The new WHO leader needs to have demonstrated clear success in building up access to healthcare in poor countries. Proven leadership in reforming important global agencies will be helpful and, crucially, the new leader will need political skills to bring together very different interest groups so that real change can be achieved. Without much ado, Tedros possess the track record that the WHO needs at this critical point in time, having distinguished himself over three decades as a performing leader who has saved and improved lives in Africa and around the world.
As Health Minister, Dr. Tedros spearheaded a comprehensive agenda of reform which resulted in a dramatic transformation of Ethiopia’s health system in a span of just seven years. Today, Ethiopia stands as a global model for effective health system reform and governance and as an inspirational story of successful African-led development.
Dr. Tedros’ specific achievements in health leadership and diplomacy
1. Improving health outcomes for millions of Ethiopians through a comprehensive sector-wide reform agenda
2. Expanding Access to Universal Health Care: When Dr. Tedros was appointed Minister of Health, there were only 600 health centers to serve Ethiopia’s entire population of 76 million. Dr. Tedros’ initiatives led to the construction of more than 3,500 health centers and 16,000 health posts—dramatically expanding access to basic health care and helping Ethiopia achieve its target of reducing child mortality by two-thirds between 1990 and 2015. During the same period, new HIV infections also fell by 90%, malaria-related mortality by 75% and mortality from tuberculosis by 64%.
3. Putting Women and Girls First: Establishing the Revolutionary Health Extension Programme (HEP): Foundational to Ethiopia’s dramatic expansion of access to health care and achievement of its ambitious targets, was the flagship HEP. Dr. Tedros recognized that millions of Ethiopian women either had no access to health services or were choosing not to seek care, largely because few of the limited health workers available were women. His response was the roll-out of HEP, which trained and deployed 38,000 health workers—the vast majority of them women. HEP revolutionized health service delivery throughout the country by fostering more assertive care-seeking behavior among women, on behalf of themselves and their families. By linking leaders at the global, national, regional, and district levels with women’s groups in every village across the country, Dr. Tedros leveraged the HEP platform to realize his overarching vision of building a sustainable health system with women at its core. Today, Ethiopia’s HEP model of community-based health service delivery is being replicated in more than a dozen countries.
4. Reforming Health Financing: Under Dr. Tedros’ leadership, the MOH developed innovative health financing mechanisms, including a community and social health insurance scheme that promoted cost- sharing between care seekers, donors and the Ethiopian Government and resulted in increases in both revenue and demand for health services.
5. Building Human Resource Capacity: At the beginning of Dr. Tedros’ service as Minister of Health, there were only three medical schools in Ethiopia, and just one physician for every 30,000 people. In partnership with the Ministry of Education, Dr. Tedros devised and led the successful implementation of a wide-ranging national strategy for investing in Ethiopia’s health care work force. The dramatic returns on these strategic investments include:
• An almost seven-fold increase in the overall number of health professionals in the country, from 16,500 to 115,000, with every district in the country having at least one appropriately staffed and operational health center.
• A significant, affordable and sustainable growth in the number of medical schools in Ethiopia, from just three—training 120 doctors annually—in 2005, to 33 medical schools training 3,000 doctors today – achieved by leveraging the infrastructure of Ethiopia’s existing hospitals.
• Initiation of a three-year master’s programme that trained and deployed more than 9,000 non- physician clinicians to perform emergency gynecological and obstetric operations, thereby accelerating reductions in maternal and newborn deaths during child birth.
• A significant increase in the country’s disease surveillance capacities, through the establishment of a master’s programme for field epidemiologists and laboratory technicians.
• Initiation of the country’s first master’s level training programme for hospital administrators, and establishment of hospital governing boards to oversee the efficiency and effectiveness of operations, resulting in significant improvements to the management and governance of hospitals and overall patient satisfaction.
6. Improving Pharmaceutical Services and Access to Life-saving Medicines: Recognizing the urgent need to address Ethiopia’s inadequate pharmaceutical services and recurrent stock-outs of essential medicines, Dr. Tedros helped to establish Ethiopia’s Pharmaceutical Supply Fund Agency, instituting transparent and accountable business processes and ensuring the availability of a reliable supply of affordable, quality- assured medicines to all Ethiopians.
7. Transforming the Health Management Information System: Dr Tedros was also instrumental in the transformation of Ethiopia’s inadequate health information system and poor health data collection and use capacities. Under his leadership, the Ministry of Health developed an integrated health information management system which resulted in significant improvements in data collection, monitoring and evaluation. The new system has had the greatest impact at the local level – right at the source of data collection—resulting in more effective use of data for improving service delivery and programme implementation.
8. Promoting Country Ownership and Donor Coordination: Ethiopia’s health system was for years largely beholden to the funding priorities of various development partners. Earmarked funds were designated only for vertical single-disease programmes, neglecting other pressing needs in the health system.
To address this, Dr. Tedros helped institute the pooled MDG Health Fund and the One Plan, One Budget, One Report country-driven roadmap for improving harmonization within the Ethiopian health sector. These efforts enhanced country ownership and resulted in increased donor harmonization and alignment in planning, financing and programming to address key health system strengthening priorities.
This country coordination across the health sector complements similar alignment initiatives in other sectors. Ethiopia, which hosts 27 UN agencies, implements the UN Delivering as One model to coordinate UN programmes at the national level for higher impact. Ethiopia has been closely working with the UN funds, programmes and agencies in the implementation of the six pillars of the Growth and Transformation Plan.
LEADING INTERNATIONAL HEALTH INITIATIVES
Dr. Tedros has also served in prominent leadership roles in a number of major global health organizations and partnerships, leaving an indelible mark on international efforts to tackle the most pressing global health challenges.
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