Bloodborne HIV: Don't Get Stuck!

Protect yourself from bloodborne HIV during healthcare and cosmetic services

Covid-19: Denialism, Brand of the Cultural Imperialist


The World Peace Foundation should be more circumspect when criticizing a country for its approach to Covid-19. The word ‘denialism’ has a distinctly pejorative use in the selectively diplomatic world of international health. Those using the word see themselves as right, empirically and morally, upholders of the orthodoxy, unassailable. 

The title ‘Tanzania’s Layered Covid Denialism’ is more inciteful than insightful, and calculatedly so. Clearly, the author does not believe there is more than one valid view. If you are not with the orthodoxy, you are against it, an authoritarian, intent on imposing your will on those you lead. 

On the basis of a handful of headline-grabbing titbits, several from Twitter, the author claims that “access to information about Covid-19 has become an elite privilege”.

Let me give you a real example of elite privilege: 

“Use of improperly sterilized syringes and other medical equipment in health-care settings can also result in HIV transmission. We in the UN system are unlikely to become infected this way since the UN-system medical services…use only new or sterilized equipment. Extra precautions should be taken, however, when on travel away from UN approved medical facilities, as the UN cannot ensure the safety of blood supplies or injection equipment obtained elsewhere;…avoid direct exposure to another person’s blood — to avoid not only HIV but also hepatitis and other bloodborne infections.” 

Note, the UN believes that their personnel risk bloodborne infections from healthcare facilities available to the public in Tanzania or South Africa. But they insist that those same facilities are safe for people living in those countries, because they claim that almost all HIV transmission is a result of unsafe sex and only a tiny fraction results from unsafe healthcare. 

For all his faults, Thabo Mbeki questioned the view that ‘unsafe’ sexual behavior could explain massive HIV epidemics in a few African countries, but nowhere else. He questioned that old western prejudice about ‘African’ sexual behavior, employed throughout history to justify numerous and lengthy lapses in ethical research and healthcare. 

Sadly, Mbeki was pushed into rejecting the far better supported view that Aids is caused by a virus, HIV. What he should have rejected was the view that HIV is almost always transmitted via heterosexual sex, because outside Africa, it isn’t. 

Mbeki was punished, branded a ‘denialist’, because he didn’t agree with the orthodox view, and said so. The international health community knows that HIV is not commonly transmitted via heterosexual behavior outside of a few African countries. They should have admitted that this serious anomaly tarnishes the entire orthodoxy. 

President Magufuli of Tanzania is certainly not in the same position as Mbeki, because Covid-19 is expected to kill relatively few people, especially compared to numerous pathogens that cause extremely high morbidity and mortality rates in African countries. 

With the economies of Tanzania’s partners under threat, and the strength of the global economy at stake, Magufuli imposed a less stringent lockdown than most other countries. Thankfully, outbreaks of violence, civil unrest, food insecurity and economic collapse seen in countries with similar economies to Tanzania’s were averted. 

Labelling someone a ‘denialist’, whether it’s about HIV or Covid-19, is an unmistakable piece of cultural imperialism. Magufuli’s initial response was entirely reasonable and sensible, more so than those of Kenya, South Africa and many other countries. Since you can’t shame the country into copying an almost global failure to address the virus, maybe you can learn from them?

The Sound of No Hacks Flapping


Silence may have been the most profound contribution to what we know about the Covid-19 epidemic in Tanzania. In fact, silence is the only truly sustainable measure to reduce the onslaught of questionable information emissions during the current infodemic. I hope to hear more of it. 

I am not referring to silence about cases, deaths, lockdown measures, masks and the like. I’m referring to the silence of the media about the terrifying consequences of extreme and irrational lockdowns. Tanzania didn’t follow other poor countries, so they don’t have to face such consequences. 

But there is silence in the mainstream media about the fact that Tanzania is peaceful, the economy is better than most, people are going to work, buying food in the market, agricultural production is little affected and children are going to school, and all because of their moderate response to Covid-19.

The media was all abuzz about what Tanzania’s President Magufuli said about praying and religious devotion, but not his advice about continuing to work, looking after families, sending kids to school and going to hospital in the event of any illness, including, but not limited to suspected Covid-19.

Negative impacts are reported in local Kenyan and Ugandan media, where rash curfews have been brutally enforced by police. But the mainstream media are not interested in that. We hear less about people persecuted, held in unhygienic and insanitary conditions, exposed to numerous health and other risks than we do about Magufuli questioning the efficacy of tests. 

