Thursday, May 28, 2009

Implications of the HIV testing protocol for refusal bias in seroprevalence surveys

HIV serosurveys have become important sources of HIV prevalence estimates, but these estimates may be biased because of refusals and other forms of non-response. We investigate the effect of the post-test counseling study protocol on bias due to the refusal to be tested.

Methods: Data come from a nine-month prospective study of hospital admissions in Addis Ababa during which patients were approached for an HIV test.

Patients had the choice between three consent levels: testing and post-test counseling (including the return of HIV test results), testing without post-test counseling, and total refusal. For all patients, information was collected on basic sociodemographic background characteristics as well as admission diagnosis.

The three consent levels are used to mimic refusal bias in serosurveys with different post-test counseling study protocols. We first investigate the covariates of consent for testing.

Second, we quantify refusal bias in HIV prevalence estimates using Heckman regression models that account for sample selection.

Results: Refusal to be tested positively correlates with admission diagnosis (and thus HIV status), but the magnitude of refusal bias in HIV prevalence surveys depends on the study protocol. Bias is larger when post-test counseling and the return of HIV test results is a prerequisite of study participation (compared to a protocol where test results are not returned to study participants, or, where there is an explicit provision for respondents to forego post-test counseling).

We also find that consent for testing increased following the introduction of antiretroviral therapy in Ethiopia. Other covariates of refusal are age (non-linear effect), gender (higher refusal rates in men), marital status (lowest refusal rates in singles), educational status (refusal rate increases with educational attainment), and counselor.

Conclusions: The protocol for post-test counseling and the return of HIV test results to study participants is an important consideration in HIV prevalence surveys that wish to minimize refusal bias.

The availability of ART is likely to reduce refusal rates.

Author: Georges ReniersTekebash ArayaYemane BerhaneGail DaveyEduard Sanders
Credits/Source: BMC Public Health 2009, 9:163

Wednesday, May 27, 2009

Diarrhoea outbreak kills 20 in Ethiopia : UN

ADDIS ABABA (AFP) — An outbreak of acute watery diarrhoea has killed 20 people out of more than 600 cases in Ethiopia in one month, the UN said on Tuesday.

"A total of 649 cases and 20 deaths of acute watery diarrhoea were reported ... between 13 April and 17 May 2009," the UN Office for the Coordination of Humanitarian Affairs (OCHA) said in a statement.

Citing ministry of health records, OCHA said the outbreak was confined to areas in the south, southeast and northeastern parts of the country.

UN agencies have supplied adequate water treatment chemicals to cater for over 85,000 people in the month.

The highly contagious disease killed more than 870 people out of some 76,000 cases around the same period in 2007.

It is common among people with suppressed immunity. In severe cases and when accompanied by vomiting it can lead to light-headedness, weakness, confusion, kidney failure and possibly death.

Saturday, May 23, 2009

Ethiopia shall have pediatric hospital: Standing Committee

Addis Ababa) - Capacity Building Affairs Standing Committee of the House of Peoples’ Representatives (HPR) underscored a need to establish pediatric hospital in Ethiopia as the children constitute a significant portion in the national population.

While visiting the Black Lion Medical School and the Specialized Referral Hospital on Friday, Head of the Standing Committee Teklie Tesema said the specialized hospital has serious capacity limitations to provide efficient medical services to children.

In fact, Teklie said, the problems related to provision of pediatric medical services in the hospital has developed from worse to worst over the last two years.

Hence, he said, the standing committee will be requesting both the HPR and the Executive Wing of the Ethiopian government for establishment of a pediatric hospital in the country in a bid to ease these problems.

Despite the problems, both the school and the specialized referral hospital have been exerting utmost efforts toward discharging their respective duties and responsibilities, according to the standing committee.

Dean of the School, Dr. Miliard Deribew and Head of the Specialized Hospital, Dr. Damiel Zewdie gave briefings to the members of standing committee and responded to questions raised by the committee.


Friday, May 22, 2009

Predictors of defaulting from completion of child immunization in south Ethiopia, May 2008- A case control study

Epidemiological investigations of recent outbreaks of vaccine preventable diseases have indicated that incomplete immunization was the major reason for the outbreaks. In Ethiopia, full immunization rate is low and reasons for defaulting from immunization are not studied well.

The objective of the study was to identify the predictors of defaulting from completion of child immunization among children between ages 9-23 months in Wonago district, South Ethiopia.

Methods: Unmatched case control study was conducted in eight Kebeles (lowest administrative unit) of Wonago district in south Ethiopia. Census was done to identify all cases and controls.

A total of 266 samples (133 cases and 133 controls) were selected by simple random sampling technique. Cases were children in the age group of 9 to 23 months who did not complete the recommended immunization schedule.

Pre-tested structured questionnaire were used for data collection. Data was analyzed using SPSS 15.0 statistical software.Result: Four hundred eighteen (41.7%) of the children were fully vaccinated and four hundred twelve (41.2%) of the children were partially vaccinated.

The BCG: measles defaulter rate was 76.2%. Knowledge of the mothers about child immunization, monthly family income, postponing child immunization and perceived health institution support were the best predictors of defaulting from completion of child immunization.

Conclusion: Mothers should be educated about the benefits of vaccination and the timely administration of vaccines.

Author: Henok TadesseAmare DeribewMirkuzie Woldie
Credits/Source: BMC Public Health 2009, 9:150

Wednesday, May 20, 2009

Yared Tekabe’s Groundbreaking Research in Atherosclerosis

Republished: May20, 2009.

New York (Tadias) - Dr. Yared Tekabe enjoys doing most of his reflections while sitting anonymously with his laptop at cafés in Harlem. When he’s not there, Tekabe is busy running studies in cardiovascular disease detection and prevention at his lab in Columbia University’s William Black building in upper Manhattan. Last November, Tekabe’s groundbreaking work on non-invasive atherosclerosis detection and molecular imaging was published in the American Heart Association’s journal, Circulation, along with an editorial citing its clinical implications.

Dr Tekabe’s success has helped his laboratory, headed by Dr Lynne Johnson, to receive another $1.6 million four-year grant from the National Institute of Health to continue his research, and Tekabe hopes that in a few years time his work can help heart disease prevention efforts and early detection of atherosclerosis in humans.

“What is atherosclerosis in layman terms?” I ask him, trying hard to correctly pronounce this tongue twister. He breaks it down to its linguistic roots. “Atherosclerosis comes from the Greek roots athere which means gruel, and skleros which means hardness or hardening,” he explains. Further research in Wiki reveals that atherosclerosis is a condition affecting our arterial blood vessels, which transport blood from the heart to the rest of the body. Atherosclerosis is the chronic condition in which inflammation of the walls of our blood vessels lead to hardening of the arteries.

“Atherosclerosis is the underlying cause of cardiovascular disease (CVD),” Tekabe says. “The result is progressive closing of the blood vessels by fat and plaque deposits, which block and further restrict blood flow. In more serious cases it may also lead to clots in the aorta (main artery coming out of the heart) or carotids (arteries supplying blood to the brain) that may dislodge and travel to other parts of the body such as the brain, causing stroke. If the clot is in the leg, for example, it can lead to gangrene. Deposits of fat and inflammatory cells that build up in the walls of the coronary arteries (supplying blood to the heart muscle) can rupture leading to blood clots. Such clots in an artery that supplies blood to the heart muscle will suddenly close the artery and deprive the heart muscle of oxygen causing a heart attack. In the case of very sudden closure of an artery a clot can cause sudden cardiac death.”

“It’s the Tim Russert story,” Tekabe says, providing a recent example of what undetected levels of plaque formation in our bodies can lead to., an online consumer health portal, had described the famed former MSNBC ‘Meet the Press’ host’s sudden heart attack as being caused by a plaque rupture in a coronary artery. Russert had previously been diagnosed with heart disease, but his atherosclerosis was asymptomatic. He had not experienced the common signs of chest pain and other heart attack symptoms to warn him or his doctors of his true condition. The undetected inflammation in his vessels and the subsequent rupture of plaque led to his sudden heart attack and untimely death. This is not uncommon, however. According to the Centers for Disease Control and Prevention (CDC), heart disease “is the leading cause of death for both women and men in the United States, and women account for 51% of the total heart disease deaths.” There is even more grim news: United States data for 2004 has revealed that the first physical symptom of heart disease was heart attack and sudden death for about 65% of men and 47% of women with CVD.

