Despite numerous global health initiatives after World War II, tuberculosis still poses a major threat in sub-Saharan Africa. This article examines one attempt to tackle this problem: the Somalia-Finland Tuberculosis Control Project. Conducted in the 1980s as a bilateral development aid project between the two countries, it became the most extensive – and expensive – tuberculosis initiative in Somalia in that decade. An interesting feature of the project is that, despite a lack of previous experience in tuberculosis work in developing countries, the Finnish partner decided not to follow the WHO global guidelines designed to standardise tuberculosis activities across the developing world. Instead, Finns established their own treatment programme based on X-ray and short-course chemotherapy – otherwise rarely used in clinical practice in Africa. Through a close reading and comparison of the correspondence, project plans, memos and minutes, the article analyses the formation of this strategy. Focusing on ground-level decision-making, it argues that the decisions were based not only on a belief in the superior clinical effectiveness of these methods, but also on the fact that they better suited Finnish ambitions and project logic. Thus, the article supports the notion that donor perspectives on resources and project objectives determined what was seen as feasible treatment in a developing country. By shedding light on the debate between the supporters of short-course chemotherapy and the WHO standard treatment strategy, it also contributes to the early history of DOTS (directly observed treatment, short course).

Development co-operation in the legal and human rights sector is challenging. It is political, nuanced, and involves multiple, often competing, stakeholders. Adding to this, significant time is spent determining suitable fields for co-operation, designing comprehensive programmes, and establishing robust monitoring and evaluation frameworks. Donors often strive for “ownership” of programmes with tangible results that justify ongoing co-operation. Amid this added complexity, it is easy to forget that good programmes are often simple, well-founded ones that set realistic goals and timeframes. Sense and simplicity can be overlooked. This article draws on lessons learned from personal experiences in two legal and human rights co-operation programmes in Indonesia to discuss six points at the heart of this concept of sense and simplicity. The points are not exhaustive, and are not always easy to implement in the face of political realities. They are a starting point, and stress the need to get back to basics when planning, implementing, and monitoring such programmes.