Tanzania’s human capital development needs are staggering and need to be addressed urgently to reap the benefits of the ongoing demographic transition. Almost half of Tanzanians are under 18 years of age, and the population is projected to double to more than 130 million by 2050. Currently, Tanzania lags its peers in terms of the coverage and quality of education and health services. This paper (i) takes stock of recent changes since the launch of the ECF program, including improvements in priority social spending; (ii) highlights the challenges to close current gaps in health and education and improve service delivery, and (iii) provides some policy recommendations.