The risk factors for atherosclerosis are well known and Tekabe runs through the list with me: “diabetes, obesity, stress, smoking, high blood pressure, family history of CVD, and diet” he says. “But of all the factors that I have mentioned, I would say diet is the most important one to change,” he adds. Food items such as red meat, butter, whole milk, cheese, ice cream, egg yolk, and those containing trans fat all put us at higher risk for plaque formation. The American Heart Association recommends eating fish such as salmon, herring and trout instead of red meat, as well as eating food that is steamed, boiled or baked instead of fried. It is better to use corn, canola, or olive oil instead of butter, and to eat more fiber (fruit, vegetables, and whole grain). Notwithstanding that March is deemed National Nutrition Month by the American Heart Association, changing our diet is largely emphasized in CVD prevention. We should also be exercising at least 30 minutes each day.

“Early non-invasive detection of the presence of inflammation and plaque could save lives,” Tekabe points out. “But the problem is two-fold: those who suffer from atherosclerosis do not display warning signs until it’s too late, and for doctors, a non-invasive method of detecting atherosclerosis is by and large not a possibility.” Research by Tekabe and others may soon change the way doctors can detect atherosclerosis.

Using molecular imaging techniques that were previously popular in cancer biology research, Tekabe and his colleagues have discovered non-invasive methods of detecting RAGE, a receptor first discovered in 1992 and thought to have causative implications in a host of chronic diseases ranging from diabetes to arthritis. Tekabe, collaborating with Dr Ann Marie Schmidt who has shown that RAGE receptors play a key role in atherosclerotic inflammatory response, notes that these receptors can be detected non-invasively in mice that have been fed a high-fat, high cholesterol diet.

“In the past, although we knew about the RAGE receptor, especially in the study of diabetes, we were not able to detect it without performing an autopsy of the lab mice. Clearly, in the case of humans it would be pointless if we said that we detected atherosclerosis in the patient after the patient had died,” Tekabe explains. “Therefore, it was imperative that our research showed a more non-invasive method, detecting RAGE receptors and locations of inflammation while the subject was still alive. The first step would be to test it on mice, which we have, and then perhaps on larger animals such as pigs, so that this research could be successfully translated to help non-invasively detect atherosclerosis in its early stages in human beings.”

Read the rest of story at :

Monday, May 18, 2009

The blind see the light of day in Debre Markos

Beginning in 2004, and after a secondary eye unit in the Debre Markos Hospital was built and furnished in 2007 by Christian Blind Mission (CBM) International and Rotary Club Stiftland, about 50,000 eye patients had received various treatments. About 5,000 of the 50,000 were those who had been blinded by trachoma, glaucoma and cataract but who are now able to see the light of day as a result of a simple surgery at the clinic.

Eye patients come to the Debre Markos clinic from nearby towns and villages and from as far away as Gondar and Wollga, Dr Mulu Lisanework, senior prevention of blindness program officer of CBM told The Reporter. The fact that patients come to the clinic from the vicinity of Debre Markos in great number testifies to the quality of service the clinic offers and is a clear indication that blindness is a serious problem in northern Ethiopia, Dr Mulu said.

The eye unit in the Debre Markos Hospital is, therefore, engaged in accomplishing two missions: prevention and cure of blindness. And after a visit to the eye unit on Monday, CBM believes that it is doing what it was intended to do in the Amhara Regional State and is well on its way to achieving Vision 2020, the elimination of blindness by the year 2020.

In addition to the services Dr Yilikal Alemu, head of the eye unit and his assistants, provide at the clinic, patients benefit from the involvement of about ten nurses trained by CBM to go around villages and towns checking on peoples’ eyes, identifying what type of problem they have and referring them to the clinic for the appropriate kind of treatment.

Until a few years ago, most eye patients in the Amhara region had to travel to Addis Ababa for treatment or be doomed to blindness for the rest of their life if they were too poor to pay for transport, lodgings and hospital fees.

Now, some eye patients do not come to the clinic simply because they can not afford to pay the bus fare to Debre Markos. Therefore, when patients can not come to the clinic, the clinic goes to the patients.

Instead of waiting for all patients to come to the clinic, Dr Yilical and his team travel every month to Mota and Finote Selam within the Amhara region carrying all the necessary surgical equipment and spend about five days serving about 100 people a day according to their needs. That the clinic was opened in Debre Markos has been so ideal for its services to reach out to a great number of patients in Amhara which is one of the regions in Ethiopia most severely affected by blindness and other eye diseases.

Dr Mulu says that owing to the quality of services the clinic offers, its reputation has spread far and wide through patients who have been treated there and were satisfied with the results. The eye unit employs a cataract surgery technique called sutureless, which uses no stitches. This is currently the most advanced technique of eye surgery being used in India and Nepal and recommended for most developing countries.

Presently, CBM is training optical technicians in the Debre Markos Hospital to work in its optical workshop which is well furnished with the latest machines, lenses and frames.

Compared to the extent of the problem of blindness in Ethiopia, so far not much has been done and CBM’s contribution alone, although valuable, is not enough, Dr Mulu says. She recommends that the government deal with it seriously enough, if not as seriously as it is dealing with malaria and tuberculosis.

CBM has constructed and furnished secondary eye units in Jimma University, Debre Markos Hospital, Debre Berhan Hospital, Felege Hiwot Hospital, Arba Minch Hospital, Yigalem Hospital and Pawe in Benishangul Gumuz.

It is building similar secondary eye units in Woldiya, Amhara Regional State. One of CBM’s main fields of engagement in Ethiopia is “Vision 2020: The Right to Sight,” a global initiative for the elimination of avoidable blindness by the year 2020. To accomplish this, CBM involves itself in infrastructure and human resource development and disease control within eye medical care.

Christian Blind Mission is an international non-governmental organization which works through partners, enabling them to provide high quality preventive, curative, educational and rehabilitative services.
In a related development, Dr Mulu told The Reporter that the eye unit which CBM had built, furnished and inaugurated in February in Chiro, Oromia Regional Sate, but was closed the same day because the regional Health Bureau had not assigned a physician, just started services on April 27 because a new graduate ophthalmologist agreed to work there.

City health bureau questions Betezatha medic who examined Tilahun

Federal cake cut

Amhara set to lose out after census

By Kirubel Tadesse

Endorsed by the House of Federation last Friday, a new budget formula has been devised to calculate how the regions will share the 20 billion birr expected to be allotted to them by the Federal Government next budget year.

Lights out at export factories

By Yohannes Anberbir

Ethiopia’s power problems have reached a critical stage, forcing the state-owned Ethiopian Electric Power Corporation (EEPCo) to incorporate all export-oriented factories into the rationing schedule.
So far, export factories were not included in the power rationing that started in March this year, due to the Government’s decision to exempt foreign currency generating factories.


Post office to take over some ETC operations

By Muluken Yewondwossen

The Ministry of Transport and Communication (MoTC) has ordered the state owned Ethiopian Telecommunications Corporation (ETC) to facilitate the shifting of some operations and duties of the corporation to the other organ under the ministry, the Ethiopian Postal Service (EPS).

Major power project nears completion

By Groum Abate

The Gilgel Gibe II hydropower generation project undertaken by the Ethiopian Electric Power Corporation will be completed in the next two weeks.
Sources told Capital that the 420 MW plant would enjoy an informal opening in the next two weeks after completing the remaining 700 metres of a 27 km tunnel.
As the result of several unforeseen natural hazards, the project completion has been delayed for over a year.

Crash landing for airport chief

By Yohannes Anberbir

Deriba Kuma, Minster of Transport and Communication, (MoTC) sacked Eyobe Estifanos, head of Ethiopian Airport Enterprise,this week.
It is the first strong measure Deriba has taken since being promoted from his former position as head of the agriculture bureau of Oromia Regional State.

Sandford governors urged to delay status change

Parents demand patience until administering agency for endowment charities is established

By Elias Meseret

Concerned parents of children at Sandford School have written to the board of governors urging them to delay a planned move to register the school as an endowment charity.
The governors are eager to do this in light of the new Charities and Societies Proclamation, but the parents have suggested that the move should only be made when an agency to administer endowment charities has been established.

Big banks look to link with micro lenders

By Kirubel Tadesse

The Ethiopian Bankers Association, a group of private and state commercials banks, established a steering committee comprising state and private agencies to facilitate links between banks and micro financing institutions.

Customs strike gold

By Yohannes Anberbir

Last Sunday, customs intelligence officers were informed about a kilo of gold being smuggled to the capital from the eastern part of the country.
They were tipped off around midday, with information including the plate number of the truck suspected to contain the gold. They then had to wait for around six hours at a customs station in the Kaliti area.


Almost nine out of 10 vocational students fail exam

By Kirubel Tadesse

Of the 10,548 graduates of various Technical Educational and Vocational Education and Training Institutions (TEVET), only just over 11 per cent passed the national competence exam, Capital has learnt.

