Global Health - Ethiopia

Through the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), the CDC Ethiopia Office supports the implementation of an effective, efficient HIV program. This support contributes directly to saving the lives of men, women and children through high quality HIV treatment services and a comprehensive combination prevention strategy. Using a data-driven approach, this strategy is tailored to the unique characteristics of the local epidemic to boost health impact and improve overall program performance.

CDC works closely with Ethiopia’s Ministry of Health (MOH) to support a full complement of HIV program activities including HIV/counseling and testing, blood safety, early infant diagnosis (EID), and strengthening health systems. Health system strengthening is needed for long term program sustainability and includes building country capacity in the areas of workforce development, epidemiology, surveillance, health information systems, and program monitoring and evaluation to assess impact and make rapid course corrections to keep pace with changes in the local epidemic. The growing effectiveness of Ethiopia’s HIV response has resulted in a dramatic decline in HIV incidence.

Under the U.S. President’s Malaria Initiative (PMI), CDC has assigned a Resident Advisor to Ethiopia as part of an interagency team with USAID to support the Ministry of Health (MoH) in implementing malaria prevention and control interventions; these include providing long-lasting insecticide mosquito nets (LLINs) and indoor residual spraying; improving diagnostics and case management; surveillance and monitoring and evaluation of malaria-related activities. Specific examples of CDC technical support have included: 1) the evaluation of the efficacy of first line antimalarials against uncomplicated malaria caused by Plasmodium falciparum and Plasmodium vivax in Oromia Region; 2) continued support of three Ethiopian public health professional staff enrolled in the Field Epidemiology and Laboratory Training Program (FELTP), a two year practical public health training program, with on-site support and technical assistance visits from the CDC staff (in Ethiopia and Atlanta).

CDC provides technical and programmatic expertise to meet national immunization goals and international resolutions to eradicate polio, reduce measles mortality, and strengthen the national routine immunization program in Ethiopia. CDC investigates circulating vaccine-derived poliovirus cases and provides operational support for acute flaccid paralysis surveillance and supplementary immunization activity. CDC conducted a comprehensive integration evaluation project to assess resource needs for integration of interventions with immunizations and to determine best practices for delivery of integrated health services at the service delivery level.

From 2011, CDC has worked with the Ethiopian Federal Ministry of Health, the Ethiopian Health and Nutrition Research Institute (EHNRI), and the African Field Epidemiology Network (AFENET) to develop the evidence base and tools needed to support the elimination of onchocerciasis in Africa. On-site activities for specimen collections started on February 2013.

To support one of the Division of Global HIV & TB’s prevention strategies, staff collaborated with behavioral scientists from the Division of Reproductive Health to develop the Modeling and Reinforcement to Combat HIV/AIDS (MARCH) Program. The goals of this behavior change strategy are to promote behavioral changes that reduce the risk of HIV infection and transmission, increase service use, and create normative environments which sustain changes, like abstinence, mutual monogamy, use of voluntary HIV counseling and testing (VCT) services, and condom use. To achieve these goals, MARCH combines two approaches to behavior change: entertainment/education through broadcast media and interpersonal reinforcement at the community level. In the past few years, DRH staff has focused on evaluation of MARCH projects, and completed the evaluation of the MARCH project in Zambia this past year. This completes DRH’s active involvement in the 2 ongoing projects.

In 2009, the Ethiopian Field Epidemiology and Laboratory Training Program was established to develop a cadre of highly skilled public health professionals in the Federal Ministry of Health and regional health bureaus. Residents of the program have investigated disease outbreaks, conducted case investigation and contact tracing, trained local health sector staff, updated guidelines, conducted and improved surveillance, and made recommendations to improve water quality, hygiene and sanitation. Upon completion of the two-year program, residents receive an MPH in Field Epidemiology from the Addis Ababa University School of Public Health.

CDC is working with Ethiopia to improve their ability to prevent, detect and respond to infectious disease threats.  This work helps meet the U.S. commitment to assist at least 31 countries  in reaching the targets outlined in the Global Health Security Agenda. CDC’s extensive global health presence and experience are critical to achieving these targets.