Viral hepatitis prevalence at 9.4 percent
The Ministry of Health has recently shifted to a comprehensive “Triple Elimination” framework, a public health approach aimed at ending the transmission of HIV, syphilis and Hepatitis B from mother to child. The new strategy replaces separate disease-specific programs with an integrated system that incorporates screening and treatment into routine antenatal care.
Under this arrangement, every pregnant woman who visits a health facility is provided with a “triple test,” often conducted through dual rapid diagnostic kits capable of detecting more than one infection with a single finger prick.
The framework sets out measurable national targets in line with World Health Organization standards. By 2030, the Ministry seeks to secure “Gold Tier” certification, signaling sustained progress in preventing vertical transmission. The goals include reducing HIV transmission to below five percent, cutting congenital syphilis to fewer than 50 cases per 100,000 live births, and achieving 90 percent coverage of the Hepatitis B birth-dose vaccine.
The initiative also prioritizes the administration of antiretroviral therapy and prophylaxis within 24 hours of birth, with the broader aim of improving maternal and neonatal survival rates and advancing universal health coverage.
Fekadu Yadetta serves as the HIV Prevention and Control Executive Office Lead at the Ministry of Health. His responsibilities include guiding program execution and supporting public health initiatives related to HIV response efforts within the Ministry.
A public health specialist and graduate of Wollega University, Fekadu brings over a decade of experience to the Ministry of Health. His tenure has been defined by instrumental leadership, where his expertise has contributed to drafting the policies and programs that shape the health sector and the well-being of the Ethiopian population.
Fekadu sat down with The Reporter’s Abraham Tekle for a deep dive into the current landscape of the national health system. The conversation covers the nation’s response to the spread of HIV/AIDS and the strategic framework designed to combat HIV, Syphilis, and Hepatitis B. He further detailed the pressing health and economic consequences of Viral Hepatitis, offering a comprehensive look at the urgent issues defining the country’s health sector today. EXCERPTS:
The Reporter: Given the general status of the national health system, specifically regarding the progress of the Health Sector Transformation Plan (HSTP) in improving service quality and rural accessibility, what can you tell us about Ethiopia’s healthcare infrastructure, focusing on equity and quality?
Fekadu Yadetta: In general, Ethiopia’s health system was guided by various strategic approaches before. Today, however, the Ministry is implementing a new direction aimed at strengthening the overall health system through recent policy reforms. While the policy applied over the last three decades focused primarily on preventive measures to address health issues before they occurred, the current approach has shifted to include life-saving treatments alongside epidemic prevention.
With the core objectives of testing, controlling, and eradicating diseases, the new Transformation Plan is now working to scale these efforts to their highest potential.
How digitalized is our health system in terms of the agenda being adapted in the new 2026–2030 cycle to ensure health infrastructure capabilities?
The current health system marks a significant turning point by prioritizing cost-effectiveness in its operations. Recognizing the country’s limited resources and the substantial decrease in international and multi-lateral technical support over the years, the Ministry has made it a primary responsibility to maximize efficiency. By integrating various tasks and streamlining operations, the sector aims to achieve more with the available funding.
To realize these goals, several strategies have been implemented, most notably the integration of services and the adoption of digital technology. This digital shift has transformed professional collaboration; for instance, online platforms now facilitate the consensus-building meetings that were previously mandatory in person. This system enables seamless communication across all levels of responsibility—from the federal government down—ensuring that health-related issues are addressed and control methods are applied with greater efficiency and speed.
Furthermore, technology has become an essential tool for delivering collaborative in-service and pre-service training. In settings such as universities, these digital platforms are used to implement strategic plans and address specific problematic cases. By involving all professionals in these training programs, the system works to minimize errors and elevate the overall efficiency of the health workforce.
Recent reports indicate a sharp 40 percent decline in external health aid as of early 2026. In your role, how are you navigating the transition from a system where domestic funding covered only four percent of the HIV response to the goals set out in the new National Health Compact, given reports of risk of an uptick in transmission?
