The Federal Democratic Republic of Ethiopia is an east-African nation in the Horn of Africa. Bordering Somalia, Djibouti, Eritrea, Sudan, South Sudan and Kenya, Ethiopia is the most populous (100 million) landlocked country in the world. As the only African nation being able to resist colonization during the 19th-century ‘Scramble for Africa’, the nation has served as an inspiration for many African nations’ flags after their independence in the 60s. Ethiopia also hosts the Capital of the African Union in Addis Ababa. Ethiopia is a multiethnic and multi-lingual nation and is attributed with being the origin of the coffee bean, as well as being the place from which some of the earliest human beings moved into the middle east’s ‘fertile crescent’ where the first human civilizations emerged.
Currently, Ethiopia has the largest economy in East and Central Africa by GDP but struggles with the provision of healthcare and clean water as well as a shortage of trained doctors and nurses.
Tuberculosis in the country
Tuberculosis is in the top-10 of causes of death in Ethiopia, claiming 32000 lives in 2014, with the combination of HIV and TB resulting in 5500 additional deaths.
“Wiping out the TB epidemic will be possible only with strong political commitment and the engagement of communities”
Dr Kesetebirhan Admasu, Ethiopian Minister of Health
Although Ethiopia ranks third in Africa and Eighth among the 22 highest TB burdened countries in the world, the country is committed to reaching the Sustainable Development Goal of ending TB by 2030 and is a practitioner of WHO’s End TB Strategy.
KNCV Activities in the country
Ethiopia is a country where the Challenge TB program is active. Challenge TB is USAID’s flagship global mechanism for implementing USAID’s TB Strategy and is led by KNCV Tuberculosis Foundation, who also led USAID’s previous TB Control projects TB CARE I, TB CAP and TBCTA. Last year, the project expanded to nine out of the eleven Ethiopian regions, covering 3,500 health facilities and reaching out to 85 million people.
More than 2,700 healthcare workers were trained, 33% of which were women.
In 2016, KNCV, under the Challenge TB project and in partnership with MSH, expanded to support nine of the eleven regional health bureaus in Ethiopia and their more than 3,500 health facilities. This means we are now potentially reaching 85 million people in addition to giving national level assistance in strategy and policy formulation. To effectively support health facilities in this enormous area, we implemented a zonal approach. When the quality of TB care in a zone is sustainably improved, the zone graduates to a different approach, requiring less intensive attention. This way funds are directed where they are needed most.
In June 2016, we started a pilot for the treatment of drug-resistant TB patients with new second-line drugs, with 24 patients enrolled since then. For these patients, there was previously no hope of a cure, but now most of them are showing clear improvements. The success of this pilot brings new hope for the approximate 70 new drug-resistant TB patients each year, for whom regular drugs do not work. The pilot will be scaled-up to the rest of the country. Laboratory staff have already been trained and were actively engaged in providing second-line drug-resistance tests in six regional laboratories in early 2017.
In collaboration with the National TB Program, KNCV also piloted the integration of Childhood TB within the overall Integrated Management of Newborn and Childhood Illnesses program. Through this program, children are checked for the main childhood illnesses as standard. In those facilities that took part in our pilot, the number of child TB patients reported increased by 180%. When scaled-up to the rest of the country, this strategy will definitely contribute to a reduction in newborn and infant mortality from TB in Ethiopia.