Global Fund News Flash: Issue 21
Country Feature: Ethiopia
“Failure is not an option” declares a sign that appears on wall after wall in St. Peter’s Hospital in Addis Ababa, Ethiopia. On the top floor of the hospital complex, which sits atop a hill, Dr. Amha Fantaye watches with concern when he sees patients with the burden of tuberculosis walk slowly up the long incline leading to the hospital.
More and more of them arrive with drug-resistant forms of tuberculosis. Dr. Amha, who runs the hospital, sees different characters and different plots. But overall the story is the same: a disease that threatens to tear apart the fabric of his country.
As scary new strains of tuberculosis emerge, resisting multiple drugs, Ethiopian health workers like Dr. Amha are alert to identify all new cases and to aggressively treat existing ones. St. Peter’s is the country’s premier TB treatment center, and Dr. Amha is determined to provide good quality treatment to every case that makes it up that hill.
Among his patients is Pastor Kassa Asmamaw. He sits on his hospital bed, his thin legs swinging feebly. Beside him is a greying white table with a pile of prayer books. The cross he holds tightly in his hand was once a tool of his trade, ministering to his parishioners at the Holy Savior Church in Addis.
His voice is stifled by disease. He has a multi-drug resistant form of tuberculosis, commonly called MDR-TB. He knows the disease won’t let him off easily. MDR-TB is just about the worst disease you can get when you are working, as a man of God, in close contact with people. One day, he noticed he had a cough. Over time, it would not go away. He was diagnosed with TB and started treatment.
But the disease kept recurring, one bout after another. For three years, he was in and out of treatment. Each time he thought he was better, he would get sick again. After his third treatment failed, he lost hope of ever getting better. Even for a man who preached hope to his faithful, the disease felt like too much of a burden. He lost weight. Rumors started going around in the church that he had HIV. One of his faithful told him to get tested.
“I was angry and shocked,” he says. “Still, I decided to go for the test.”
Even after testing negative, he still knew something was terribly wrong in his body. He came to St. Peter’s Hospital for help. The hospital, whose newly-refurbished TB wards are supported by a grant through the Global Fund, is a place of last resort for tuberculosis patients from all over the country.
“When I arrived, I couldn’t eat solid food,” the priest says. He would look at injera, Ethiopia’s spongy textured flatbread, and his mouth would water.
Fortunately, within two weeks of treatment, his condition improved sharply. While he can hardly believe that a rigorous two-year treatment is needed to get him back to full health, he deeply appreciates his change in condition. “Now I can eat injera again,” he says. He hopes to return to his faithful soon. But Dr. Amha will not let him go until he fully stabilizes. When quality care can be delivered, it allows patients to avert other infections, and reduces the chances of infecting others.
“There could be no place better than St. Peter’s to show how the Global Fund contributes to saving lives,” Dr. Amha says.
But St. Peter’s is not isolated. It is a symbol of Ethiopia’s commitment, and also of the global solidarity that has helped make this possibility become real.
Sai Pothapregada, fund portfolio manager for Ethiopia at the Global Fund, credits the country’s visionary leadership, ambition and single-minded focus on results. By consistently coming up with smart and aggressive grant proposals, Ethiopia has secured more than US$1.3 billion to achieve its targets. The transformation that has come with this partnership has been staggering, says Dr. Pothapregada.
By 2010, Ethiopia created a system combining solid infrastructure with skilled health workers and quality treatment. It completed 15,000 health centers and recruited an army of 30,000 community health extension workers. In five years, it increased the number of health facilities providing antiretroviral therapy for HIV from 93 to 743.
Other achievements are even more dramatic. Between 2003 and 2010, the number of health facilities providing prevention of mother to child transmission of HIV services increased from 30 to over 1,400. The number of insecticide treated mosquito nets grew to 40 million, ensuring that more than 70 percent of the country is protected from malaria with mosquito nets and indoor residual spraying. Also, during the same period, the country put all its ordinary and resistant TB patients on treatment. It provided state-of-the-art diagnosis technology for MDR-TB, and high-quality drugs to treat HIV, tuberculosis and malaria.
On a recent visit to St. Peters Hospital, Mark Dybul, the Executive Director of the Global Fund, said Ethiopia is likely to be one of the first countries where these types of fruitful partnerships will completely control AIDS, tuberculosis and malaria.
To defeat TB, Ethiopia is testing and putting on treatment every TB patient. At St. Peter’s, the infectious patients are admitted and treated in newly-equipped TB labs. This is done with meticulous care to avoid slip-ups. “I will allow no mistakes under my command,” says Dr. Amha resolutely.
St. Peter’s was once the residence of the country’s defense minister, and where plans to defend the country were laid. Today, it is where the best operations of the fight against tuberculosis are rendered and delivered.