Synopsis "Ethiopia Operational Plan Report FY 2013 (in English)"
With 82 million people, Ethiopia is the second most populous country in Sub-Saharan Africa. Despite impressive economic growth, Ethiopia remains a low-income country with a real per capita income of US $351 and 39% of the population living below the international poverty line of $1.25/day . According to the UN Human Development Index, 2012, Ethiopia ranks 174 out of 187 countries on both the overall index and the per capita GNI (Gross National Income). It is also one of the least urbanized countries with 82% of the population living in rural areas. In 2010, Ethiopia launched a five-year Growth and Transformation Plan (GTP) which envisages an annual Gross Domestic Product (GDP) base growth case scenario of 11% and a high growth case scenario of 14.9%. Improving the quality of social services and infrastructure, ensuring macroeconomic stability, and enhancing productivity in agriculture and manufacturing are major objectives of the plan. The high growth rate has been offset by high inflation in recent years. Year-on-year inflation peaked at 64% in July 2008 - the second highest in Sub-Saharan Africa after Zimbabwe. In 2012 the situation had apparently improved as the inflation rate had dropped from 35.9% in January to 15.6% by December 2012. The Health Sector Development Plan IV (HSDPIV) and the Strategic Plan for Intensifying Multisectoral HIV and AIDS Response (SPMII) outline their contributions towards the GTP. The death a few months back of Prime Minister Meles has led to a change in leadership. The new Minister of Health leads a young team and is looking to develop his own legacy after the charismatic leadership of the former Minister, Dr. Tewodros Adhanom who became Foreign Minister in December 2012. The HIV/AIDS situation in Ethiopia continues to be characterized by a mixed epidemic with significant heterogeneity across geographic areas, urban vs rural, and population groups. The 2011 Ethiopia Demographic and Health Survey (EDHS) found HIV prevalence at 1.5% nationally, compared to 2.4% according to the formerly accepted Single Point Estimate. Comparison with 2005 EDHS data suggest stable low HIV prevalence of 0.6% in rural areas but substantial declines from 7.7% to 4.2% in urban areas. Routine biannual antenatal surveillance confirms sustained declines in HIV prevalence in both urban and peri-urban areas up through the most recent estimate published for 2009 . There are contrasts in prevalence across regions (ranging from 6.5% in Gambella and 5.2% in Addis Ababa to 0.9% in SNNP), residence types (4.2% urban versus 0.6% rural) and gender (1.9% for women vs. 1.0% for men). Prevalence among 15-24 years has also significantly declined from 12.4% in 2001 to 2.6% in 2009 . SPECTRUM projections combining DHS and ANC data estimate a rapidly declining mixed epidemic where incidence has fallen to 0.03%, a 60% reduction since the introduction of PEPFAR in Ethiopia in 2005. Only Gambella region in southwestern Ethiopia with less than 0.5 percent of Ethiopia's population of 82 million showed a net increase in HIV prevalence over the same period and a worrying 9% prevalence among women aged 15-24 years. At the same time, projected national incidence rates were substantially lower than previously estimated with just over 20,000 new cases in 2012 compared to over 134,000 according to the former Single Point Estimate, although the country retains a substantial burden for secondary prevention and treatment with an estimated 734,000 people currently living with HIV in 2013. According to SPECTRUM, 70% of projected new infections in 2013 will come from sexual transmission, which is disproportionately low compared with other countries. This may be attributable to the relative successes with prevention of sexual transmission and high treatment coverage, compared with relative lack of success with prevention of vertical transmission..
