Save the Children Japan organized a parliamentarians' mission to Ethiopia from July 2 to July 5, 2024.

The objective of the mission was to deepen the understanding of the roles of Gavi Vaccine Alliance and the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund), and the impact of their collaborative work with the government of Ethiopia and other global health partners including Save the Children to improve access to quality healthcare by building sustainable and resilient health system across Ethiopia in achieving Universal Health Coverage (UHC).

The Japanese delegation of parliamentarians, Mr. Sakon Yamamoto, Member of the House of Representatives, Ms. Rio Tomonoh, Member of the House of Councilors, and Dr. Kazuhiro Fujii, Member of the House of Councilors joined the mission

Through meetings with government officials and observation of the government-led immunization expansion program supported by Gavi as well as the Global Fund's support for prevention, diagnosis, and treatment of the three major infectious diseases, the participants appreciated the comprehensive efforts and synergies to protect the lives and health of mothers and children in Ethiopia.

On the first day of the mission, the parliamentarians visited the Ministry of Health and engaged in discussions with Her Excellency Dr. Mekdes Daba, Health Minister, and His Excellency Dr. Dereje Duguma, State Minister and other officials responsible for collaboration with Gavi and the Global Fund. Her Excellency expressed gratitude for the Japanese government's continued support for Ethiopia through financial contributions to the Global Fund and Gavi, and expressed her hopes for further collaboration with Japan.

The parliamentarians also visited the Ketema Health Center in Addis Ababa, where we received an overview of primary healthcare services, including prenatal and postnatal care, HIV diagnosis, antiretroviral therapy, and tuberculosis screening provided at the center. The center also conducts monitoring to improve vaccination rates among children and to reduce the number of zero-dose children who have never been vaccinated.

On the second day, the parliamentarians moved to Jijiga, Somali Region and visited health posts and health centers offering essential healthcare services. Health posts serve as entry points for the community to access healthcare services, and trained Health Extension Workers (HEWs) provide a range of health services, including vaccinations, malaria testing, and treatment. At the Dufeska Health Post in Gursum District, which typically operates with two HEWs, we observed that only one person was temporarily handling all responsibilities, highlighting the severity of the shortage of healthcare personnel.

At the Fafen Health Center, the parliamentarians witnessed the vaccine cold storage facility that was introduced and utilized with the support of Gavi. Also, the system for prevention, diagnosis, and treatment of infectious diseases was established with the support of the Global Fund. 

On the third day, at the Obale Health Center in Degahbur District, the parliamentarians observed the immunization program. This program is part of the maternal and child health initiative which was supported by Save the Children for five years. Two years after the end of the support, the vaccine refrigerators and vaccination calendars were still fully utilized. Also, Gavi-procured vaccines was being administered to children brought in by their mothers.

The parliamentarians also visited the Somali Regional Health Bureau and had an opportunity to discuss with Dr. Mussa Ahmed, Head of Regional Health Bureau and Mr. Mohamud Mohammed, Deputy Head of Regional Health Bureau about the current state of healthcare in the region. The most severe challenge in Somali Region is the difficulty of reaching nomadic populations living across vast areas, as well as those displaced by natural disasters such as droughts and floods. To ensure that the most vulnerable communities can access healthcare services, mobile clinics providing prenatal and postnatal care and vaccinations have been introduced, offering timely support tailored to people’s lifestyles. Importantly, Gavi’s support promotes the Bureau’s efforts to improve vaccine distribution efficiently, and the Global Fund contributes to the sustainability of healthcare services by providing water tanks to the health facilities in Somali Region. However, challenges such as the lack of funding, slow digitalization, and shortage of healthcare personnel were also highlighted.

On the last day of the mission, the parliamentarians visited two institutes in Addis Ababa. At the Ethiopian Pharmaceutical Supply Service (EPSS), the large warehouse we toured was stocked with numerous medicines, including HIV, tuberculosis, and malaria treatments, supplied with the support of the Global Fund. In Ethiopia, the last-mile delivery of vaccines and medicines to health facilities in remote communities is a significant challenge. However, thanks to Gavi's support for cold chain infrastructure, solar-powered vaccine storage refrigerators, and motorcycles for vaccine delivery, it has become increasingly possible to distribute vaccines to health facilities in various regions. Finally, the parliamentarians visited the Ethiopian Public Health Institute (EPHI), working on the surveillance of disease and progressing the diagnosis methods and data management. The parliamentarians also observed the laboratory where research for TB diagnostic techniques are conducted using equipment installed with the support of the Global Fund.

Throughout the mission, it has become clear that the support from Gavi and the Global Fund plays an indispensable role in strengthening Ethiopia’s health system and in delivering healthcare services to particularly vulnerable communities. At the same time, the parliamentarians witnessed remaining issues and needs to improve treatment systems as well as disease prevention, addressing the shortage of healthcare personnel, including improving workload conditions, and investing additional resources to further strengthen resilient health systems.

Save the Children Japan will continue to widely disseminate the achievements of Global Health Initiatives (GHIs) such as Gavi, the Global Fund, and the Global Financing Facility (GFF), and to advocate for the government of Japan as a major donor to further expand its support for strengthening health systems towards achievement of UHC.