City health bureau questions Betezatha medic who examined Tilahun

Taskforce makes surprise visits to hospitals and clinics

By Elias Meseret

The Addis Ababa Health Bureau has told Capital that it has questioned the doctor at Betezatha Higher Clinic who examined the late Tilahun Gesesse.
It says this only happened after several days of failed efforts to reach the medic.


Tobacco enterprise to punish illegal traders

State monopoly to introduce Nyala Premium

By MulukenYewondwossen

The National Tobacco Enterprise (NTE) has announced that it will take severe measure against illegal cigarette distributors and traders in the near future.
When the operation starts it will shut superstores, including small shops who sell illegal products.

Safety net unravels due to donor deficiencies

By Yohannes Anberbir

Ethiopia unable to deliver aid under to beneficiaries the safety net program due to a shortfall from donors, the Ministry of Agriculture and Rural Development (MoARD) has reported.
Currently there are 8.29 million people chronically affected by food insecurity. MoARD planned to deliver 509,917 metric tonnes of food to the affected people within the first half of the fiscal year, however, the ministry obtained only 396.7 metric tonnes of food from donors and distributed only a small amount of it.


Higher education bill in final stage

By Kirubel Tadesse

A new bill, which improves the 2003 Higher Education proclamation, in an effort to boost the quality of higher education, is on it way to parliament for final endorsement.
The Council of Ministers approved the bill, which oversees both state run and private higher educational institutions, during its 83rd regular meeting.

NGO help organisations deal with CSO law

Initiative Africa, an NGO promoting good governance, is developing a program to help business support associations (BSO) adapt to the new realities created by the recently enacted Law of Charitable Associations.
Animal laboratory opened

Dr Aberra Deressa, State Minister for Agriculture and Rural Development, officially opened East Africa’s safest laboratory for diagnosis of animal diseases at the National Animal Health Diagnostic and Investigation Centre (NAHDIC) in Sebeta, on Friday, May 15.

Ethiopia to host World Public Health Congress

By Addis Mulugeta

The World Public Health Federation has nominated Ethiopia to host the 13th World Public Health Congress in 2012 that will discover what is happening in health sectors around the world.
Mengistu Asnake (MD) president of Ethiopian Public Health Association (EPHA) told Capital that this is a very important opportunity for developing countries, particularly Ethiopia, to gain knowledge of health sectors in developed nations.

Government protests UN malaria outbreak report

By Elias Meseret

The Ministry of Health has denied UN reports of a malaria outbreak in southern Ethiopia.
The United Nations Office for the Coordination of Humanitarian Affairs (OCHA) reported this week that a malaria outbreak in many low and midland areas of Ethiopia is worsening the nutritional situation of Southern Nations Nationalities and Peoples Regional State (SNNPR), but the ministry said there is no outbreak at all.


Al-Jazeera food security report rejected by ministry

By Addis Mulugeta

The Ministry of Agriculture and Rural Development (MoARD) has rejected an Al-Jazeera report on the number of people who are suffering food shortages because of the failure of the meher rains.

Record number of accountants achieve global standard

By Groum Abate

A record number of Ethiopians celebrated success in their final ACCA (Association of Chartered Certified Accountants) examinations at a ceremony held at the Sheraton Addis on Friday 15 May.


Cement imported to meet rising demand

By Groum Abate

The Government has started importing cement worth 44 million dollars to avoid interruptions to major construction projects. The move comes after two big cement factories, Mugher and Mesobe, were ordered to renovate their factories due to the shortage of electric power.


Toyota dealer celebrates 50 years of service

By Elias Meseret

The Motor and Engineering Company's (MOENCO) first Toyota franchise was established back in January 1959 when there was no such kind of business at the time in the country, thanks to the audacious vision of Mr. Lappine, founder of the company, and Mrs. Maroussia Lappine, his courageous partner.
The enterprise that started 50 years ago in a small garage with a capital of 200,000 birr in the heart of Addis Ababa, around the area commonly known as Mexico, 50 years ago, is now the biggest car sale outlet in Ethiopia.

Police gets more time to investigate plot suspects

By Kirubel Tadesse

Last Monday, the police was granted another fourteen days to investigate the alleged foiled plot to kill senior government officials.
The joint Anti-terror Taskforce of the National Intelligence, Security Service and the Federal Police operation first put 35 individuals under its custody on Friday, April 24.


Ethiopian pharma company receives international standard

By MulukenYewondwossen

Ethiopian pharmaceutical company, Sino-Ethiop Associate (SEA) received international Good Manufacturing Practices (GMP) certification following a pharmaceutical inspection cooperation scheme.


Federal cake cut

Amhara set to lose out after census

By Kirubel Tadesse

Endorsed by the House of Federation last Friday, a new budget formula has been devised to calculate how the regions will share the 20 billion birr expected to be allotted to them by the Federal Government next budget year.
The effect of the controversial census released last December, which put Amhara State’s population below projection, means that it will be receiving a smaller share than in the past.
Some members of the House expect Amhara’s share to slide by some three per cent from what it pocketed last year and Ayalew Gobeze chairman of the House’s Standing Committee and also the president of Amhara State, says the budget allocation was done according to the latest census and that it would be redone if the Central Statistics Agency’s (CSA) investigation into the Amhara population leads to a readjustment before parliament announces next year’s budget.
The new budget, which will serve for the coming three financial years, introduces a new mechanism to allocate one per cent of the overall subsidies exclusively for the four less developed regions: Afar, Somalia, Benishangul Gumuz and Gambella.
The Federal Government apportioned 17 billion birr for regions in last year’s budget, but, according to the comprehensive macro economic and fiscal package for 2010 – 2012 by the Ministry of Finance and Economic Development (MoFED), which the Council of Ministers approved a month ago, three billion more will be diverted to regions this year.
The Formula?
The new formula is designed to provide equivalent service to citizens, while encouraging less developed regions. Previous formulas had considered revenues collected by the regions, however, it was a source of controversy, as House members, argued that it discouraged collection efforts in the regions. Because of this, the new formula only factors into its calculations 80 per cent of revenues and 90 per cent of expenditure,which ensures states are not punished for good performances.
The final numbers?
As per the new formula, Oromia takes the lion’s share by being awarded over 32.53 per cent from the overall subsidies. It is followed by Amhara with 23.3 per cent.
Southern Nations, Nationalities and Peoples’ Regional State (SNNPR) ranks third with 19.9 per cent, while Somalia and Tigray are at numbers four and five respectively, with 8.43 and 7.04 percentages shares.
“We are not sure if the subsidies will cover the salaries we pay, due to salary improvements, but we want to share some of the pain our other regions who are least developed endure,” Shiferaw Shigute, SNNPR president said, pointing out that some of the areas in his state which have development levels that are low even when compared to the least developed regions, were not considered by the formula.
However, extraordinary factors, such as for security, desert allowance, and temperature influence on electrification costs, were considered for all relevant regions.
Lights out at export factories

By Yohannes Anberbir

Ethiopia’s power problems have reached a critical stage, forcing the state-owned Ethiopian Electric Power Corporation (EEPCo) to incorporate all export-oriented factories into the rationing schedule.
So far, export factories were not included in the power rationing that started in March this year, due to the Government’s decision to exempt foreign currency generating factories.
Since then, the factories have been receiving power throughout the week, but the special treatment granted to them has not lasted
The corporation sent an official letter to all the factories explaining its failure to meet their electricity demands.
The corporation has been forced to suspend the privilege due to the severe reduction of water volumes in all the hydroelectric station reservoirs, the letter signed by Mesfin Berhane, head of distributions systems of the corporation, reads.
The factories will face eight days without power per month starting from May 11, 2009, according to the letter, which also details the schedule.
More than 13 leather processing and shoe factories and textile factories will be challenged by EEPCo’s latest measure. Leather and leather products are the fourth larget export items of the country, fetching over 106 million dollars last year.
The power shortage tied with price reductions in foreign markets will harm the factories’ profitability, but a management member of the biggest tannery, Ethiopian Tannery, told Capital they understand the Government has no option.
The Government also ordered all cement factories to stop production last Monday, aiming to retain the remaining generating capacity of the power stations.
The measures taken against local cement factories will aggravate the current cement shortage, however, the Government has decided to import two million quintals of cement, from Pakistan and Yemen the coming two months to combat the problem.
Despite the current foreign reserve shortage, the Government budgeted 44 million dollars to import the cement.
Currently, the country’s foreign reserves stand at 850 million dollars, a level that can only support six weeks’ worth of imports, according to data from the National Bank of Ethiopia.

