Imagine a future where healthcare reaches everyone, even in the most remote villages. Ethiopia is striving to make this a reality, and according to Health State Minister Dr. Dereje Duguma, they're making significant strides with their primary healthcare system. But here's the real question: are these efforts enough to truly transform healthcare across the nation and the continent?
Speaking at the Lusaka Agenda Monitoring and Accountability Framework Validation Workshop in Addis Ababa on December 10, 2025, Dr. Duguma highlighted Ethiopia's long-standing commitment to community health. He emphasized that the Lusaka Agenda, a crucial initiative for reforming global health financing, must be driven by individual countries to be truly effective.
"Our primary healthcare system has evolved over the last many years. We have decentralized services at community level to the lowest available community structure," Dr. Duguma stated. This decentralization is key. It means bringing healthcare services closer to the people who need them most, rather than relying on centralized hospitals that may be inaccessible to many. And this is the part most people miss: it's not just about building more clinics, it's about empowering local communities to manage their own health.
Dr. Duguma attributes Ethiopia's successes in areas like reducing maternal mortality to this robust primary healthcare system. He also pointed to the "one plan, one budget and one report" principle, which has allowed Ethiopia to streamline its partnerships and ensure that investments are aligned with national priorities. This harmonization prevents duplication of effort and ensures that resources are used effectively.
The State Minister made it clear that Ethiopia intends to remain a champion of the Lusaka Agenda, emphasizing the importance of collaboration among partners to achieve sustainable and lasting solutions, particularly in financing the healthcare system across Africa. He stressed that governments must lead the way, with partners aligning their efforts with national strategies, priorities, and policies.
Echoing this sentiment, Africa Centres for Disease Control and Prevention (Africa CDC) Deputy Director General, Dr. Raji Tajudeen, underscored the need for a strong, pandemic-ready, and climate-resilient primary healthcare system. He also emphasized the importance of strategic and coherent global health initiatives that align with national priorities. Strengthening collaboration, especially in health financing through domestic resource mobilization, is also critical, according to Dr. Tajudeen.
Dr. Tajudeen also announced that the Lusaka Agenda Secretariat has been established at the Africa CDC headquarters, following a decision by heads of state and government. The Lusaka Agenda, launched in December 2023, aims to overhaul global health financing and architecture by aligning donor support with national health plans, increasing domestic funding, and strengthening primary care systems to achieve Universal Health Coverage (UHC). It's an ambitious goal, but one that many believe is essential for building a healthier and more equitable world. But here's where it gets controversial... some argue that relying too heavily on domestic funding could put undue strain on already stretched national budgets, potentially diverting resources from other vital sectors.
According to the Africa CDC, Ethiopia is among the African nations already actively implementing the Lusaka Agenda, tailoring its approach to its specific national context. Other countries include the Central African Republic, DRC, Nigeria, Tanzania, Ghana, Malawi, Mozambique, Senegal, and South Sudan.
Ethiopia's experience offers valuable lessons for other countries seeking to strengthen their primary healthcare systems. The emphasis on decentralization, community involvement, and harmonized partnerships provides a roadmap for achieving Universal Health Coverage. But are these strategies truly scalable across diverse African contexts? And what role should external donors play in supporting these efforts without undermining national ownership? What are your thoughts on the balance between domestic funding and international aid in achieving healthcare goals? Share your perspectives in the comments below!
