Discussion with Dr. Lia Tadesse: Ethiopia’s Fight Against COVID-19
Dr. Lia Tadesse Gebremedhin is the Minister of Health of Ethiopia. She is an obstetrician and gynecologist with extensive experience in healthcare leadership and hospital administration. She has worked in government, NGOs, academia and leading grant-funded programs.
Dr. Tadesse participated in a discussion with Peter Sands, Executive Director of the Global Fund to Fight AIDS, Tuberculosis and Malaria, moderated by Sherwin Charles, CEO and co-founder of Goodbye Malaria during the GBCHealth webinar, Reimagining Commitment to Fighting HIV, TB and Malaria During COVID-19: Focus on the Private Sector, on July 16, 2020. During the discussion, Dr. Tadesse shared her perspective on how Ethiopia is adapting to continue essential services for HIV, TB and malaria while combating COVID-19, how the country is leveraging existing systems to address the three diseases and COVID-19 concurrently, and the role of the private sector as a partner in this response. This interview was adapted from her comments during the discussion.
What was the key to Ethiopia’s swift response to COVID-19?
Ethiopia activated its public health emergency response at the end of January, opening the national Emergency Operations Center, introducing screenings at all borders, and preparing facilities for an influx of COVID-19 cases. As soon as the first case was detected in mid-March, a mechanism for multi-sectoral national response was initiated and the Prime Minister set up a National Ministerial committee to lead and coordinate the government responses.
We had a strong coordinated platform with regional health bureaus, ensuring these had necessary technical and financial support to continue their work without interruptions. Urgent non-pharmaceutical interventions were also swiftly instituted, such as school closures and a ban on big public gatherings.
There was a strong collective response, not only within the different sectors in the government, but from the community itself, which played a big role in terms of donating spaces for treatment and isolation centers and by providing financial support and commodities.
Public-private partnership has also played an important role; for example, Ethio telecom pushed out important phone messages and reminders about COVID-19 and Ethiopian airlines played a significant role in delivery of much needed critical supplies like SARS-COV 2 test kits. The media and entertainment industry has also disseminated important public health messages. Associations of private employers led the development of private workplace guidance to coordinate and ensure evidence informed workplace responses. Some private industries are involved in the production of non-medical masks and sanitizers for public use. Overall, the private sector came together to help the government’s response by providing expertise. In addition, the professional community set up an advisory council that supported the response with evidence based interventions.
How has the pandemic impacted the country’s ability to maintain other healthcare services, especially for HIV, TB and malaria?
Another critical aspect of the national response is our regular and ongoing review of the government’s pandemic strategy. We are revisiting our strategy every two weeks to ensure it remains agile and responds to the changing situation. For instance, when the first COVID-19 case was reported, we noticed that there was a significant drop in outpatient and in-patient emergency visits across the country. Realizing this was in part due to fear in the community of contracting COVID-19, we quickly adjusted the strategy to include continuity of essential services as one of its key components. We developed guidelines to prioritize key essential services, including sexual and reproductive health, HIV, TB, malaria, a few services related to non-communicable diseases, and acute care. We further designated some of the facilities as COVID-19-only, while others were for non-COVID-19 cases but included temporary isolation rooms, in case these were needed. Proactive public awareness messaging to communicate that the government was working to make health facilities safe for patients to visit for their treatment was a critical component to the success of our response.
The other key issue is making sure people are receiving their medicine and treatments. In some facilities we conducted follow-ups over the phone with patients in order to ensure that they had enough medication to last for multiple months. By looking at data around essential services weekly, we were able to continuously assess the situation and ensure that people began coming into facilities to receive services.
We integrated the COVID-19 response with non-COVID-19 support and this coordination, the agility of our response, and focusing on continuity of essential services were some of the factors that helped us.
How has Ethiopia harnessed the power of its partners in this fight?
One of the key factors that helped us in this response is our collaboration with different partners.
The role of development partners is clear, as they helped us mobilize resources and allowed us to reprogram funds to the emergency response to COVID-19. There has been significant support from our development partners, specifically the Global Fund, Gavi, the World Bank, Jack Ma, WHO and others.
The business community has also been one of the strong partners in the response, through financial, in-kind donations and other support. For example, we have been working closely with local manufacturers to shift some of their capacity to produce personal protective equipment (PPE) and sanitizers. We are now in discussions to begin local production of test kits. Local manufacturing not only ensures the availability of the supplies, but also supports local businesses during this crisis. The Ministry of Health has been working closely with the Ministry of Industry and Trade to make regulatory processes faster while also maintaining quality of commodities.
The protection of health workers is key to the successful response. PPE is needed for all health services. The private sector, development partners, other countries, and the community exemplified solidarity by working together to fill gaps in PPE.
What was the role of the private health sector in Ethiopia’s response?
We created a regular forum with the private sector, especially with the private health sector, to collaborate and leverage their capacity within the COVID-19 national responses. Given that most of our facilities thus far have been under the public sector, the government created a clear protocol on how to engage more private sector facilities to operate as COVID-19 treatment centers.
The government also realized that health coverage and life insurance for health workers was an issue. We decided to work closely with the insurance sector to support health workers’ coverage. The government further incentivized the private sector engagement through tax exemptions of industries directly supporting production of COVID-19 related supplies.
This pandemic has taken a toll on the economy in different ways. We need to work in partnership to address COVID-19, but also to maintain the economy. We have been working with the private sector around sustainability of essential services and local manufacturing, but we know that we still need to grow that engagement to best support the health system.