Post office to take over some ETC operations

By Muluken Yewondwossen

The Ministry of Transport and Communication (MoTC) has ordered the state owned Ethiopian Telecommunications Corporation (ETC) to facilitate the shifting of some operations and duties of the corporation to the other organ under the ministry, the Ethiopian Postal Service (EPS).
A letter signed by Driba Kuma, the Minister of Transport and Communication, instructed both organisations to study how they could work jointly on the post paid (mobile, internet, and landline) services, and how to transfer the billing system, public phone service, and the corporation’s value added works to the post office.
The letter also recommended the postal service handle ETC employee’s payroll and that the two organisations work together on the sale of low cost mobile apparatuses.
“A new plan is being examined by both parties before implementation” a senior high level official at the corporation told Capital.
Currently, EPS is working on the sale of SIM cards by commission with the corporation.
ETC’s management passed a decision in 2004 to outsource its mobile SIM card sales, in order to focus on infrastructure development in the sector. Five private companies - Dire Electronics, Garade, Haron Computer, Admas Tele, Glorious and EPS - have initially been selected to distribute the cards for a price of 368.10 birr, which then reduced by 54 per cent to 169.10 birr a few months ago.
In related developments, after months of delay, the state monopoly ETC announced that in the coming weeks it will handover top up card sales to selected private companies who won the bid with a margin of three per cent commission. The move follows the boost ETC received from the increase in the number of pre paid mobile telephone users.
However, the corporation did not give out the subcontract over the last seven months, despite ETC’s board posting a letter in its branches announcing the winners.
“We were working on the risks and market impact assessment of the subcontracting in relation to the new tariff adjustment of the SIM card. That is the main cause for the delay,” a senior ETC official on condition of anonymity told Capital, “but we will outsource the service in the next couple of weeks to the winners,” he added.
Currently, ETC is carrying out the distribution of voucher card for retailers by itself.
In the nine month performance report of MoTC, disclosed to parliament two weeks ago, mobile service sales showed a shocking underperformance by twenty per cent, mainly due to network congestion and late projects. The report explained that the first nine months of the current budget year saw overall telecom service sales falling from the target at an average of nineteen per cent.
The number of mobile subscribers is mounting and the state telecom monopoly ETC says it now has 3,119,493 customers enjoying the service of its current capacity to support nearly 4.8 million customers.
According to the MoTC report, the disappointing sales are partly caused by the ongoing optimisation work on a number of vendors’ networks.
Major power project nears completion

By Groum Abate

The Gilgel Gibe II hydropower generation project undertaken by the Ethiopian Electric Power Corporation will be completed in the next two weeks.
Sources told Capital that the 420 MW plant would enjoy an informal opening in the next two weeks after completing the remaining 700 metres of a 27 km tunnel.
As the result of several unforeseen natural hazards, the project completion has been delayed for over a year.
Six months ago the project was halted for several days after the drilling machine got stuck in muddy terrain. This came just after striking a hot spring, a development that forced the diversion of the tunnel.
Gilgel Gibe II is a continuation of the Gilgel Gibe I project, using the water discharged by the dam currently in use and channeled through the 27km tunnel under Fofa Mountain.
The project cost is projected to be 373 million Euros. When the Gilgel Gibe II hydropower plant becomes operational it is expected to increase the electricity generating capacity of Ethiopia by 30 to 40 per cent.
Though the Ethiopian Electric Power Corporation (EEPCo) has started a number of generation projects, the country's annual power demand growth of 16 per cent has risen faster than it could keep up with, causing huge power shortages. Accordingly, power shedding has already begun to affect the state power monopoly's customers, as the Tekkeze and Gilgel Gibe II hydropower projects are in danger of not being operational during the coming rainy season.
EEPCo recently announced that geological, geophysical and hydro-geological phenomenon have caused construction of the nearly complete dams in the country to lag behind schedule. The two dams, Tekezze and Gilgel Gibe II, are said to have been delayed for almost a year after the projects faced geological phenomena that would cost the state power monopoly, EEPCo, billions of birr.
The two billion birr Tekeze hydroelectric power project was faced with landslides where the arch dam was constructed. This led to an additional 400 million birr cost to stabilise the surrounding land.
Crash landing for airport chief

By Yohannes Anberbir

Deriba Kuma, Minster of Transport and Communication, (MoTC) sacked Eyobe Estifanos, head of Ethiopian Airport Enterprise,this week.
It is the first strong measure Deriba has taken since being promoted from his former position as head of the agriculture bureau of Oromia Regional State.
Eyobe had served for five years as director of air transport and planning at the Ethiopian Civil Aviation and he had been heading the Airport Enterprise for the last two years.
However, he was not able to build his career at the enterprise because of the sudden move of MoTC: "I was attending a three day conference in Dubai last week and when I got in to my office early this week, I found the letter from the ministry," Eyobe told Capital.
The letter ordered me to return any equipment and documents belongs to the enterprise and to leave office, without explaining any reasons for the move Eyobe added.
"I didn't feel anything, except to wonder why it happened?" said Eyobe, expressing surprise at his dismissal.
It is impossible to link Eyobe's dismissal with the Business Process Reengineering, because it is not at its implementation stage, a source said.
The ministry appointed Shiferaw Alemu to replace Eyobe. Shiferaw had been serving as head of Engineering and Regional Airports Bureau, according to sources in the enterprise.
Capital's attempts to reach Minister Deriba were not successful.
The Airport Enterprise is a Federal Government entity responsible for administering and building airports in the country.
Sandford governors urged to delay status change

Parents demand patience until administering agency for endowment charities is established

By Elias Meseret

Concerned parents of children at Sandford School have written to the board of governors urging them to delay a planned move to register the school as an endowment charity.
The governors are eager to do this in light of the new Charities and Societies Proclamation, but the parents have suggested that the move should only be made when an agency to administer endowment charities has been established.
The letter came at a time when the board of governors is scheduled to conduct their annual general meeting and register the school next Saturday as an endowment charity.
Parents say this is a scheme that is neither legal nor appropriate since the agency that will administer endowment charities is not yet set up.
The letter states that the proclamation has given the school the option of registering either as a charitable endowment, or a charitable society.
"The agency which has been given the responsibility of administering the new law is not operational yet. It has also announced publicly that all associations and endowments should conduct their usual businesses without interruption until the agency is up and running," the parents' statement read.
According to parents, while these are significant developments with positive implications for the future of the Sandford International School Association, the board of governors are trying to come up with their own 'by-laws' so as to gain re-election to the board of their planned endowment charity.
"First, SISA can pursue legality not only within the framework of a charitable endowment, but also under a charitable society. Secondly, parents are given an ample time to thoroughly deliberate on the implications of both charitable endowment and charitable society. So, parents, along with teachers and associate members, can conduct informal discussions on all relevant matters on their own, without the constraints of structured meetings that hardly allow open and frank discussions to take place," the letter reads.
The parents argue that the draft statute circulated by the board in a form of 'by-laws' falls short of what is legally required, be it for a charitable endowment or a charitable society. They say this is a matter best left for the agency. "As far as we are concerned, no lawyer, board or parent body has a final say on the legal form or content of the document, except the authorised agency," the parents argued.
Accordingly, they advised the board to refrain from endorsing any document that has not been given the green light by the registering agency. "To do so otherwise will be nothing more than an exercise in second guessing the work of the agency. Let the agency be operational first, then, we will endorse a document that is appropriate for our circumstance."
Some parents told Capital that the current board of governors, comprising of five Ethiopians and five British citizens, have finished their term, so election should be held on the general assembly meeting and a 'Blue Ribbon Board' should be elected.
The parents have long been protesting the Board of Governor's document (by-law) entitled 'Sandford International Endowment Foundation Memorandum of Association', which they say was prepared and unanimously approved by the board. Capital’s effort to contact the board of governor s failed.

Big banks look to link with micro lenders

By Kirubel Tadesse

The Ethiopian Bankers Association, a group of private and state commercials banks, established a steering committee comprising state and private agencies to facilitate links between banks and micro financing institutions.
Official data shows micro financers have over 2.2 million active borrowers with an outstanding loan portfolio of approximately 4.6 billion birr. The commercial banks now see potentially big markets among micro financers dominated areas.
"We as institutions were not set up to provide loans as small as micro financers do," Leikun Berhanu, Ethiopian Bankers Association (EBA) President said, explaining that partnering with micro financers is a must if commercial banks are to expand outside the main cites.

