The party said 997,015 people had reportedly been registered under the Universal Health Insurance programme, but 501,981 had yet to receive insurance cards.
ACT Wazalendo argues that the numbers point to a significant gap between the government’s ambition for universal coverage and the number of vulnerable citizens currently benefiting from the programme.
The concern is particularly important for low-income households, for whom unexpected medical expenses can quickly translate into debt, reduced household consumption or loss of income.
ACT Wazalendo has also raised concerns over the structure of health insurance packages, arguing that the level of healthcare available to citizens should not depend heavily on their ability to pay.
The party cited four packages — Ngorongoro Afya, Mikumi Afya, Serengeti and Tanzanite Afya — saying lower-cost packages provide fewer specialist services, diagnostic tests and treatments.
The opposition party argues that a genuinely universal system should provide meaningful protection against serious illnesses, particularly those capable of pushing vulnerable households into financial hardship.
ACT Wazalendo has singled out chronic illnesses as one of the areas that will test the effectiveness of Universal Health Insurance.
The party questioned whether vulnerable patients suffering from kidney disease, cancer, diabetes and heart conditions are receiving the full range of specialist services promised during the campaign.
It specifically raised concerns over access to services such as dialysis, MRI and CT scans.
For patients and their families, the issue is less about insurance registration figures and more about whether an insurance card can translate into treatment when a serious illness occurs.
The party has also pointed to the shortage of health workers as a major challenge to universal healthcare.
ACT Wazalendo cited government figures showing an estimated requirement of 348,923 health workers, compared with approximately 182,430 currently available, leaving the country with only about 52.3 percent of its estimated staffing needs.
The party said recruiting 5,000 workers, while important, would not be enough to close the existing gap.
It estimates that Tanzania would need to recruit about 33,298 health workers annually for five years to meet current staffing requirements.
The shortage affects the entire healthcare chain, including doctors, nurses, laboratory specialists, pharmacists and other health professionals.
ACT Wazalendo also highlighted shortages of medicines, medical equipment and diagnostic services at health facilities.
The party argued that expanding insurance membership without ensuring adequate supplies could leave citizens with coverage on paper but limited access to actual treatment.
It cited government debts to the Medical Stores Department (MSD), which it estimates at TZS 471.11 billion, as part of the challenge affecting the availability of medicines and medical supplies.
For patients, the central question remains straightforward: Can an insured person receive the necessary treatment without being forced to pay additional costs out of pocket?
ACT Wazalendo further questioned whether the government has fully delivered on its pledge to end the withholding of bodies of deceased patients over unpaid medical bills.
The party said complaints from different parts of the country indicate that some families still face difficulties securing the release of bodies because of outstanding bills.
The issue has a direct impact on families already dealing with bereavement and raises broader questions about how medical debt should be handled within the public health system.
ACT Wazalendo is calling for Universal Health Insurance to be linked with a broader social protection system.
Under its proposal, people in the formal and informal sectors would contribute according to their financial capacity, while the government would fully finance coverage for the poorest households.
The party also wants a more equitable insurance system in which citizens receive essential healthcare without major differences in benefits based on income.
It has further called for greater investment in domestic pharmaceutical manufacturing and reliable government procurement of locally produced medicines to reduce dependence on imports.
ACT Wazalendo argues that sustainable universal healthcare will require greater public investment.
The party pointed to Tanzania’s health spending as remaining below the 15 percent target under the Abuja Declaration, arguing that limited public financing continues to place pressure on citizens and external development partners.
The wider debate is therefore not simply about issuing insurance cards. It is about whether Tanzania can build a healthcare system in which citizens can obtain medicines, qualified health workers, diagnostic services and specialist treatment when they need them — regardless of their income.
For Universal Health Insurance to earn public confidence, ACT Wazalendo argues, coverage must translate into real and affordable healthcare at the point of service.