There have been substantial increases in food prices, shortages of staple foods, with many in Kenya and Uganda facing starvation. Kenyan schools will reopen next year, by which time state school pupils will have missed almost a year of schooling. Both countries struggle to maintain law and order and keep their economies afloat.   

Uganda’s President Museveni is less widely quoted, but his only advice to his people was stay at home and pray, nothing else. There are no mainstream media articles about how astute Magufuli has been, nor mention of the moderate lockdown imposed in March, a more moderate one than their neighbors imposed, and for a few months, not indefinitely.   

Does this selective silence in the mainstream media suggest a tacit admission that they were wrong about how poor countries should best address Covid-19, wrong to sneer at Magufuli for his exemplary response, while ignoring the chaos that resulted from neighboring countries’ slavish obedience to wealthy donors?

Covid19 in Tanzania: Faith and Secular Institutions


The media have been quick to trumpet anything President Magufuli of Tanzania says about faith, or the power of prayer, in defeating Covid19. He has refused to address the epidemic in the manner prescribed by the WHO and numerous ‘experts’. Magufuli is anxious to keep things ticking over, as a developing country must.

Specifically, the president had no wish to risk the kind of economic meltdown or civil unrest that some developing countries are now experiencing. The WHO (Guardian, BBC, NY Times, etc.) had all the answers about Covid19, or so they would have us believe. But they are not responsible for the security and welfare of people who live in poor countries. 

Mainstream stories about Tanzania have come from social media, opposition politicians, NGOs and other parties whose views may not be entirely impartial. No one would claim President Magufuli has only ever made sound decisions during his five-year tenure. But standing up to international institutions, foreign donors and the media is a courageous move, one that most leaders will never make. 

Magufuli can be described as having done the opposite of what most countries have done. Or he can be described as having made the right decisions for a country where the majority depend on the informal economy for their livelihoods. Today’s journey, work, purchases and sales pay for today’s meals. Few pathogens can make staying at home, perhaps indefinitely, the better decision. 

Magufuli is frank in his belief that God will keep Tanzania safe. People want to go about their daily tasks in relative safety and security. Some may have little. But no one needs a lockdown to remind them how close they are to having less. Mafuguli refuses to accept the orthodoxy of institutions urging everyone to cower in their homes, indefinitely. This is far from blind faith.

Covid-19: Love the Sin, Hate the Sinner


If I were working for a UK government health agency, I would be obliged to sign a non-disclosure agreement and would be prohibited from sharing information about the agency. That’s standard, in public and private employment in the UK. 

The BBC and Guardian have been inviting people from government agencies to give them information that would breach such an agreement. Both outlets claim that people working in the public sector have given them confidential information about Covid-19 activities. 

Many, whether working for health agencies or not, will know that certain things published by these media outlets are biased; some of them don’t even sound credible. But who are we to judge the pronouncements of a free press in a democratic country? 

UK media report with glee how horrific things are in Sweden. But a UK doctor posts an article by a Swedish doctor, who writes that Covid-19 has been blown out of proportion. The UK doctor has tried to interest UK media, but only Russia Today ran the article.

Tanzania is reported as taking a ‘faith-based’ approach in an article in the BBC. Like Sweden, Tanzania implemented more moderate measures, sent children home from school, and reassured people that the lockdown was a short-term measure, that no one should panic. 

New Zealand seems to have been lucky, with few confirmed infections. However, a slight rise in cases and the coming election is postponed for a month. It will be in October, like Tanzania’s. 

Australia, in contrast, has announced that Covid-19 vaccination will be mandatory. That’s even before a vaccine, safe and effective for everyone, has been developed. Even people in favor of vaccinations may wish to object to mandatory vaccination against a virus that is not a threat to most people. 

Big social media is being cautious about saying the ‘right’ thing about Covid-19, as if there are true and indisputable things about the virus, and untrue, contemptible things, and moderators who can tell them apart. 

After the 2007 Kenyan election, when the country descended into violence and looting, people said they were told to stay inside, so they did, because there was a curfew. If they went outside for food they risked being shot, and accused of looting. 

This went on for months, there was starvation and displacement, schools, hospitals and other facilities were closed. Banks were closed as food prices rocketed, people tried to move to safer areas, but transport and infrastructure were disrupted. 