A study, which resulted in the establishment of the steering committee, explained that commercial banks suffer inflexible systems and slow rates of loan disbursement with high collateral oriented policy. According to the study conducted by Partners Consultancy and Information Services, the commercial banks' weaknesses can be addressed with micro financer involvement, which in turn will help micro financers with their problems of lack of access to capital markets and funds.
The half day workshop organised by EBA debated possible linkage models for banks and micro financing institutions.
The micro financing institutions twelve year performance, which mobilized 1.6 billion birr in savings, is the next big market, as the 31 bankers gathered at Ghion Hotel last Thursday agreed. But a representative of the Development Bank of Ethiopia Rural Financial Intermediation Programme (RUFIP) is less enthusiastic about the realisation of the partnership.
"The mandate of the steering committee is vague as to whether the composition will allow it to direct policy either to the regulator or to the commercial banks to revise collateral oriented loans," Bahiru Ayalew of RUFIP said, adding that the commitment of the banks should start by looking into their own loan policies.
The regulator, the National Bank of Ethiopia (NBE) doesn't see why it will be an obstacle, as long as it keeps on playing its three key tasks: stabilising prices, creating a sound financial system and maintaining loan quality.
Muluneh Alemu from the NBE agreed to the establishment of the steering committee, which comprises other state agencies like Ministry of Finance and Economic Development and the ten year old Association of Ethiopian Microfinance Institutions (AEMFI), which has a reputable record of representing its 29 members.
Customs strike gold

By Yohannes Anberbir

Last Sunday, customs intelligence officers were informed about a kilo of gold being smuggled to the capital from the eastern part of the country.
They were tipped off around midday, with information including the plate number of the truck suspected to contain the gold. They then had to wait for around six hours at a customs station in the Kaliti area.
The suspected truck arrived at the customs station around 6pm, but it passed through the usual inspection process and no gold was found on it.
However, the customs intelligence unit had no doubt about their information, which led them and the Federal Police to secretly drive behind the truck with the intention of locating collaborators. Four hours were spent following the truck, but they didn't find any other people involved.
Finally, the intelligence unit ordered the police members to stop the truck and arrest the driver and a passenger.
At the request of the intelligence officers, the police checked the two side boxes of the truck and found six bars of gold inside.
"We submitted the gold to the National Bank of Ethiopia the next day following authentication of the gold at the Geological Survey," Ephram Mekonnen, public relations manager of the Revenue and Customs Authority told Capital.
According to him, the bars of gold totally weighed 15.6 kilograme.
The following day the authority brought the suspects to the Federal First Instance Court, where they obtained 14 extra investigation days.
"We are investigating the suspects' links," said Ephram.

Almost nine out of 10 vocational students fail exam

By Kirubel Tadesse

Of the 10,548 graduates of various Technical Educational and Vocational Education and Training Institutions (TEVET), only just over 11 per cent passed the national competence exam, Capital has learnt.
Offered by the Ministry of Education (MoE), the national competence exam was introduced last year after being designed for Ethiopian industries to enjoy qualified graduates with a National Competence Certificate. Only 1, 203 students (11.4 per cent) qualified for the certificate, official data has revealed.
The certificate does not only certify TEVET graduates, but is also offered to certify professionals with years of practice, who have been educated informally. MoE also put passing the exam as one criterion for TEVET students to join academic studies.
Additionally, the story of the teachers at TEVET is not that far from their students, a nine month performance report of the Ministry of Capacity Building, revealed last week.
The ministry's report to parliament's standing committee, explained that TEVET reform is a component of the Engineering Capacity Building Program (ecbp) - an Ethiopian program established under the Ministry of Capacity Building with the support of the German government. There has also been under qualification of TEVE instructors - only 161 of 4067 teachers who sat for the assessment were found to be qualified.
Yilma Tibebu, from the Ministry's Public Relation Office, said the latest number are enouraging: "It does not mean that once the candidates didn't qualify they will be fired, rather works to build their capacity will follow.
"The latest numbers from the Education Ministry show that TEVET instructors qualification percentage rose to 48 per cent following extensive efforts.!
TEVET reform is striving to achieve an efficient, competent and demand-oriented middle-level qualified and semi-skilled labour force.
The Goverment is looking into other options such as hiring Filipino and Germans professionals to make up for the lack of qualified instructors.
City health bureau questions Betezatha medic who examined Tilahun

Taskforce makes surprise visits to hospitals and clinics

By Elias Meseret

The Addis Ababa Health Bureau has told Capital that it has questioned the doctor at Betezatha Higher Clinic who examined the late Tilahun Gesesse.
It says this only happened after several days of failed efforts to reach the medic.
Had it not been for the doctor's absence, the city's health bureau would have concluded its investigations at the beginning of last week.
Wolde Rufael Dirar, head of health institutions inspection and quality control in the Addis Ababa Health Bureau (AAHB), said the issue is now ready for investigation and will finally be sent to the minister of health.
"Our inspection so far has revealed that Tilahun was dead on arrival at Senay Hospital. But we still want to know what the circumstances were. Our main investigation is now into Betezatha Hospital," he added.
Tilahun's case is under investigation by experts from the city's health bureau and the Ministry of Health (MoH) after allegations surfaced that the medical treatment he received on the night of his death was sub-standard.
The investigation was ordered by the minister of health, Tewodros Adhanom (PhD). The report is expected to be finalised in the coming few days and submitted to the minister.
Tilahun Gesesse died on April 19, 2009 in Addis Ababa as he was being taken to hospital by his wife. He had just returned to Ethiopia from the United States where he had been in poor health for several years due to diabetes.
His family claims the legendary singer was not provided with the necessary medical treatment at the hospitals he went to. They said there was no oxygen in Betezatha Hospital, the nearest health centre to his home. In addition to this, the medical staff on duty at Betzatha Hospital could not provide Tilahun with any medical treatment, his family added.
However, Bethezatha Higher Clinic argues all the necessary effort was made to deal with the urgent situation at the time. "There was an oxygen cylinder available at the time. The problem was that it was not possible to bring it to Tilahun's car as it was big," representatives of the hospital have said. Some also question the unavailability of ambulance at the time.
In a related development, the city's health bureau is conducting surprise visits to the city's public and private hospitals and clinics to examine their operational capacity during night and holiday times.
According to the information Capital obtained, the taskforce started the visits last Monday. The group of four will conduct the visits and report back to the city's inspection and controlling unit led by Wolde Rufael.
It is said to be part of the ongoing effort the city's health bureau is conducting to control illegal and unethical conduct by some hospitals and clinics.

Thursday, May 14, 2009

Ethiopia to host 13th World Public Health Congress

Addis Ababa, May 14 (ENA) - Ethiopia has been selected to host the 13th World Public Health Congress in 2012, the Ethiopian Public Health Association said on Wednesday.

The association said Ethiopia has already started preparation to host one of the world's biggest congresses. It is the first time that the congress is hosted by a developing country like Ethiopia.

Association president, Dr. Mengistu Asnake told journalists in Addis Ababa that Ethiopia has been selected from a group of countries which includes Canada, Costa Rica, Germany and India. The selection made Ethiopia the first developing country to host the congress.

Plan has already been put in place to attract more African health professional with a view towards establishing regional health association for Africa, Dr. Mengistu said.

A national committee aimed at promoting Ethiopia among participants of the congress will be established, he said.

The 12th World Public Health Congress was recently held in Istanbul, Turkey, where the association made efforts to promote Ethiopia, the next hosting country of the congress.

Over a thousand CDs depicting Ethiopia’s tourist's destinations were distributed among the participants of the congress in Turkey, he added.

AIDS Hotline for Ethiopian Health-Care Workers

Ethiopia is home to an estimated 980,000 people living with HIV or AIDS, including some 75,000 pregnant women.

With support from large-scale international donors, there has been a dramatic increase in the number of individuals receiving life-saving care over the past five years.

Currently, some 3,500 health-care workers at nearly 420 separate facilities spanning the country are providing combination antiretroviral treatment to more than 180,447 patients.

The vast majority of these are receiving first-line therapy.While the recent strides in improving access to treatment are a significant victory in Ethiopia's war against HIV/AIDS, the low ratio of experienced HIV-care providers per infected patient poses an equally significant obstacle - particularly in remote areas of the country.

Physicians, nurses, pharmacists and a broad range of allied health-care workers all play an integral role in providing quality care, but many do not have the specialized knowledge and skills necessary to manage complex HIV treatment regimens.

To fill this void, the National AIDS Resource Center in Addis Ababa has established the Fitun Warmline, a toll-free telephone service designed to provide health-care professionals across Ethiopia with quick, accurate and up-to-date answers to their questions about HIV/AIDS care and treatment.

Fully functional since May 2008, the Warmline helps caregivers stay current on the latest information about HIV/AIDS despite the country's limited resources, evolving communication infrastructure, and lack of time for busy health professionals to maximize continuing education opportunities.

The service was developed jointly by Ethiopia's National AIDS Resource Center, Johns Hopkins Center for Communication Programs, and Ethiopia's National HIV/AIDS Prevention and Control Office with support from PEPFAR through the U.S. Centers for Disease Control and Prevention.