As previously noted, both international and local support have recently declined. Despite these challenges, we put the country in a better position to protect citizens and control the spread of HIV. To ensure the sustainability of these efforts, the country is pursuing strategies centered on increasing the sector’s efficiency. A key component of this approach is the introduction and expansion of digitalization, which allows us to integrate various health systems into a single, cohesive framework.
We are also focused on fostering commitment among health professionals and leaders by responsibly organizing and allocating available resources. Furthermore, by mobilizing local resources, we aim to build the capacity to replace dwindling international support with sufficient domestic funding. The Ministry remains dedicated to these strategies to ensure the health sector operates with the highest possible level of efficiency.
While national HIV prevalence remains stable at around 0.8 percent, major urban hubs like Addis Ababa, display significantly higher rates. What can you tell us about this?
While the issue of equity remains a persistent challenge, we are working diligently to bridge existing gaps. Data regarding the national spread of the virus indicates that we are in a much better position than we were two decades ago. During that period, the prevalence rate was recorded at two percent; today, that figure has successfully dropped to below one percent nationwide.
According to the most recent public health survey, the average HIV prevalence rate across the country stands at 0.8 percent. However, because the level of spread varies and reveals disparities among regional states, the Ministry is focused on addressing these specific gaps. In the Gambella region, for instance—which faces unique challenges and problems—the federal government and all relevant stakeholders are providing attentive support to resolve these issues.
In the case of Addis Ababa, recent data shows a prevalence rate of 1.2 percent, a significant decline from the three percent recorded in previous years. This progress is the result of rigorous efforts to curb the spread in the capital while resisting various man-made and natural challenges. These obstacles have impacted the social and economic stability of the community, creating a sense of instability.
The Ministry views these results as major achievements, particularly when considering the numerous setbacks that have affected the community and contributed to relative instability.
However, we have observed that the rate of new infections among the youth has not decreased to the desired level. Despite the fact that the general prevalence rate across the country has shown a relative decline over the years, the infection rate within this specific age category remains a concern. Recognizing this as a significant gap, the Ministry has vowed to intensify its efforts to achieve better results addressing the youth.
What specific mechanism the Ministry applied to address this gap?
To effectively address the spread, we have categorized the community by vulnerability, prioritizing those who require special attention. This includes high-risk groups such as long-distance drivers, sex workers, individuals struggling with drug addiction, and those in prison. Additionally, we have identified “hotspot” areas where ongoing national development has led to an influx of daily laborers. Recognizing that these segments of the population are highly susceptible to infection, we are formulating targeted strategies to specifically address these vulnerabilities.
Our approach does not involve testing every passerby; instead, we conduct focused screening and testing on those most at risk. This targeted method allows us to more accurately identify positive cases and increase our diagnostic yield. Beyond these specific groups, we are also focusing on youth—both in and out of school—who are considered highly vulnerable.
Furthermore, we are addressing geographical disparities in infection rates, particularly in regions such as Gambella and Amhara, the northern part of the country, and in Harari and Dire Dawa. So, our work remains centered on reaching the most vulnerable populations across these diverse locations.
Reports indicate that the prevalence of the virus is notably high in conflict-affected regions. In response, what has been done from the Ministry to address these challenges in areas affected by both past and present instability?
The HIV program stands as the Ministry’s most robust initiative, characterized by a digital infrastructure that allows for proactive testing and early detection of emerging issues. By collaborating with NGOs and local institutions, the program is designed to identify potential challenges before they escalate. Whenever obstacles do arise, we employ specific, specialized strategic methods to ensure a swift recovery.
Consequently, aside from occasional minor setbacks, we have not faced any major disruptions regarding HIV management. This success is validated by consistent data from various sources, with the sector’s digitalization playing a vital role in providing the up-to-date information necessary for these results.
The ongoing conflicts within the country have decreased in intensity and scale compared to previous periods. While some logistical challenges remain, we have successfully utilized public transportation networks to maintain our programs and address issues as they arise. This has been particularly effective for our HIV response, which we have managed both properly and promptly. Based on the data and evidence collected from various regions, the national effort to control the virus remains in a strong position.