President Magufuli warned against scaremongering and advised people to keep working and running their households. He knew that if people panicked, peace would quickly deteriorate. What happened in Kenya in 2008 could happen in Tanzania. Indeed, things in Kenya now look similar to 2008. 

Before ridiculing Tanzania’s leader, accusing him of being irresponsible and undemocratic, implying that he has a naïve belief in religion, check which countries have food security and are at peace, and which are threatened with economic collapse and civil unrest.

With Responses Like These, Who Needs a Pandemic?


The Open Society Initiative has announced a Covid19 Emergency Response Fund. Great to hear, but first key area on their list is health system strengthening. Health systems have been in need of funding for decades.  

Second on the list is mitigating the economic impact of Covid19, but that is far more a matter of the devastating effects of lockdowns, people unable to work, purchase food, tend to food production, sell produce, etc. 

A few headlines highlight some of the emergencies faced by African countries and they seem to be either: 1) caused by the response to Covid19, not the virus itself, or 2) emergencies that go back many decades, and increase the harm that kneejerk lockdowns, curfews and the like can cause. 

Unemployment, nothing new, but exacerbated by global lockdowns: Nigeria Records 21.8 Million Jobless People After Covid-19 Effects 

Female Genital Mutilation, nothing to do with the pandemic, but NGOs need to follow the money: No Christmas for West Pokot Girls 

Economic inclusiveness, again, every cause needs to mention the current focus of the media: Covid-19 – Where to From Here for Efforts to Support Youth Economic Inclusion? 

The number of confirmed deaths from Covid19 in Africa is about a third of the number of people who die of rabies every year: Lessons From a Community-Driven Rabies Vaccination Campaign in Kenya 

Diabetes, a recognized risk factor for many conditions long before Covid19: Covid-19 – Understanding the Increased Risk in People With Diabetes 

Foot and Mouth, like all other health conditions, put on the back burner. If there’s an outbreak of this disease now, countries that have closed their economic and administrative functions down will be able to do little to protect themselves: Mozambique: Foot-and-Mouth Outbreak in Maputo Province 

Tourism, conservation, environmental and other projects, all threatened by lockdowns: In Kenya, Maasai Entrepreneur Moves Conservancy Beyond Tourism Hit By Pandemic 

Hardly surprising that food prices have rocketed. They are unlikely to drop anytime soon. Unlike most articles on the pandemic/response, this one identifies other pressures driving up food prices, all of which were there before Covid19, but are made a lot worse by the response: Food Prices in Nigeria Have Shot Through the Roof 

If countries can’t get food locally, or import it from other countries because they can’t get around restrictions on movement and trade, they may end up depending on illicit trading, black markets and other threats to economic and political stability. The above list is from today’s AllAfrica.com newsletter, not at all exhaustive, unfortunately. 

Many are now questioning the wisdom of rigid Covid19 responses urged on them by international institutions, NGOs, donors and foreign leaders. Tanzania is one of the only one to impose a modest lockdown with a viable exit plan. Other countries could soon follow their example. None can afford the millions shelled out by rich countries. 

Adversarial Public Health is Counterproductive


There’s a familiar feel to the shaming of national leaders, and anyone else who questions the received view of Covid19, in any way. Few dare to do so. There seems to be a lot of fear, and the belief that everyone is at risk is still common.

Back in 2012 there was an article in the Tanzanian Daily News about calls for compulsory HIV testing for all. Thankfully, serious objections were raised, and it never happened. But the received view of HIV remains that it’s almost all a result of unsafe sex, though there is no evidence for this.

One of the numerous objections to mass HIV testing was that poor nations don’t have the capacity to test everyone, even if they would agree to spend the millions such an exercise would require. The same objection could be made about Covid19 testing. How often would mass testing have to happen? Once? Every year?

Writing about HIV in 2012 I suggested that some public health approaches to HIV could be seen as ‘adversarial’. A few years later, the massive Ebola outbreaks in West Africa brought civil unrest, with public health professionals accompanied by armed security personnel hunting down people suspected of being infected.

Colonial era syphilis eradication programs in African countries involved threats, lies and extremely painful injections, which some of the colonial administrators felt made the programs more worthwhile. Unfortunately, it only made it more likely that people wouldn’t turn up for the full course of injections.

Tanzania’s President Magufuli questioned the reliability of tests and this event was widely reported. He said that he had tried out the tests on a goat, a papaya and other non-human subjects, and several of them tested positive for Covid19.