The American International Health Alliance's HIV/AIDS Twinning Center provides technical assistance for the project, linking the National AIDS Resource Center with similar call-in services in Uganda and at the University of California-San Francisco (UCSF).

According to Dr. Adefirs Beyene, one of the physicians who staff the Warmline, the service has three key objectives at this time: to produce rapid, evidence-based responses to a wide range of questions on HIV/AIDS-related topics; to contribute to the quality of comprehensive HIV prevention, care and support services in Ethiopia; and to develop a targeted communications strategy that will increase its number of callers.

The partnership with UCSF is helping staff meet their objectives, Beyene points out. "Working with our counterparts at UCSF is helping improve access to quality HIV care and treatment in Ethiopia by strengthening our clinical consultation skills and organizational capacity, as well as by assisting us to develop a strong continuous quality improvement program," he reports.

Health-care professionals can contact the Warmline by dialing 932 free of charge from any mobile phone or landline. Queries may also be submitted on its website. "When possible, we answer the questions immediately. For more complex questions, though, we conduct additional research to produce a reliable and informative answer and then return the call within two hours. When necessary, we also supply documentation to support the answer provided," Beyene said.

The Warmline is staffed by a multidisciplinary team of HIV/AIDS experts that includes two medical doctors, a pharmacist, a laboratory technologist, two nurses, a public health specialist, and a psychiatrist. "The Warmline has fielded some 16,000 calls - mostly from mobile phones -and six e-mail queries since its launch last spring.

These days, we average about 400 calls a week, half of which originate in Addis Ababa. The remainder come from more remote outlying regions," according to Dr. Emebet Dendir, another staff physician, who stresses that the majority of these focus on the complex issues surrounding the provision of antiretroviral therapy.

Monday, May 11, 2009

Health Extension Workers Improve Tuberculosis Case Detection and Treatment Success in Southern Ethiopia: A Community Randomized Trial

One of the main strategies to control tuberculosis (TB) is to find and treat people with active disease. Unfortunately, the case detection rates remain low in many countries. Thus, we need interventions to find and treat sufficient number of patients to control TB. We investigated whether involving health extension workers (HEWs: trained community health workers) in TB control improved smear-positive case detection and treatment success rates in southern Ethiopia.

Methodology/Principal Finding

We carried out a community-randomized trial in southern Ethiopia from September 2006 to April 2008. Fifty-one kebeles (with a total population of 296, 811) were randomly allocated to intervention and control groups. We trained HEWs in the intervention kebeles on how to identify suspects, collect sputum, and provide directly observed treatment. The HEWs in the intervention kebeles advised people with productive cough of 2 weeks or more duration to attend the health posts. Two hundred and thirty smear-positive patients were identified from the intervention and 88 patients from the control kebeles. The mean case detection rate was higher in the intervention than in the control kebeles (122.2% vs 69.4%, p<0.001). In addition, more females patients were identified in the intervention kebeles (149.0 vs 91.6, p<0.001). The mean treatment success rate was higher in the intervention than in the control kebeles (89.3% vs 83.1%, p = 0.012) and more for females patients (89.8% vs 81.3%, p = 0.05).


The involvement of HEWs in sputum collection and treatment improved smear-positive case detection and treatment success rate, possibly because of an improved service access. This could be applied in settings with low health service coverage and a shortage of health workers.

Trial Registration

Friday, May 8, 2009

EOC prepares HIV/AIDS, HTPs prevention manual

Addis Ababa, May 7 (WIC) - The Ethiopian Orthodox Church Development and Inter-church Aid Commission (EOC/DICAC) announced that it has prepared HIV/AIDS and harmful traditional practices (HTPs) prevention manual.

DICAC assistant commissioner, Derese Kassu, speaking at a two day workshop organized to develop the manual said that the practical manual would support the effort the church is making to prevent HIV/AIDS and HTPs.

The manual, which was prepared with the financial support obtained from the Population Council Technical Cooperation and the UNFPA, would be used by religious fathers during religious festivities and other social occasions.

The assistant commissioner also said that the manual would also be used to train religious fathers in Tigray and Amnara states as well as the Addis Ababa city administration.

According to the assistant commissioner, the manual provides basic knowledge on HIV/AIDS, HTPs, sexual health and other related matters.

Ethiopian MoH muscles in on the swine flu - A/H1NI

The Ministry of Health announces precautionary measures

Petrified with the spreading Swine Influenza (A/H1N1), Ethiopian Ministry of Health (MoH) and the Addis Ababa Bole International Airport Enterprise have moved to install a remote sensor to detect flu symptoms from passengers on incoming flights.

Late last week authorities comprised from the two institutions identified a special isolation room at the airport where passengers with symptoms of the flu would stay upon landing in Addis Abeba.

The isolation room would help keep the suspected victims separate while they receive treatment from the medical professionals, a measure taken by the government to make sure the recent outbreak of influenza does not enter the country, according to Ahmed Emano, head of Public Relations Directorate at the MoH.

If symptoms are discovered, the person concerned would be taken to one of the few specialized hospitals in Addis Ababa, St. Paulos, for possible treatment.

Prescribed medicines for such influenza types are Oseltamivir Phosphate and Zanamivir, however, the country doesn’t have any of the two, according to Tsehaynesh Melese (MD) director general of Ethiopian Health and Nutrition Research Institute (EHNRI). On the other hand, she believes the medicines will be imported very soon in view of the gravity of the situation.

The ministry has also prepared a form to be completed by passengers, which includes basic personal information, where they come from, date and time of their departure, health condition in the preceding 10 days and if any of the symptoms of the flu have been seen.

There has not been any reported cases of the swine flu in the country yet.

Swine Influenza or Swine Flu, a contagious respiratory disease that was earlier believed to primarily affect pigs, has now reached a level where it is spread from person to person. The symptoms of the Swine Flu (A/H1N1include fever, runny nose, sore throat, nausea. Vomiting and diarrhoea occur in rare cases.

To help stop the spread of disease, the United States based Centers for Disease Control and Prevention have advised people to;

*Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.

* Wash your hands often with soap and water, especially after you cough or sneeze.

* Avoid touching your eyes, nose or mouth. Germs spread this way.

* Try to avoid close contact with sick people.

* Stay home if you are sick for 7 days after your symptoms begin or until you have been symptom-free for 24 hours, whichever is longer. This is to keep from infecting others and spreading the virus further.

Africa must manufacture own AIDS drugs: AU

Africa must manufacture its own generic medicine if it is to continue to fight HIV/AIDS during the financial crisis and ensure its faltering economies can benefit from drug production, the African Union (AU) says.

“Africa shouldn’t just import drugs all the time,” AU Commissioner for Social Affairs, Bience Gawanas, told Reuters on the sidelines of a conference of African ministers for health in Ethiopian capital Addis Ababa.

“Most of our HIV/AIDS drugs come from sources outside Africa. How can we be sure this will continue during the financial crisis?”

South Africa is the only African country that makes its own HIV/AIDS drugs

Michel Sidibé, the new head of the United Nations HIV/AIDS agency and the first African to hold the position, has said ensuring all Africans who suffer from the virus have access to drugs will be his priority.

Most infected Africans have no access to treatment, though a few countries were doing exceptionally well, Gawanas said.

“Some countries in Africa now have 80 percent of people with HIV/AIDS on anti-retroviral drugs,” Gawanas said. “But if there are cuts (in support from donor countries) can that progress continue? We need to mobilize local production.”

African economies would profit from the drugs being made locally, Gawanas said.

An estimated 33 million people globally are infected with the HIV virus that causes AIDS, and most of them live in Africa and other developing countries.

Wednesday, May 6, 2009

Press Statement: HIV is not in recession! TB is not in recession!

Press Statement

6 May 2009

HIV is not in recession! TB is not in recession!

A coalition of Sub-Saharan HIV/TB activists demand that African governments and international funders close the gap on health financing. The right to treatment and health is non-negotiable.

(Cape Town - Nairobi - Port Louis, 6 May) On the occasion of the Conference of African Ministers of Health in Addis Ababa, Ethiopia, a coalition of health advocates from Sub-Saharan Africa warn that the lives of millions of people in Sub-Saharan Africa are in jeopardy because of the lack of political will and investment to realise the right of access to life-saving treatment.

Only one third of HIV-positive people in need of antiretroviral therapy (ART) to survive have access to treatment in the African region. The coalition fears that national and donor governments are betraying their health commitments, particularly promises to support the universal roll-out of ART by 2010.

"The broken promises and skewed priorities of governments and donors have reduced the right to health and access to treatment to unattainable rhetoric. In the last few months, we have seen trillions of dollars spent on financial ‘bailouts’ to stimulate economic recovery”, said Nonkosi Kumalo of the Treatment Action Campaign. "A tiny portion of this sum could have bought quality, sustainable healthcare for millions of people."

