DAR ES SALAAM, Oct. 12 -- Tanzania is facing a growing challenge to the sustainability of critical health programmes as changes in United States foreign assistance expose the risks of relying heavily on external financing for HIV prevention, treatment, laboratory services and community-based healthcare.

For more than two decades, U.S.-supported programmes, particularly through the Presidents Emergency Plan for AIDS Relief (PEPFAR), have played an important role in Tanzanias HIV response, supporting testing, treatment, prevention, laboratory systems, surveillance and health-system strengthening.

The scale of that support has made the question of what happens when American financing is reduced more than a funding issue. It has become a te...