But Magufuli raised an important point about false positives from tests, and there’s a good account of why this is so vital in a blog post entitled ‘Why Covid-19 is Guaranteed to Never End’. The author even mentions that Magufuli’s demonstration is not unprecedented.

International media coupled Magufuli’s tests with Twitter rumors of huge outbreaks and night burials of alleged victims of the virus. But ‘Disco funerals’ were reported to have occurred in Western Kenya in 2014, and it was claimed that there was a risk of unsafe sex (=HIV in African countries, apparently) during these events.

The US Embassy in Tanzania issued a warning against visiting the country because, although they had no evidence, they believed the epidemic was extremely serious. They had Twitter posts to back this up. At the same time, calls were being made to censor Twitter and Facebook posts that disagreed with the received view.

When Magufuli addressed the press about his decision to keep public health measures moderate, and vowed that he would not allow day to day economic activity to be jeopardized, he warned against the dangers of spreading fear and of scaremongering.

Media jeering at and shaming ‘dissenters’ during infectious disease outbreaks, including predicted and alleged outbreaks, may be nothing new. So it’s worth noting that a number of HIV, Ebola, hepatitis C and other serious infectious disease outbreaks have occurred in healthcare facilities, as a result of unsafe healthcare, something you’ll rarely read about in mainstream media.

If global efforts to address infectious disease epidemics propose the continued use of fear, ridicule, shaming and bullying, in collusion with a sycophantic and slavish media, they can expect more responses like Magufuli’s in the future. Everyone needs protection from harm caused by destructive and costly lockdowns.

Magafuli and Covid19: Skin in the Game


The first nuanced article I have seen on Covid19 in Tanzania comes from a surprising source, Devex, an NGO focused ‘platform’. Read the whole article to find the balance. 

The article acknowledges measures that Tanzania has taken in response to advice from WHO and other parties. It is argued that communications and messaging became confused and ineffective after the country’s initial response. 

However, this analysis raises the question of who was confused? President Magafuli reassured his people that the country would not be taking action that would risk immediate shortages of food and vital supplies, cease most economic activity, and countless other consequences. 

At the same time, NGOs and ‘civil society’, who depend mainly on foreign income to exist, wanted the country to take any measures that their funders insisted were necessary to prevent a major disease outbreak. 

Another news source that beats the drum for NGOs is The New Humanitarian, formerly the UN’s IRIN. They cover Covid19 in Kenya’s most media-friendly slum, Kibera. 

The first photograph, alone, is enough to suggest that Covid19 will never be the biggest threat that people face, on a daily basis, in urban slums. But the article also illustrates how immediate an impact a rash lockdown has on subsistence living, at the best of times. 

We get some insight into NGOs’ need to keep their eye on the diseases, social issues and other developments that are currently attracting funding. The author focuses mainly on one NGO, but they all need funding.

Close to the end of the Devex article we read that some have said: “the decision to avoid a full lockdown might have made sense in the Tanzanian context.” That’s exactly what I would expect people living and working in developing countries to say, although the source of the quote is not clear. 

Devex goes on to quote an NGO in Tanzania that spells out why you can’t impose a rich country solution in a poor country: “You might even be flattening the curve for 10 years without making it possible for our health sector to cope if our caseload and severity had been comparable to the U.S. and the U.K.” 

Data collected a couple of years ago in Tanzania was published recently, with Covid19 bits bolted on, and it finds that compliance for hand hygiene in health facilities is extremely low (7%), glove use is 75%, disinfection of reusable equipment is 5% and waste management scores just over 40%. 

Devex comes closer than others to distinguishing between Covid19, the pathogen, and a country’s response. The virus is said to have infected about 1m people on the African continent, which is about 0.1% of the population. But systematic reporting on negative consequences of the response is rare, notably so in rich countries. 

Confirmed deaths from Covid19 in Africa are about 0.0022% of the population. So, Tanzanian deaths from HIV in one year (2019), even with widespread coverage of antiretroviral drugs, still outnumber deaths from Covid19 for the whole continent. 

Deaths from pathogens that debilitate and/or kill people far exceed those from Covid19, and many of these are also preventable or treatable.

Some would argue that the biggest killers are not pathogens. They are background conditions, such as inadequate healthcare, unhealthy habitation, poor diet and lack of water and sanitation. 

Agreed, things could have been smoother, with Tanzania continuing to issue the data and communications international health and other agencies demanded. But the country seems to have been able to avoid the destructive scaremongering and panic that you’ll find in almost every other country. 

