“This report documents the 2017 work of the WHO country team for ETHIOPIA – the focus and achievements of the country team made possible by the extraordinary support of the WHO Regional Office for Africa and WHO headquarters. In 2017, the work of WHO in Ethiopia was organized around THREE investment pillars – (1) responding to health emergencies, (2) building resilient health system, and (3) reforming WHO for effectiveness – in the context of such core principles of the Agenda 2030 as leave no one behind, working across sectors, and whole of government and whole of society approaches”
Organizing the work of WHO around the three investment pillars was in pursuit of the “Africa Health Transformation Programme 2015 – 2020: A vision for Universal Health Coverage” (AHTP) and “the transformation agenda of the world health organization Secretariat in the African region, 2015 – 2020” (TA) launched by Dr. Matshidiso Moeti, the Regional Director for Africa, in 2015. Both the AHTP and the TA are founded on the WHO 12th General Programme of Work, 2014-2019 (GPW 12).
The AHTP articulated five strategic priority areas for WHO investment in the African region: (i) improving health security by tackling epidemic-prone diseases, emergencies and new health threats; (ii) driving progress towards equity and universal health coverage through health systems strengthening; (iii) pursuing the post 2015 development agenda while ensuring that the MDGs are completed; (iv) tackling the social and economic determinants of health; and (v) building a responsive and results-driven WHO secretariat.
Towards investment pillar (1) which addresses AHTP strategic priority area (i), WHO in 2017: deployed resources towards control of ongoing public health emergencies; undertook root cause analysis of the cyclical public health emergencies in Ethiopia, concluding that breaking the humanitarian vicious cycle in Ethiopia required the adoption of new way of working in the context of the humanitarian-development nexus; and adapted the WHO health emergency strategy to the Ethiopian context with focus on three results pillars: RESULT PILLAR 1, prevention of public health incidents – through reducing risks/vulnerabilities by frontloading development investments in priority areas informed by risk/vulnerability maps; RESULT PILLAR 2, preparation for public health incidents through building shock responsive regional health systems (prepared systems) with capacity for early detection of public health incidents and rapid deployment and scale-up of life saving resources and interventions; and RESULT PILLAR 3, protection of life during public health incidents through responding rapidly by activating and operationalizing the prepared systems.
Pursuant to investment pillar (2) which addresses AHTP strategic priorities areas (ii), (iii) and (iv),
WHO in 2017 invested in: developing shock responsive regional health systems in disease epidemic prone areas; mainstreaming water-centered development (resilient WASH); strengthening public health emergency management system; generating strategic information for health policies and strategies; and strengthening national health systems g towards universal health coverage including investments in enhancing access to essential medicines and technologies, strengthening initiative on local pharmaceutical manufacturing, strengthening immunization systems, controlling communicable and non-communicable diseases, promoting health along the life course, mainstreaming equity, gender equality and human rights in health and integration of health into the Ethiopia-Kenya “crossborder integrated programme for sustainable peace and socio-economic transformation.”
WHO initiatives in its investment pillar (3) which addresses AHTP strategic priority area (v) were guided by feedback from stakeholders during consultations towards the development of the country cooperation strategy in 2016. In 2017 therefore, WHO invested in programmatic reforms that consisted of: initiatives towards enhancing WHO capacity for health emergency preparedness and response; finishing the unfinished business of polio eradication; and shifting WHO health development investments towards outcome/impact levels. WHO also invested in management reforms that included initiatives towards: strengthening accountability for results and resources; strengthening risk management and compliance; enhancing transparency and equity in human resource management; fostering transparency in procurement of goods and services; enhancing resource mobilization and external communication capacities; and strengthening WHO field presence for enhanced impact.
The ongoing work of the WHO in Ethiopia around the three investment pillars will continue in 2018; it will be fully aligned with the 13th General Programme of Work (GPW 13) led by Dr. Tedros Adhanom Ghebreyesus, the WHO Director General, with a strategic focus on accounting for outcome and impact.
In 2017, Ethiopia struggled with the consequences of La Niña-induced drought in the southern and southeastern parts of the country with no time to recover from the 2016 El Niño-induced drought.
Ethiopia in 2017 therefore experienced dire humanitarian situations: population displacements among pastoralist communities in search of water and fodder for their animals; loss of animals and other livelihoods; outbreak of moderate and severe acute malnutrition; epidemic of communicable diseases including acute watery diarrhea (AWD), measles, hepatitis A, dengue fever, and guinea worm disease (GWD). The drought-induced internally displaced persons (IDP) crisis was compounded by conflict-induced IDPs in 2017.
Consequently, WHO in 2017 focused on responding to the prevailing public health emergencies without losing sight of the need to continue priority health development investments like: enhancing access to essential medicines and technologies; advancing the initiative for strengthening local pharmaceutical manufacturing; strengthening immunization systems; controlling communicable and non-communicable diseases; promoting health along the life course; and mainstreaming equity, gender equality and human rights in health. Also WHO in 2017 invested in organizational reform in line with the TA; WHO invested in strengthening its capacities and systems towards enhanced delivery and accounting for strategic results.
Thus the work of WHO in Ethiopia during 2017 was organized around three investment pillars: (1) responding to health emergencies; (2) building resilient health systems; and (3) reforming WHO for effectiveness. Towards WHO commitments in Ethiopia along these three investment pillars, cognizance was taken of the imperatives of the sustainable development goals (SDGs) and the core principles of Agenda 2030 such as leave no one behind, working across sectors, and whole of government and whole of society approaches. In 2017 therefore, WHO actively engaged within and outside the UN development system, partnering with other organizations including non-health sectors like the ministry of industries and the ministry of water resources.
The sections that follow are organized along the three investment pillars of the work of the WHO in Ethiopia in 2017. They document progress made in planned investments under each pillar. Finally, the section on future perspectives defines the ways forward in 2018 and beyond.
Partnerships with various stakeholders is appropriately acknowledged in the section on WHO’s partners in ETHIOPIA.
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