How Tanzania's cardiac care transformation saves lives, strengthens economy

Dar es Salaam. Until just over a decade ago, a diagnosis of heart disease in Tanzania often carried a silent sentence: overwhelming costs, a long journey abroad, or, in the worst cases, the gradual loss of hope.

Before 2008, advanced cardiac surgery was not available in the country, forcing patients to seek care in faraway places such as India.

For many, this option was simply unaffordable. However, everything began to change when Tanzania embarked on building its cardiac care capacity, marking the start of a quiet revolution that is now saving lives and bolstering economic resilience.

“I had no idea I could access such services in Tanzania,” recalls a resident of Kivule in Dar es Salaam, Ms Sarah Jackson.

Diagnosed with a heart condition in 2016, Ms Jackson initially sought treatment at private hospitals.

When her doctor recommended surgery, she travelled to India, a procedure that cost her over Sh20 million and left her wondering whether the same care could have been provided closer to home.

By 2019, her condition had worsened, and she was referred to the Jakaya Kikwete Cardiac Institute (JKCI).

There, she discovered that not only was the surgery she had undergone in India available locally, but her health insurance also covered it.

“I was suffering from frequent dizziness and fainting,” shares Ms Jackson, who works as a police officer in Dar es Salaam.

“Since my surgery at JKCI, I feel like a new person. I didn’t even need to return to India as previously advised. The services here are excellent; even at night, you can reach your doctor,” she adds.

Ms Jackson’s experience reflects a broader shift in Tanzania’s health system that began in 2008 with the establishment of a cardiac surgery unit at Muhimbili National Hospital.

This initiative laid the foundation for what later became the JKCI, formally launched in 2015 as a semi-autonomous public institution specialising in cardiovascular care.

“When we started, our Intensive Care Unit (ICU) had only four beds. Today, we have 27. In the general ward, we began with 15 beds, and now there are 156,” explains Head of Adult Cardiac Surgery at JKCI, Dr Evarist Nyawawa.

Initially, the institute had three cardiac surgeons; today, there are 10, two of whom specialize in performing pediatric heart surgeries.

“We started with five cardiologists, and now there are more than 20. They are supported by specialist trainees from Muhimbili University of Health and Allied Sciences (Muhas), who now number 10, but were not present at the very start in 2015,” adds Dr Nyawawa.

“We began with just 105 operations a year, mainly for congenital heart defects and damaged valves. Today, we perform up to 800 surgeries annually, including complex procedures such as coronary artery bypass grafts and valve replacements,” he emphasises.

Dr. Nyawawa notes that the first significant leap in self-reliance occurred when Tanzanian doctors returned from training in India and Israel, bringing back life-saving skills that were previously unavailable in the country.

“We now perform advanced procedures independently. We also treat patients with severely dilated blood vessels, valve defects, and blocked arteries, all right here in Tanzania,” he says.

One of the early beneficiaries was a resident of Arusha, Mr Osward Mollel, who was diagnosed with severe artery narrowing in 2007.

He sought care in Kenya, where the surgery cost exceeded Ksh300,000 (about Sh6 million).

“The surgery could not be done in the neighbouring country because of higher charges. I also had to return every three months for follow-ups, and the cost and travel made it very difficult,” he recalls.

In 2009, he became one of the first patients treated at the cardiac surgery unit at Muhimbili National Hospital, later JKCI.

“I didn’t pay anything except transport from Arusha to Dar es Salaam. Now, I just go for an annual check-up. I never thought I’d survive,” he says.

The affordability and accessibility of care at JKCI have become game-changers.

Procedures like coronary artery bypass surgery, which cost over Sh40 million in India, are now offered locally for around Sh15–20 million.

Furthermore, patients are often covered through health insurance, an option rarely available abroad.

JKCI’s impact extends far beyond cost savings. The institute has grown into a regional centre of excellence, attracting patients from Kenya, Uganda, Zimbabwe, Zambia, and the Democratic Republic of Congo (DRC).

Dr Nyawawa notes, “Patients coming from outside the country pay 20 to 30 per cent more, depending on the type of care they receive, compared to local patients.”

The institute has also partnered with international organisations, deploying experts to provide paediatric heart surgeries in Zambia in collaboration with Israeli specialists.

“The quality of our services now meets international standards. The fact that patients are flying into Tanzania for treatment speaks volumes about what we have achieved,” he says.

The institute’s growth has also sparked calls for decentralisation.

“Our country is large, with over 60 million people, yet we have only one major heart institute. It’s time to establish regional centres to bring services closer to the people,” he adds.

The economic ripple effects are significant. An economist and lecturer at the Open University of Tanzania (OUT), Dr Timoth Lyanga, emphasises the link between a healthy population and national productivity.