Dr Bactrin Killingo of the HIV Collaborative Fund warned that “if the current cost constraints faced by HIV treatment programs are not addressed, while the demand for expensive second-line treatment increases, we will find ourselves in a situation similar to the ’90s, where millions of lives were lost unnecessarily because people could not afford the treatment they needed to stay alive”.

The region of sub-Saharan Africa bears the greatest burden of disease, and has 68% of the world’s HIV-positive people but only 1% of the global expenditure on health, and 2% of the global health workforce. A recent African Union report states that sub-Saharan Africa faces “a grim scenario with respect to the health of its people”, estimating that only 7% of total government expenditure in the region goes to health despite the 2001 Abuja Declaration commitment to commit 15% of government expenditure to health.

These shortcomings will be highlighted at the CAMH in Addis Ababa this week, where the Africa Public Health Alliance is submitting a petition to African heads of state and ministers of health and finance to close the US$10.7 billion funding gap for regional implementation of the Global Plan to Stop TB.

Most governments in the region cover less than half of their national health budgets with national resources, while the rest comes from out-of-pocket spending or international funders – most notably, for HIV and TB, the Global Fund. The financial support of the Global Fund and other donor agencies has had a remarkable impact on scale-up of services in sub-Saharan Africa.

The Global Fund reports that it has saved an estimated 2.5 million lives worldwide and has disbursed 57% of international donor aid raised for TB, 50% of malaria, and 23% of funds for HIV/AIDS. However, the increasingly steep trajectory of demand for Global fund grants, coupled with dwindling donor input and the global economic crisis, have resulted in the Global Fund announcing that it is at least $4 billion short of the money that it will need to continue funding essential HIV, TB and malaria services in 2010.

In 2005, the leaders of G8 countries, the richest nations in the world, committed to the goal of universal access to ART by 2010 – a goal that governments across the world pledged to support. Many of these same countries are now becoming antagonistic towards disease-specific funding, calling instead for “horizontal” approaches to health financing such as the International Health Partnership, without committing to the massive increases in funding that would be necessary to finance health across the board.

The coalition rejects pitting HIV against other diseases. Contrary to what some influential health economists and ‘development experts’ are claiming, there is ample evidence that ARV roll-out has strengthened health systems, and the work done by AIDS service organisations has revolutionised healthcare in the developing world.

African heads of state in 2001 stated that “We are fully convinced that containing and reversing the HIV/AIDS epidemic, tuberculosis and other infectious diseases should constitute our top priority for the first quarter of the 21st century”. This conviction is not reflected in the resources that African governments have commited to health, nor in the lethargic progress towards scaling up TB and HIV programs in the region. The global economic crisis threatens to worsen this situation, with a recent World Bank report estimating that the negative impact of this crisis on HIV programs will affect 70% of people on ART in Africa within the next 12 months.

Said Paula Akugizibwe of the AIDS and Rights Alliance for Southern Africa (ARASA): “We need to ensure that African lives do not become a silent casualty of the global financial downturn. Our lives are not cheap or expendable. We expect health to be prioritised over weapons, sports and lavish politics.”

ARASA hosted a meeting on financing for Eastern and Southern African HIV/TB activists last week, out of which this coalition was formed to advocate around several key messages: “We believe that health is our right. We are committed to sustained, universal access to ART. We are committed to prevention and treatment for TB, malaria and other illnesses that devastate our communities. We demand that African governments and donors honour their commitments to funding for health, and close the resource gaps as needed to secure universal access to HIV and TB treatment. Through a sustained and coordinated regional campaign, we will fight for our non-negotiable right to health until it is realized.”



Paula Akugizibwe, AIDS and Rights Alliance for Southern Africa, +27 83 627 1317

Inviolata Mmbwavi, Grassroots Empowerment Trust, Kenya +254 722 749 603

Dhiren Moher, RAVANE+ PVVIH Network for the Indian Ocean Region, Mauritius (Français), +230 427 0151

Rebecca Hodes, Treatment Action Campaign, South Africa +27 79 426 8682

Medical Officer /Internist Job Vacancy: African Union (AU) Commission

Medical Officer /Internist Job Vacancy: African Union (AU) Commission
The African Union Established as a unique Pan African continental body, is charged with spearheading Africa’s rapid integration and sustainable development by promoting unity, solidarity, cohesion and cooperation among the peoples of Africa and African States as well as developing a New Partnership worldwide. Its Headquarters is located at Addis Ababa, capital city of Ethiopia.

In seeking to achieve these objectives, the African Union intends to strengthen its capacity to deliver, by amongst others, the implementation of a new organizational structure and the filling of all vacant posts.

The Commission of the African Union invites applicants who are citizens of Member States for the position of Medical Officer (Specialist in Internal Medicine).

Post Title: Internist
Post Level: P4
Unit: Medical Centre, African Union Commission
Duty Station: Addis Ababa
Immediate Supervisor: Head of Medical Administration

A. Major Duties and Responsibilities

The AU Medical Centre is an outpatient polyclinic that provides curative, preventive and acute care/observation services to the AU Staff and registered dependents, AU Consultants, African Diplomats accredited to Ethiopia and the AU, AU Delegates and Consultants. It also administers the Medical Assistance and Plan and Medical Insurance within the AU Commission and Regional Offices.

A senior and highly skilled specialist in internal medicine is targeted to fill this position.

Under the direct supervision of the Head of Medical Administration, the Internist will be responsible for the following:

1. To provide health care to African Union Commission staff members and their eligible dependents, staff members of the African Diplomatic Corps based in Addis Ababa, in the field of internal medicine and related fields.

2. To organize a high level internal medicine outpatient consultation for adult patients, that includes specialized clinics for diseases falling under her/his sub-specialties, qualifications or expertise

3. To serve as an expert medical consultant and main reference physician for health problems in the field of internal medicine, cardio-vascular medicine, or endocrine / metabolic diseases;

4. To participate in upgrading the AU Medical Centre in the field of internal medicine, cardio-vascular medicine, rheumatology, medical oncology and endocrine / metabolic diseases in respect of:

◊ Equipment
◊ Investigation technologies
◊ Continuous Medical and Nursing Education

5. To provide expertise in the development and delivery of health promotion and disease prevention programmes.

6. To participate in various programmes of AU Medical Centre in respect of:

◊ Outreach to AU Regional Offices
◊ Medical coverage of AU Field Missions

7. To provide expertise in critical review of health problems facing the AU staff and African Embassies in Addis Ababa

8. To perform any other duties that may be assigned by the Supervisors.

B. Educational Qualifications and Work Experience Required:

MD degree or MBBS degree, with a clinical specialization in internal medicine, or related clinical disciplines.
A documented qualification in endocrinology and metabolic diseases, cardio-vascular diseases, rheumatology, or gastro-enterology, will be an added advantage; any other clinical field related to adult medicine will be considered.
At least ten (10) years of clinical practice in government hospitals or in private practice as a physician including at least 3 years as a specialist;
Experience in private practice will be an advantage.
Proven experience as head of a clinical unit, section, service or department is a requirement.

C. Other Relevant Skills:

Must be computer literate;
Hands-on experience/exposure to telemedicine ultrasound, and modern imaging techniques is a must;
Sound scientific communication abilities as evidenced by scientific /other publications;
Excellent interpersonal skills, ability to organize and motivate others, and to work in a multi-cultural environment;
Good communication skills with patients, colleagues and the public
Excellent and updated clinical skills.

D. Language Requirement:

Proficiency in one of the African Union working languages. Knowledge of other working languages would be an added advantage.

E. Age Requirement:

Candidates should preferably be between 35 and 50 years old.

F. Tenure of Appointment:

The appointment will be made on a fixed term contract for a period of three (3) years, of which the first twelve months will be considered as a probationary period. Thereafter, the contract will be for a period of two years renewable, subject to satisfactory performance.

G. Gender Mainstreaming:

The AU Commission is an equal opportunity employer and qualified women are strongly encouraged to apply.

H. Application:

To apply, please submit the following:

A letter stating reasons for seeking employment with the African Union Commission;
A detailed and updated CV, indicating your nationality, age and gender;
Names and contact details (including e-mail addresses) of three references;
Certified copies of degrees, diplomas and certificates;
A list of scientific publications if any;
Documented registration to a National Medical Board/Association as a physician.
I. Remuneration:

Indicative basic salary of US$38,489.00 per annum plus other related entitlements-e.g. Post adjustment (40% of basic salary), Housing allowance ($14,016.00 per annum), education allowance (75% of tuition and other education related expenses for every eligible dependent up to a maximum of US$6,500.00 per child per annum), etc for internationally recruited staff of the commission.

