Ethiopia
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Ethiopia ranks eighth among the world’s 22 countries with a high tuberculosis burden. According to the World Health Organization (WHO) Global TB Report 2006, the country had more than 267,000 TB cases in 2004, with an estimated incidence rate of 353 cases per 100,000 people. Ethiopia’s TB and Leprosy Control Program (TLCP) began to implement Directly Observed Therapy, Short-Course (DOTS) in two zones in 1991, and in 2004, DOTS coverage was 70 percent in areas where health services had adopted the strategy. TB treatment is integrated into general health services, although only 40 percent of Ethiopia’s people have true access to DOTS. The DOTS detection rate in 2004 was only 36 percent, compared with the WHO target of 70 percent detection. The treatment success rate is well below the 85 percent target set by WHO and declined from 80 percent in 2000 to 70 percent in 2003. The number of TB cases is likely to increase as Ethiopia’s HIV/AIDS epidemic expands, as nearly one-quarter of adult TB cases are HIV-positive.
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Note: All data are for 2004 except where noted otherwise.
Source: Global Tuberculosis Control: WHO Report 2006 |
USAID Approach and Key Activities
USAID began working on TB control in Ethiopia in 2001 in collaboration with the Disease Prevention and Control Department of the Ministry of Health and regional health bureaus. The major TB and TB-HIV/AIDS prevention and control activities supported by USAID are implemented at the public health center level and in workplace clinics and hospitals.
Between 2000 and 2005, USAID funds for TB programming in Ethiopia averaged $1.2 million per year. Program activities focus on the following areas:
- Supporting the roll-out of the national and regional TB-HIV/AIDS advocacy communication and social mobilization strategies, which will be operational in 450 health centers in February 2007
- Supporting the development of public-private mix (PPM) DOTS
implementation guidelines
- Initiating pilot PPM DOTS services in private for-profit health clinics and hospitals in Addis Ababa and the Oromiya region
- Conducting site assessments for selected health centers
USAID Program Achievements
USAID’s assistance and support have helped address TB prevention and control in Ethiopia. USAID’s program achievements include the following:
- Established TB-HIV/AIDS committees at 126 selected health centers
- Introduced provider-initiated HIV counseling and testing and referral between DOTS and CT clinics in the 126 selected facilities, including referral of eligible patients for antiretroviral treatment-related services to hospitals linked to the health centers
- Presented the recently revised TB-HIV/AIDS recording and reporting formats in all the selected health centers
- Provided TB-HIV/AIDS training to DOTS clinic staff in the selected health centers and to more than 100 regional, zonal, and woreda (district) TB/leprosy coordinators
- Initiated pilot PPM DOTS services in 26 private for-profit health clinics and hospitals in Addis Ababa and the Oromiya region
Case Detection and Treatment Success Rates Under DOTS
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Note: DOTS treatment success rate for 2004 will be reported in the 2007 Global Report.
Source: Global Tuberculosis Control: WHO Report 2006. |
Partnerships
Partnerships are one of the most important elements in combating TB in Ethiopia. WHO and Italy’s University of Bresica are supporting training of trainers. The Dutch government is providing funds for TB drugs, while the German Leprosy Relief Association is funding overall program support. Médecins Sans Frontières/Belgium provides technical and financial support in the Somali region. USAID also partners with ABT Associates and Intrah for TB and TB-HIV/AIDS interventions in the private sector and John Snow, Inc./Deliver for drug logistics. In addition, the Global Fund to Fight AIDS, Tuberculosis and Malaria approved $21 million for TB activities between 2002 and 2006.
September 2006
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