“You cannot build a strong economy without a healthy workforce. Investing in local healthcare protects human capital. When people spend millions abroad for treatment, it weakens the local economy and leaves the poor behind,” he explains.

Dr Lyanga adds that access to life-saving care domestically prevents financial ruin.

“Imagine someone paying Sh50 million abroad. That’s capital lost to another country. If they cannot afford it, they may die or live with a disability, reducing our national productivity,” he said.

Local treatment also allows for more inclusive financing mechanisms, such as insurance schemes, and helps retain financial resources within the country.

“Health is not just a social investment, it’s an economic one. The growth of JKCI, attracting even foreign patients, shows how health services can become an economic sector in their own right,” insists Dr Lyanga.

JKCI continues to expand its scope through outreach programmes and training initiatives, setting a model for specialised care in Africa and proving that high-quality, affordable treatment can be both a public good and an economic driver.

To reach higher levels of service, Dr Nyawawa says a larger workforce is required.

“Most specialists are concentrated here, but we need more professionals with advanced training to meet the growing number of patients,” he explains.

Currently, there are only three other heart surgeons in the country, two at Bugando Hospital in Mwanza and one at Mbeya Referral Hospital.

He stresses the need for regional facilities. “Tanzania is vast, with over 60 million people, yet we have only this one major cardiac hospital.”

“Establishing similar hospitals in other zones, or at least providing these services in regional facilities, would significantly reduce the burden on citizens seeking treatment,” added Dr Nyawawa.

For those without health insurance, a subsidy system is in place.

“Patients who genuinely cannot pay are referred to our social welfare desks and receive care free of charge,” says Dr Nyawawa.

He adds that children often benefit from support and donations from banks, organisations, and foundations, including the Heart Team Africa Foundation.

The Heart Team Africa Foundation (HTAF) and Deputy Speaker of the National Assembly, Mr Mussa Zungu, says the organisation coordinates initiatives to assist citizens, particularly children, with heart conditions.

“More than 13,800 children are born each year with heart problems, and many families cannot afford treatment charges,” he explains.

“We mobilise contributions through fundraising campaigns and government support. In 2025 alone, we have raised over Sh3.2 billion,” unveils Mr Zungu, who doubles as outgoing Ilala lawmaker.

JKCI has treated more than 745,000 patients in the past four years.

The institute’s executive director, Dr Peter Kisenge, says, “In just four years, JKCI has served 745,837 patients, 674,653 adults and 71,184 children, with 30,645 requiring hospital admission. This reflects our commitment to making specialised cardiac services accessible and affordable in Tanzania.”

The Upanga-based facility treated 513,484 patients, while the Dar Group hospital at the Tazara area attended to 278,839.

The range of services has expanded, including advanced cardiac care, general surgery, dental services, emergency care, paediatrics, maternal health, ear, nose, and throat (ENT), and internal medicine.

A flagship initiative, the Dr Samia Suluhu Hassan Outreach Services, reached 20 regions and 14 workplaces.

“We screened over 21,000 people for heart disease, referring more than 3,200 patients to JKCI for specialised treatment,” said Dr Kisenge.

JKCI’s expertise has extended to neighbouring countries. “Our specialists treated 1,189 patients in Malawi, Zambia, and Comoros, with 262 referred to JKCI for further care,” he explains.

The institute also received 689 international patients from countries including the UK, Germany, China, and Somalia.

Innovations such as the Cathlab (Catheterization Laboratory) have enhanced care, treating 8,789 patients.

Advanced procedures, including Transcatheter Aortic Valve Implantation (TAVI) and open-heart surgery without stopping the heart, have been performed, with 2,784 major heart surgeries completed.

Cost-saving technologies include oxygen-generation plants worth over Sh1.8 billion, reducing reliance on expensive oxygen cylinders.

Infrastructure improvements, including a Sh3.6 billion diagnostic and administration building, and upgraded intensive care units (ICU) for children and adults.

JKCI has strengthened academic partnerships locally and internationally.

“We’ve trained more than 180 staff in short- and long-term programmes and signed agreements with institutions in Rwanda, Zambia, Poland, and the United States,” says Dr Kisenge.

These initiatives enable specialists to train abroad or locally, increasing expertise to extend services nationwide.

“Some professionals are currently training outside Tanzania, sponsored by the Institute, to expand the number of experts and bring services to more regions,” he says.

Dr Kisenge affirms JKCI’s ongoing commitment: “With continued investment and innovation, we will continue to provide high-quality heart care, not only for Tanzanians but for patients across the region.”

From individual survival stories to national strategy, Tanzania’s journey in cardiac care is more than a medical achievement; it is a reminder that with vision, investment, and training, lives can be saved, futures rebuilt, and economies strengthened.