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Financial Management for the TUNAJALI HIV/AIDS Project in Tanzania

2006-2011 || U.S. Agency for International Development


Through the TUNAJALI “We Care” program supported by the President’s Emergency Plan for AIDS Relief (PEPFAR) and United States Agency for International Development (USAID), Deloitte Tanzania provided financial, grants and strategic consulting services to regional and district government institutions charged with coordinating and providing HIV prevention, care, treatment and support services. In addition, Deloitte provided capacity development services to civil service organizations which provide HIV services to tens of thousands of clients. Project activities focused on building regional, district, and civil society capacity to manage programs and comply with U.S. Government regulations.

The Challenge

The United Republic of Tanzania faces many economic and social development challenges, including those posed by a generalized AIDS epidemic and other communicable diseases. Tanzania has an estimated 5.8 percent prevalence of HIV, with approximately 1.4 million people living with HIV. Nearly 1.3 million children have been orphaned by HIV.1 The Government of Tanzania is committed to improving the health and welfare of its people, by both increasing domestic spending on health and HIV and receiving increased support from bilateral and multilateral donors. However, the regional and district authorities lacked strategic and financial planning, programming, and monitoring capacity to effectively manage and implement health programs. In addition, local civil society organizations did not have the capacity to manage large programs and could not be leveraged sufficiently to deliver health services.

How We Helped

Through the two components of the project, Deloitte supported both local government bodies and civil society organizations involved in HIV care, treatment and support. More specifically, Deloitte assisted with the following activities:

  • Building the capacity of civil society organizations to deliver home based palliative care and support services
  • Providing grants of over US$16 million to civil society organizations to implement TUNAJALI Community Care for People Living with HIV/AIDS and OVC Program activities
  • Building the capacity of regional and district authorities to efficiently plan for, use and monitor resources through implementing standardized financial management procedures to meet the national standards for and increase the access to antiretroviral (ARV) treatment sites
  • Monitoring the use of funding provided to promote high levels of accountabilities
  • Managing contracts with local government agencies to appropriately manage and disburse grants of over $20 million for the TUNAJALI HIV/AIDS Care and Treatment Program in accordance with U.S. Government guidelines
  • Supporting the rapid disbursement and full liquidation of funds
  • Building strong relationships and networking closely with key stakeholders including the National AIDS Control Program


Deloitte’s consortium of highly experienced global health consultants assisted the regional and district governments to facilitate the availability of quality and comprehensive HIV prevention, care, treatment and support services while building the capacity of civil society organizations to deliver critical community support services. As a result, an increasing number of Tanzanian institutions are able to more independently manage complex HIV/AIDS care and treatment initiatives to provide the full continuum of care for People Living with HIV and AIDS. Through these efforts the TUNAJALI program is on track to provide care, treatment and support services to 101,638 clients on care, of which 59,787 will be on ART in 125 care & treatment clinics.

1UNAIDS, United Republic of Tanzania HIV and AIDS Estimates (2009),

As used in this document, “Deloitte” means Deloitte Consulting LLP, which provides strategy, operations, technology, and human capital consulting services, Deloitte Financial Advisory Services LLP, which provides financial advisory services, and Deloitte & Touche LLP which provides governance and risk oversight and reporting advisory services. These entities are separate subsidiaries of Deloitte LLP. Please see for a detailed description of the legal structure of Deloitte LLP and its subsidiaries. Certain services may not be available to attest clients under the rules and regulations of public accounting.

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