Applications must be received not later than 26 June 2009 and should be addressed to:

AU Commission
P.O. Box 3243
Addis Ababa, Ethiopia
Fax: +251-11-5525840/5510430

E-mail: au-recruits @

Gains in access to antiretroviral treatment come with some costs

In this week’s PLoS Medicine magazine, Yibeltal Assefa, from the National HIV/AIDS Prevention and Control Office in Addis Ababa, and colleagues describe the successes and challenges of the scale-up of antiretroviral treatment (ART) across Ethiopia.

They report remarkable achievements in expansion of access to ART and to HIV counseling and testing (HCT), while managing to maintain the performance of other health programs such as tuberculosis and maternal and child health services. Task shifting to the health officers and health extension workers is thought to be responsible for these successes, say the authors.

At the same time, however, HIV prevention interventions and the management of chronic care patients are lagging behind now in Ethiopia. The authors say this may be due to lack of attention to these health care areas and to physicians leaving the public sector for non-governmental organizations (NGOs), including AIDS-related NGOs. They say urgent attention is needed in the areas of HIV prevention, management of chronic care patients, and retention of doctors in the public sector to ensure an effective and sustainable health system in Ethiopia.

Addis Ababa University Addis Ababa Faculty of Medicine

Medicine established in 1964 with the goal of producing medical doctors to handle the country’s health problems. Starting from 1979 the faculty launched graduate programs, which was the first graduate program in the history of AAU.

In 1998 Tikur Anbessa Hospital, which is the largest referral hospital in the country was given to Addis Ababa University (AAU) from the Ministry of Health (MoH) for the faculty as a main teaching hospital. The faculty is the oldest and the largest among the health training institutions in the country, staffed with the most senior specialists.

The faculty has a vision of promoting healthy society that meaningfully contribute to the over all socio economic development of the country by establishing excellence in academics, health service and research.

Fulfill the human resource demand in the medical, training and research fields with good quality and quantity demanded.

To make effective collaboration with domestic and international professional partner organizations in the fields of education, medicine and resear

Tuesday, May 5, 2009

Job poting: General Coordinator - Médecins du Monde, Ethiopia

Closing date: 31 May 2009
Location: Ethiopia - Kebri dehar
MDM is present in Ethiopia since 1988 and has implemented different programmes (long term and emergency) in different regions. Two other programmes are in stand by in the northern part of the country (Prevention of mother-to-child transmission of HIV and Training in emergency obstetrics and surgery). The second one should restart soon. The general coordination team comprising an expatriate general coordinator, an expatriate administrator, and four national staff is based in Addis Abeba, the capital city.

The general coordinator will work on the programme: “Support to Primary Health Care and Maternal Health Services in Korahe Zone, Somali Regional State, Ethiopia”.

The general objective of the programme is to improve the health status of Korahe Zone population.
Assessment have shown a very poor health services' offer, and the region is regularly affected by draughts. Started beginning of 2007, the programme aims at strengthening Primary Health Care in 11 Health Posts of Kebri Dehar District, strengthening the activities of Kebri Dehar referral hospital with a special focus on obstetrical and surgical activities, and implementing an Early Warning System concerning epidemics and malnutrition in the zone. Activities related to malnutrition and assessments are conducted in partnership with Action Contre la Faim, present in the zone since several years.

At both Health Posts and Kebri Dehar Hospitals levels, the activities of the programme are to:
assess infrastructure needs
rehabilitate accordingly and equip according to standard list
assess needs for trainings and carry out trainings
revise/update protocols and ensure their implementation
support drug supply
implement vaccination outreach programmes, to monitor obstetrical activities
ensure immunisation activities
monitor and improve the epidemiological surveillance
sensitise communities
improve the management of the hospital

The general coordinator will have to supervise and co-ordinate all the activities of the mission, in accordance with the safety of property and people, and to guarantee that the mission is relevant and complies with the contract of objectives.
S/He is in charge of planning the entire mission and assessing programs; s/he supervises and organises their implementation.
S/He is in charge of the safety of people and property for the entire mission; s/he supervises and organises the implementation of safety rules and ensures that decisions are applied.
S/He defines the general organisation of the mission and the staff; s/he manages and supervises the co-ordination team; s/he makes or approves management decisions; and s/he is in charge of the quality of the overall climate and the working conditions of the entire mission.
S/He ensures compliance with the administrative and legal framework of the country and the rules and regulations of the mission.
S/He supervises and s/he is in charge of drawing up the budget; s/he approves any eventual adjustments; ensures the quality of the budgetary follow-up, as well as the safety and transparency of funds’ use.
S/He is in charge of raising funds in the field; guarantees that the contract of objectives defined by the donors is fulfilled and that contractual obligations are respected.
S/He carries out negotiations and maintains regular relations with the local authorities and partners of the mission, with the support of the sectoral coordinators (medical and logistics) if necessary; s/he ensures the respect of agreements and contracts.
S/He organises relations and communication with the head office of MDM; s/he is in charge of the quality of the submitted reports on activities and ensures compliance with procedures for the exchange of information and reporting.
S/He encourages contacts with the media, transmits and spreads the Association’s official positioning to the staff and to the media; s/he ensures the visibility of the mission and the consistency of any comments made with the Association's positioning.
In terms of international human rights law / international humanitarian law, s/he is in charge of heightening the staff’s awareness, of collecting and spreading data collections according to the directives of the DH unit; s/he makes sure that the actions led are coherent and that the Association’s positioning on the gathering of testimonies is respected.

Departure: 01/06/2009
Duration: one year
Status: salaried

Training Management and Public Health and Medical background is a plus
Experience in an international NGO in a similar position
Experience in team management and project management
Significant experience in the field security management in a tense security environment
Communications skills, with strong sense of diplomacy
Drafting and reporting skills, ability to write concise and well presented reports in a timely manner
Ability to lead and work as part of a team of expatriate and national staff
Ability and flexibility to understand the cultural and health environment and work with the communities and local authorities
Ability to work under pressure in a harsh and isolated environment
Computer skills Microsoft Office, Internet and data management
English: very well spoken and written and French is a plus
How to apply

Improving Healthcare In Ethiopia

Authorities in Ethiopia's health sector are working to overcome serious challenges and a chronic shortage of resources.

Ethiopia has one of the highest newborn infant mortality rates in the world. One in 6 children dies a preventable death before they reach the age of 5. Acute lack of health care means that Ethiopians of all ages die of common illnesses at a very high rate. One result: the life expectancy of the average Ethiopian is only 41 years.

Since 1997, the Ethiopia Public Health Training Initiative has helped to address these alarming health issues through a landmark partnership between the Government of Ethiopia, 7 Ethiopian universities, 21 Ethiopian hospitals, the non-governmental U.S.-based Carter Center, and the United States Agency for International Development.

The initiative is truly making a difference in the delivery of health care in Ethiopia. By enhancing the quality of pre-service training for health sector workers, more and more Ethiopians are receiving better health care services.

The Ethiopia Public Health Training Initiative helps Ethiopians determine the best way to deliver public health care to their country, rather than imposing a one-size-fits-all approach common in other parts of Africa. International experts work alongside Ethiopian teaching staff at the University of Gondar, Defense College of Health Sciences, Haramaya University, Hawassa University, Mekelle University, Jimma University, and Addis Ababa University to conduct training workshops and seminars to enhance faculty skills and assist in developing learning materials based on Ethiopian experience. The Initiative also provides computers, anatomical models, and supplies, such as stethoscopes and gloves.

The program has made major progress: more than half a million copies of approximately 230 health learning materials have been produced, and more than 8,500 students have graduated from universities assisted by the Ethiopian Public Health Training Initiative since its inception. Already, these efforts have improved health care delivery for 75 million rural Ethiopians.

"Patients can now see health officers regularly, and many complicated cases can be managed in our health centers instead of having to transport patients to hospitals," said Rahel Terefe Bogef, a health officer trained by the Initiative.

The United States is committed to working with the Government of Ethiopia to help provide better health care for all the people of Ethiopia.

Friday, May 1, 2009

University launches construction of referral hospital

Gondar, April 30, 2009 (Gondar) -Work on the construction of the Gondar University Referral Hospital was launched at a cost of 50 million Birr.
Public Relations expert with the University, Endalkachew Tsegaye told ENA on Wednesday that the construction of one of the three hospital buildings to be constructed in the premises of the university was launched last Monday.

The building comprises various service delivery sections including surgical ward, gynecology centre and 250 beds.

The construction of the building launched with the stated sum secured from Ethiopian tycoon, Sheikh Mohammed Hussein Ali Al Amoudi is expected to be fully completed by the end of the next Ethiopian fiscal year.

The construction of the remaining two buildings would soon be launched, he said