Despite current interruptions, our HIV monitoring and control systems continue to operate through a sophisticated care process, keeping us on a positive trajectory. However, we have seen a significant increase in the infection rate. Yet, our systems remain resilient in the face of these challenges, ensuring that the progress made in controlling the spread is not undermined by external instabilities.
What specific “market-shaping” mechanisms is the Ministry employing to encourage the private sector to take over service delivery areas traditionally managed by NGOs?
The Ministry is proactively addressing potential gaps that may arise from shifts in global health approaches by anticipating challenges before they occur. By mobilizing and consolidating internal resources, we are ensuring the continuity of our programs through the strategic use of government-allocated budgets. This approach, built upon the Ministry’s extensive experience, is directed toward achieving complete control over the health sector’s objectives despite fluctuating international support.
Ethiopia has transitioned from “Dual Elimination” of HIV and Syphilis to a “Triple Elimination” framework, adding Hepatitis B. What are the primary bottlenecks in integrating Hepatitis B birth-dose vaccinations into the existing workflow at the primary healthcare level?
In coordination with our HIV response, the Ministry has intensified its efforts to tackle the spread of Viral Hepatitis—a challenge that has recently received significantly more attention than in previous years. A cornerstone of this initiative is the introduction of the birth-dose vaccination to protect newborns from vertical transmission. Administering this vaccine within the critical 24-hour window after birth ensures that the child is protected from the virus, providing them the foundation for a healthy life free from infection.
The Ministry’s ultimate goal is the complete eradication of Viral Hepatitis in Ethiopia by 2030. Achieving this will require the same level of rigorous dedication that characterized our success in minimizing HIV. This includes launching large-scale public awareness campaigns to educate the population on protection and transmission prevention. We remain committed to these strategic actions to ensure a successful outcome for the nation’s health.
Viral Hepatitis has become a serious issue in Ethiopia’s health system. Can you provide details on its prevalence and the economic and health burdens associated with it?
Currently, the combined prevalence of Viral Hepatitis B and C has reached 9.4 percent nationwide, affecting an estimated population of over ten million people. It is important to note, however, that not all those infected are currently symptomatic, as the virus can take years to progress into active illness. A significant challenge remains that many individuals are unaware of their status until the disease manifests as a serious health issue. This delayed diagnosis ultimately impacts the nation’s workforce and economy by diminishing the productivity of those affected.
Recognizing the viral nature of the spread and the high cost of treatment, the Ministry has identified public awareness as a critical priority. We underscore that media advocacy is vital in educating the population and preventing new infections. To this end, the Ministry is actively working to strengthen communication strategies and outreach efforts to address the impact of the disease across the country.
Given the high costs of viral load testing, what progress has been made so far toward localizing the production of diagnostics or to fund a national hepatitis treatment subsidy?
What sets the response to viral hepatitis apart from other major health initiatives is the distinct lack of international financial support. Unlike programs for diseases like HIV, which benefit from significant global funding, nearly all efforts to combat viral hepatitis in Ethiopia are managed locally using domestic resources, with the notable exception of vaccine supplies.
The high cost of testing materials remains a critical barrier, as these diagnostics require both expensive equipment and a high level of technical expertise. Given our currently limited-service capacity, the Ministry is focused on a long-term plan to mobilize the ample resources and time necessary to strengthen this sector. While these limitations are significant, our initial activities have already yielded positive results.
Moving forward, we must intensify our efforts to ensure that life-saving diagnostics and care become accessible to all who need them.
With the 2025 target for eliminating Mother-to-Child Transmission (MTCT) of Syphilis having just passed, what does the latest 2026 data tell us about the success of the mother and baby cohort follow-up system in rural regions?
As part of the national Triple Elimination strategy, we provide universal testing to prevent the vertical transmission of infections from mother to child. This comprehensive approach ensures that every pregnant woman in Ethiopia, without limitation, has the opportunity to be screened. The strategy specifically integrates testing for HIV, Viral Hepatitis B, and Syphilis into routine care. While universal screening is a labor-intensive undertaking, the Ministry is dedicated to reaching every pregnant women across the nation to ensure a healthy start for their children.
Achieving the ambitious goal of total coverage requires more than just clinical services; it demands robust public awareness and sustained advocacy including comprehensive trainings
