Ethiopia’s Example Shows the Way to a New Era in World Health
By Ariel Pablos-Méndez, MD, MPH
Historians will view the past 25 years as a truly golden era in global health. New resources and political leadership have led to unprecedented progress that has improved the health of billions of people worldwide. Sustained campaigns against killers like HIV/AIDS, tuberculosis and malaria have cut mortality rates by half, and more than 100 million childhood deaths have been prevented.
Ethiopia, one of the poorest countries in the world, has been an unlikely star of this success story, reducing child mortality by 70% since 1990. Over roughly the same period, HIV infections in the country declined by 90%, and malaria and TB deaths plunged by 75% and 64%, respectively. This progress is especially remarkable because Ethiopia is surrounded by fragile states in conflict, in a region prone to droughts and famine.
This extraordinary accomplishment was not an accident. It came through innovative reforms to the country’s health system, designed to dramatically expand access to health care. Nearly 40,000 women were hired and trained by the Ethiopian Government to be health extension workers, providing essential health services around the country.
Today, the world has an opportunity to build on Ethiopia’s successes. This coming week, for the first time, all 194 United Nations member states will vote on who will become the next Director-General of the World Health Organization.
Dr. Tedros Adhanom Ghebreyesus, who as Minister of Health of Ethiopia was the architect of the country’s health system reforms, is one of the three candidates to lead the agency. If Dr. Tedros is elected, he will be the first African to lead the WHO.
The stakes could not be higher. As noted by The Lancet Commission on Investing in Health, chaired by the former U.S. Treasury Secretary, our generation has the capacity to dramatically reduce the major causes of preventable death worldwide. To do that, we need to make the right investments and choose the right leader.
As the leader of the Global Health Bureau at the U.S. Agency for International Development during the Obama administration, I had the chance to work closely with Dr. Tedros. In 2012, the United States, India and Ethiopia co-convened a Call to Action to End Preventable Child and Maternal Deaths. I saw him take on important global responsibilities, becoming board chair of a number of international agencies including the Global Fund to Fight AIDS, Tuberculosis and Malaria.
Most importantly, I have seen how passionate Dr. Tedros is about helping countries build sustainable health systems. This is a cause I have believed in since my time as Managing Director of The Rockefeller Foundation. As we learned from the recent outbreak of Ebola in West Africa, gaps in the health system make the prevention, detection and response to epidemics nearly impossible. Resilient health systems that cover everyone with essential services, on the other hand, have proven their effectiveness.
Instituting universal health coverage is a challenging proposition for any country — particularly those with more limited resources. As Minister of Health in Ethiopia, Dr. Tedros introduced community-based health insurance that today covers 15 million people and growing, and increased medical school enrollment tenfold.
Ethiopia was also an early champion of the International Health Regulations to promote cooperation around global public health emergencies, and commissioned an external evaluation to monitor its progress in disease outbreak surveillance and reporting. The country now also hosts the headquarters of the new Africa Centres for Disease Control and Prevention.
Like many countries, Ethiopia has fallen short in some health markers and still has significant challenges. But by almost any measure, it is showing the way to a new era in world health. The basis of this progress has been innovative leadership by Dr. Tedros.
For those of us who have devoted our careers to international development it is reassuring and satisfying to see this leadership emerge from what used to be called the “developing” world.
Ariel Pablos-Méndez was the Assistant Administrator for Global Health at USAID from 2011–2016. He is currently teaching at the Universidad de Guadalajara.
You can read more about Dr. Tedros and his vision for a healthy world as #NextDG at #WHA70 on his website: www.drtedros.com/ — and follow along with his campaign on social media at Facebook.com/DrTedros.Official and on Twitter at @DrTedros. Sign up for the campaign’s newsletter `From the Desk of Dr. Tedros’ at http://bit.ly/2nGWtLm.