Mediating abundance and scarcity: implementing an HIV/AIDS-targeted project within a government hospital in Tanzania.

While free antiretroviral therapy (ART) in Tanzania has undeniably increased accessibility of services, the effects of ART programs as they are brought into existing health facilities are more ambiguous. As transnational nongovernmental organizations (NGOs) establish clinics within government hospitals, we see a telling example of how NGOs are providing services from within the state. The conditions of NGO-operated clinics within government health facilities act as a daily reminder of the failures of the government to provide health workers with that to which they feel entitled: adequate pay, access to sophisticated technology, upgraded training, extra-duty allowances, and a professional working environment. At the same time, health personnel compete to position themselves in such a way to be able to make claims on the state through these NGO clinics, which is the only means available for them to access the very resources to which they feel entitled by their profession.