The New York Times claims that “More than 88 days have passed since Tanzania reported even a single new coronavirus case”. Everything reported in the article is at least 88 days old, as well. But it concludes with a reminder about the coming election, in October. 

Civil society, the press, international institutions and foreign experts have little to lose if they are wrong. Tanzanians, including the President, have skin in the game. Magufuli has maintained calm, avoided civil unrest, protected local economies and stood up for his electorate, and will answer to his people. How many others can say the same? 

Covid-19 – Tanzania Refuses to Peter Pan


Voice of America claims that “Tanzania has taken a controversially relaxed approach to tackling the coronavirus pandemic”. That’s an odd view of ‘controversy’ when you compare it to violently enforced lockdowns in several neighboring countries, resulting in starvation on a massive scale.

The East African asks if some middle ground can be found between campaigning for upcoming elections in East Africa, and what is seen as an ongoing need to avoid large gatherings. Tanzania’s election is due in October of this year and Uganda’s in January of next year.

The article argues that Covid-19 restrictions seen in many countries could reinforce “a long-established culture of unfair competition” and “serve the interests of the incumbency”. However, Tanzania only imposed relatively mild restrictions, and they were lifted two months ago. 

There’s little comparison between Tanzania and Uganda. Uganda’s president has been in office for 34 years, has worked hard to ensure that he will be able to stay in office for at least another five years, and can run for office again in 2026. That is, by anyone’s definition, controversial. 

But the East African’s argument implies, perhaps inadvertently, that Tanzania’s Magafuli, who has only been in office for five years, is willing to risk campaigning for reelection without depending on the kind of de facto martial law that Uganda’s Museveni has imposed. 

Also controversial is the director of the US National Institute for Allergies and Infectious Diseases, Anthony Fauci. Aside from holding this office for longer than Museveni (and even Cambodia’s Hun Sen), Fauci has a long history of what Michael Fumento calls “nightmare scenarios”.

One of Fauci’s earliest scenarios was that HIV might be transmitted by casual contact, before he went on to champion a threat of high rates of HIV transmission between heterosexuals, both of which turned out to be dangerously inaccurate. 

Most countries, rich and poor, experienced relatively low levels of transmission of HIV. But a handful, all in sub-Saharan Africa, experienced levels of transmission among heterosexuals that went well beyond Fauci’s dreams. Transmission among people with no identifiable sexual risks is still high in those same high prevalence countries. 

An English Guardian article suggests that poor countries are not able to afford the kind of measures that the UK, US and other rich countries have imposed. But that doesn’t go far enough to explaining why some poor countries appear to have been more successful than richer countries in their efforts to reduce the spread of Covid-19.

What poor countries cannot afford to do is to close down their economies, stop working, producing food and other goods, and run off to their bunkers until effective vaccines and/or cures are available for all dangerous pathogens, known and unknown. Even a few European countries already suspect they may have imposed some ineffective measures. 

Poor countries can’t afford lockdowns of a few days, but they may also know that the longer-term damage to economies will hit them, regardless of whether they impose the sort of restrictions that most rich countries have imposed. Of course, it is possible that rich countries will realize the same; there’s a lot we don’t yet know. 

Tanzania may have found a strategy that other countries, bombarded by conflicting advice and unaffordable loans from rich countries, can follow to minimize the risks of a Covid-19 epidemic, whatever those happen to be. Crucially, Tanzania’s strategy also minimizes the risks of reversing progress they have made over the past few years. Perhaps that’s hard for the media to process.

Covid-19 – Tanzania’s Measured Response


A Dutch journalist based in Kenya got ‘stuck’ in Tanzania after borders were closed as a measure against the spread of Covid19. Like the British journalist who decided to stay there to look after his dogs, it’s the fact that both foreigners can move about freely in the country, there is no curfew or infringements on basic freedoms in the name of public health, that is most revealing about how Tanzania’s response to the threatened epidemic has fared. 

The Dutchman did what he calls a ‘survey’, because he finds it hard to believe that numbers infected in Tanzania are low when they are said to be high in other African countries. With all the scare stories about the virus threatening widespread destruction on the continent, the intrepid reporter has missed the fact that only around 0.09% of Africans have been confirmed to have been infected (fewer than 1m). 

He visited the town and found people getting on with their lives, going to and from work, buying and selling goods in the markets; he went to graveyards and found  nothing startling; hospitals looked normal, though staff and guards were wearing masks. He even went clubbing the week before, and neither he nor the people he was with had any virus some time later. 

