Chinese-Tanzanian Relations, Medical Knowledge, and Development after 1968

Dr Andrea Azizi Kifyasi of the University of Dar es Salaam tells the fascinating story of global knowledge flows around health in postcolonial Tanzania.

During the Cold War, the Eastern and Western blocs provided different forms of assistance to African countries, reflecting their respective priorities. Donors from the West prioritised projects with immediate, tangible outcomes. By contrast, donors from the East prioritised long-term development projects, including basic industries, scientific and educational facilities, and health care. The Chinese government provided grants and sponsored long-term projects in Africa intended to stimulate local production. Its assistance was framed in the moral lesson from the ancient Chinese proverb, which goes: “Give a man a fish, and you feed him for a day. Teach a man how to fish, and you feed him for a lifetime.” China’s assistance to Africa was provided under the South-South Cooperation (SSC) framework, which emphasised knowledge and resource exchange. This framework is often described as the act of ‘poor helping the poor.’ How did China’s medical assistance in Tanzania reflect so-called ‘Southern solidarity’? This blog post critically assesses both the prospects and challenges of this agenda. I argue that China’s technical assistance was vital to Tanzania’s development and self-reliance and aligned with the goals of SSC. However, the knowledge that was exchanged failed to promote development in Tanzania’s health sector in effective and sustainable ways.

China’s Medical Assistance to Tanzania

From the mid-1960s onwards, like many other independent African countries, Tanzania received various forms of assistance from the Chinese government. In the health sector, assistance took several forms. The first was the Chinese Medical Teams (CMTs), dispatched to the country by the Shandong Province. Since 1968, over 2,000 personnel have worked in Tanzania. The second form was on the research and treatment of diseases using Traditional Chinese Medicine (TCM), with the HIV/AIDS project from 1987 to the 2010s a key focus. The third project was the establishment of pharmaceutical industries, in which the Chinese government sponsored two industries: the Mabibo Vaccine Institute (MVI) and Keko Pharmaceutical Industries (KPI), both established in 1968. These projects are good examples of South-South knowledge exchange, as they involved the exchange of technical knowledge among low-income countries. The knowledge was exchanged through both tangible assets, such as equipment, raw materials, and medicines, and intangible assets, including operational and maintenance skills and know-how, via the dispatch of Chinese experts to Tanzania and through formal and informal training of Tanzanians.

A Tanzanian dentist practising dental surgery under a Chinese doctor (undated, likely 1970s) Source: Health Department of the Shandong Province, The Chinese Medical-Aid Team in the United Republic of Tanzania, 1968–1998 (Shandong, 1998), 76.

Sino-Tanzanian Medical Knowledge Exchange: Prospects and Challenges

From its inception, the Chinese government dispatched medical aid to Tanzania while promising to foster knowledge exchange in several modes. The first was through long- and short-term training for Tanzanians at several Chinese medical colleges, and on-the-job training, promising to shift knowledge dependence away from the Global North. However, stereotypes and Cold War politics undermined the long-term training programme, as medical graduates from China were perceived as incompetent by the Medical Council of Tanganyika and by their colleagues who had studied outside China, discouraging Tanzanians from accepting Chinese government scholarships. This context reflects the mismatch between Tanzania’s and China’s education systems. Tanzania, a former British colony, inherited the colonial education system, with its MD (medical doctorate) programme following the globally accepted 7-year duration. Yet, following the Cultural Revolution, China reduced the MD training period to five years to produce a large number of graduates in a short time.

Ultimately, the on-the-job training model proved difficult to implement in practice. It was ineffective in sectors involving complex technology, such as the pharmaceutical industry, where equipment and machinery require highly trained and experienced personnel to operate effectively. Yet, at its establishment, MVI and KPI were handed over to under-trained Tanzanian experts who received only on-the-job training. Generally, the local experts lacked effective production and managerial skills; as a result, the industries collapsed a few years after the Chinese experts left.

Both short-term and on-the-job training were also defeated by communication barriers. Effective on-the-job training involves both theory and practice, which integrates trainers and trainees. Yet, many Chinese technical personnel could neither speak English nor Kiswahili fluently. They mostly passed medical knowledge to the locals through gestures, which was useful only for types of knowledge that did not require extensive theoretical information and depended on the recipient’s prior knowledge for its effectiveness. The few translators hired to address the language barrier were unfamiliar with certain complex technical jargon, thereby defeating the knowledge exchange programme.

An acupuncture trainee practising the therapy in Kasulu District, 1975. Source: Tanzania Health Department, The Chinese Medical-Aid Team, 74.

South-South knowledge exchange was also expected to occur through the importation and use of Chinese medical and industrial equipment in Tanzania. However, some industrial equipment sourced from China proved unsuitable due to unfavourable climatic conditions and inadequate water and electricity supply. This reflects the complexities of adapting foreign technology to the destination area. The language barrier further complicated the use of imported equipment and medicines. Inscriptions and manuals for some equipment, machines, and medicines were in Chinese and therefore required Chinese-speaking staff to use them.

Ultimately, Tanzania’s Ministry of Health lacked a strategy for the use of foreign aid, partly due to financial handicaps and poor coordination between training providers and personnel development planners. The Ministry sent medical personnel for overseas training without developing favourable plans or conducive environments for trainees to apply the knowledge they acquired upon completion of their courses.

Conclusion

Ultimately, unequal power relationships strongly influence the means and terms of knowledge exchange related to medicine between China and Tanzania. For example, Tanzanian actors lacked bargaining power in a Chinese-sponsored project on TCM research and treatment of HIV and AIDS. The project was designed by Chinese actors, with an unequal distribution of responsibilities between the Chinese and Tanzanian actors. While the Chinese dominated research activities, the Tanzanians played supporting roles. Local experts were excluded from crucial aspects of the experiment and medicine production, which were central to knowledge exchange.

And yet, the Sino-Tanzanian medical knowledge exchange was important to South-South Cooperation, which encouraged the sharing of ideas, insights, and practical skills among Southern countries in order to foster socio-economic development and, potentially, related socio-economic rights. However, the way Sino-Tanzanian medical knowledge was exchanged undermined its prospects, making it less useful and unsustainable. The necessary principles for sustainable knowledge exchange were not seriously practised, and the training of local experts and information sharing between Chinese and Tanzanian actors were complicated by language barriers. These weaknesses reveal that effective development agendas cannot rely solely on the adoption of new knowledge in recipient countries. Instead, they also required the creation of a suitable environment in the destination country. More importantly, effective knowledge exchange required sustained, comprehensive investment, which extended beyond information sharing and training alone. Only that way can fishing truly be taught, and the final objective of a right to health for all be achieved.

Further Reading

Andrea Azizi Kifyasi, “How Effective Was the Global South Knowledge Exchange? The Chinese-Funded Medical Projects in Tanzania, 1968–1990s.” Technology and Culture 65:1 (2024): 39–61.

Andrea Azizi Kifyasi, “Angels of God”? A History of China’s Medical Assistance in Post-Colonial Tanzania (Berlin: De Gruyter Oldenbourg, 2025).

Andrea Azizi Kifyasi. “China, a Friend in Need”? Disentangling the Contexts of China’s Medical Assistance in Tanzania, 1961–1978,” European Journal for the History of Medicine and Health 82:1 (2025): 201–226.

Randall M. Packard, A History of Global Health: Interventions into the Lives of Other Peoples (Baltimore, MD: Johns Hopkins University Press, 2016).