MWE Correspondent
Public debate has intensified in Tanzania following remarks by a Muslim cleric questioning the religious permissibility of health insurance, raising broader concerns at a time when the government is advancing plans for universal coverage.
The discussion was triggered after comments aired on KHIDMA Online TV, where the cleric described health insurance as haram, arguing that it bears similarities to gambling and urging Muslims to instead pay directly for healthcare services. The remarks have since circulated widely on social media, prompting mixed reactions and renewed scrutiny of the role of insurance within Islamic principles.
Offering an economic perspective, Anna Tibaijuka weighed in on the issue, stressing the importance of grounding public discourse in facts and informed understanding, particularly given the significance of the reforms currently underway.
She noted that the concept of universal health insurance is not new in Tanzania. As early as 1989, during her time at the University of Dar es Salaam, she prepared a consultancy paper for the Planning Commission proposing the introduction of such a system. At the time, the country was grappling with a severe economic crisis, and the sustainability of free public services was already under strain.
Although the proposal was not adopted then, she pointed out that the current push toward universal health coverage reflects a long-delayed but necessary shift in policy. Against this backdrop, she warned that misconceptions or misinterpretations could undermine progress toward a system designed to improve access to healthcare for all citizens.
Addressing the religious dimension of the debate, she acknowledged that concerns about insurance within Islamic jurisprudence are not without basis. Some scholars have historically raised objections to conventional insurance models, citing elements such as uncertainty, known as gharar, gambling (maysir), and interest (riba), which are generally discouraged under Islamic law.
Also Read; Tanzania Pushes Green Mineral Industrialisation Drive
Critics argue that insurance contracts may involve uncertainty because policyholders pay premiums without certainty of receiving benefits, while insurers cannot predict when claims will arise. Others contend that the structure resembles gambling, as outcomes can disproportionately benefit one party over another. Additionally, the investment of insurance funds in interest-bearing instruments has been a longstanding point of concern.
However, many contemporary scholars and economists have also pointed to alternative interpretations and evolving financial models that seek to address these concerns, including cooperative and risk-sharing approaches designed to align more closely with Islamic principles.
Professor Tibaijuka emphasized that her contribution to the discussion is based on economic analysis rather than religious authority, encouraging a balanced and informed dialogue that considers both faith-based perspectives and practical realities.
As Tanzania moves forward with its universal health insurance agenda, the debate highlights the complex intersection of policy, religion, and public perception. Observers note that constructive engagement between policymakers, religious leaders, and the public will be essential to ensure that reforms are both inclusive and widely understood.
The ongoing conversation reflects a broader challenge faced by many societies: how to reconcile modern economic systems with deeply held cultural and religious values, while advancing policies aimed at improving quality of life and social protection.