Aside from rumors among other foreigners, who were warning fellow foreigners to work from home and to ‘be careful’, the Dutchman decided that he would ‘take the risk’ to go back to Kenya. So they all had homes, and jobs that could be done from home.

Meanwhile Kenya, and neighboring Uganda, struggle to keep law and order, if that’s what you’d call their dusk to dawn curfews. Kenya wants to extend their curfew for another month, and people continue to be persecuted, beaten and killed in both countries. An estimated 10 million people face severe food shortages in Sudan

The Dutch journalist should think carefully about returning to Kenya; in fact, he should seriously consider staying in Tanzania. The enormous damage that a disproportionate response can do is already evident in poor countries. According to some sources, the damage will be soon be felt in some rich countries, as well.

Covid-19 in Tanzania: Pursuit of Health Sovereignty?


What’s the difference between Kenya’s response to Covid-19 and Tanzania’s? It’s difficult to know about Tanzania because journalistic practice dictates that if an African leader stands up to western leaders, experts or even mere bureaucrats or journalists, they must be slapped down, ridiculed and hounded for the remainder of their office for their temerity. 

It’s not so difficult to find out about Kenya’s response: a curfew was imposed and violently enforced, many people were held (effectively, interned) in insanitary conditions, some were beaten and some died, children will remain out of school until next January, hospitals are said to be overwhelmed (aren’t they always?), there are restrictions on movement, shortages of food, etc. 

In Tanzania, children were sent home for a few months, but people were encouraged to go to work, feed their families, take care of themselves so that they could take care of people who were not able to. Magufuli refused to go running to the international community for handouts earmarked for (well-behaved) African leaders.

Consequences from Kenya’s response to Covid-19 are far more severe than those from the virus itself. Of course, Tanzania is going to have to face the consequences of the responses of countries around them, and the consequences of their trading partners’ respective responses; for example, there is already a massive drop in tourism, globally, something a lot of poor countries disproportionately depend on. 

But perhaps the difference between Kenya’s and Tanzania’s response to the virus runs deeper than the daily struggle for basic things, such as food, habitation, education, healthcare and the rest. The BBC, in that sneering tone specially honed for Africans, have coupled Magufuli’s approach to Covid-19 with his objections to ‘imperialism’.

In fact, Magufuli objects to the likes of mining operators from rich countries granting his country a paltry 3%, quaintly referred to as ‘royalties’, of anything declared as a profit. He advises people to balance rich countries’ ‘giving’ against what they take, which is not unreasonable. Or perhaps the BBC doesn’t recognise imperialism that hasn’t been branded as such by them?

While the Constitution of the World Health Organization states that “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”, their response to the virus appears to view health as the avoidance of certain pathogens deemed more catastrophic than others, pretty much at all costs. Tanzania, and all poor countries, have a lot more to worry about than Covid-19. (Don’t we all?)

In their anxiety to depict Magufuli as an unworthy opponent of imperialism, an incapable leader of Tanzania and a generally uninformed person whose tenure verges on dictatorial (and I’m certainly not saying he’s faultless), many commentators have missed something important. Africa and Africans won’t be ‘rising’ when, or because the English Guardian or the BBC plasters it up in banner headlines. 

Perhaps it will happen when leaders like Magufuli, human as he is, stand up to the sanctimony of the western media, the neo-imperialism of wealthy countries, and the complicity of the ‘international’ institutions they fund. But the difference between Kenya’s and Tanzania’s response? Tanzania refused to be cowed into overseeing a complete breakdown of the economy, of law and order; they even refused to take money to do what Kenya and other countries happily did. 

It could be argued that Magufuli is striving for health sovereignty, which is, by definition, autonomous, unlike the top-down, one-size-fits-all ‘solutions’ that rich countries and their institutions are so keen for poor countries to adopt. At least, he seems to be highlighting a tension between the WHO’s definition of health and their approach to health emergencies, especially in poor countries (but not exclusively). 

Much remains to be seen, but what Magufuli has done so far has resulted in a lot less harm than what Kenyatta has done, which is just more of the same. In contrast, Magufuli has stood up, with his people; he has refused to be goaded, and to be induced into handing over everything to rich countries and institutions. He refused to betray the Tanzanian people, refused the readies. How many other leaders, in Africa and elsewhere, can claim the same?