No. 13, April/May 2005
The UN Millennium Project, UN agencies, and other development partners are supporting a process to assess Ethiopia's needs in terms of funding and strategies for meeting the Millennium Development Goals (MDGs). Two reports on health have been presented which will contribute to the review of the country's Sustainable Development and Poverty Reduction Programme, towards ensuring health occupies a central position.
A brief on Ethiopia MDG Needs Assessment Process
Ethiopia is one of four countries in Africa piloting a process to assess needs across sectors and undertake national planning towards meeting the Millennium Development Goals (MDGs). This process is supported by the UN Millennium Project/MDG Support Centre, UN Agencies and other development partners. The process, coordinated by the Ministry of Finance and Economic Development, has benefited from strong Government commitment and leadership and has involved high-level stakeholders.
Reports covering the eight MDGs have been produced, including on education, health, HIV/AIDS, gender equality, water and sanitation, urban development, private sector and trade, rural development and food security, telecommunications, electricity and roads. The reports propose interventions and provide ambitious estimates of their costs, taking into account contribution from non-public sector actors and issues of sustainability over the longer-term. The reports reflect a consensus among stakeholders on the proposed interventions, who reviewed them to ensure consistency with existing national development policies, strategies and plans, including the poverty reduction strategy.
The health MDGs have been presented in two reports. The first report covers goal four (reduce child mortality), goal five (maternal health), and part of goal six (malaria, tuberculosis and other diseases), and some general aspects of health systems. HIV/AIDS has been presented under a separate report. The health sector report shows that Ethiopia will require about US$ 29 per capita in addition to current spending of US$ 5.60, for a total of US$ 34.60 per capita, to meet the health MDGs. However, these may be underestimates as they do not reflect full health system development costs. This model implies an aggregate expenditure of about US$ 21.2 billion at the end of 2015, out of which about US$ 8 billion is attributed to HIV/AIDS-related expenditure. The report on HIV/AIDS estimates the cost for HIV/AIDS prevention, care and treatment and psychosocial support in the next 10 years (up to 2015) at US$ 8.1 billion and for orphans and other vulnerable children at US$ 11.8 billion.
To reduce the high costs of meeting the health MDGs, it would be useful to foster closer synergies across sectors and goals. In addition, strengthened collaboration with development partners and involvement of the private sector could help close the funding gap. At the level of health systems, the reports proposed several areas for attention, including decentralization of services, expansion of infrastructure, increasing and improving human resources and improved access to health services, with special attention to remote rural areas, pastoralists and urban slums.
The final health MDGs reports, with full estimates of costs, have been endorsed by the Ministry of Health and have been sent to the Ministry of Finance and Economic Development. They will contribute to the process of reviewing the national Sustainable Development and Poverty Reduction Programme. The reports are also serving as a useful tool for mobilizing support for the “Quick Wins” proposed by the Millennium Project in its January 2005 report, “Investing in Development – A Practical Plan to Achieve the MDGs”. The Quick Wins are actions that could be taken immediately to produce short-term gains in well-being to millions of people and start countries on the path to the Goals.
Health Systems Specialist, UN Millennium Project