Country situational analysis [1]

With an estimated 1.1 million people living with HIV, Ethiopia has one of the largest populations of people livng with HIV in the world. However, HIV prevalence among the adult population is lower than many sub- Saharan African countries. Adult HIV prevalence in 2009 is currently estimated to be between 1.4% and 2.8%. A new single point estimate of HIV prevalence will be generated following the completion of a population-based sero-survey in late 2010.

Ethiopia’s AIDS epidemic pattern continues to be generalized and heterogeneous with marked regional variations. At the national level, the epidemiologic trend over the past eight years has been stable. However, HIV prevalence appears to be declining in urban areas, according to analysis of data from ante-natal sites that collected data consistently for more than ten years. For example HIV prevalence among pregnant women attending ante-natal clinics in Addis Ababa has declined from 23% in 1996 to 10% in 2007. Periurban and small market town residents, young females are the most at risk individuals and affected segments of the population by the epidemic.

According to the 2010 UNAIDS Reporto on the AIDS epidemic, there were 176,632 people on antiretroviral treatment at the end of 2010. This represents 37% coverage of all people in need.

Key elements of the national response

Ethiopia is committed to achieving Universal Access to HIV prevention, treatment, care and support by 2010. The Multi-sectoral Plan of Action for Universal Access to HIV Prevention, Treatment, Care and Support in Ethiopia 2007 –2010 was developed in consultation with a broad range of stakeholders who shared lessons learned during implementation of the HIV response. The plan includes detailed activities, targets, cost estimations and a financial gap analysis, represents a major step towards the implementation of the 'Three Ones' principle.

The latest major initiative within the national response is the three-phase Millennium AIDS Campaign which aims to create a sense of urgency, ensure involvement of all stakeholders and increase in HIV prevention, care, support and treatment services. The Millennium AIDS Campaign has played a key role in strengthening of the health sector’s response to HIV, including counselling and testing, prevention of mother-to-child transmission and antiretroviral treatment.

Social mobilization is also being fostered by the initiative “Community Conversations” which promotes interactive spaces within communities in order to generate a local response to HIV.

Key achievements

• Establishment of the National Partnership Forum which enabled key actors to discuss key issues and share experiences
• Increased commitment of the country to move towards universal access
• Increased experience in strategic planning
• Increased ownership and involvement of stakeholders
• Increased experience and capacity in management of HIV interventions by sectors.
• Increased experience and materialization of mainstreaming in public, non-governmental organizations, faith-based organizations and the private sector.

Key challenges

• Insufficient human resources
• Weak health infrastructure, transportation and general systems
• A need to improve the quality of care (improve adherence among people on antiretroviral treatment and institute antiretroviral resistance surveillance)
• A need to improve harmonization and alignment
• A need for increased focus on high-risk groups in urban areas and regions with high prevalence
• Need to accelerate uptake of prevention of mother-to-child transmission services. Uptake is currently 7% and Ethiopia target for 2010 is 80%
• Resource limitations as well as inadequate commitment and support from the leadership and top management the main obstacles to mainstreaming of HIV in Ethiopia.
• A need to improve surveillance in rural areas
• Poverty, conflict and famine exacerbate the vulnerability of people to HIV the impact of the epidemic
• Difficulty in reaching rural areas to provide care, support and treatment services to people living with HIV

Useful links

• National Strategic Plan
• Plan of Action, 2007-2010
• HIV/AIDS Behavioural Surveillance Survey
• Single point HIV prevalence estimate
• Guidelines for paediatric HIV and AIDS care and treatment
• Multisectoral plan of action - Universal access to HIV prevention, treatment and support
• Workplace HIV and AIDS policy guidelines
• Epidemiological sythesis
• PMTCT and Paediatric Care and Treatment Fact Sheet
• Ethiopia 2010 UNGASS Report

Contacts