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“Ethiopia still needs a lot of work when it comes to ensuring universal health coverage”

“Ethiopia still needs a lot of work when it comes to ensuring universal health coverage”

Markos Feleke (MD)

Markos Feleke (MD) is an Ethiopian American entrepreneur involved in a number of projects in Ethiopia, including a medical center, an education facility and volunteerism. Here, be reflects with Samuel Getachew of The Reporter on the idealism of coming back to Ethiopia to contribute to its new narrative, on partnerships, educating the next generation of medical professionals, on wanting to become an engaged local citizen and finally reflects on the slew of recent reforms that have impressed him most. Excerpts:

The Reporter: It has almost been a decade since you started ABH Partners. Share with me the highlights of your work so far?                                                                                       

Markos Feleke (MD): Initially founded as a short course training and operation research company at the peak of the HIV/AIDS response nationally in 2007, ABH Partners has evolved as one of the leading local knowledge management agencies. We integrate the generation, dissemination and application of knowledge using local resources and yet international standard. We have made significant contribution to the Health and Education Sector in Ethiopia through our 4 major service pillars: Consultancy, Research, Education and Implementation.

ABH has served a range of clients from US government agencies such USAID to UN agencies and major international development partners. We have also closely worked from the lowest administrative level to the highest level in the country and have got the opportunity of working Ivy League universities such as Harvard and Johns Hopkins Universities.

ABH Partners has managed to train and deploy thousands of field workers to collect data on different public health intervention programs to inform decision makers and stakeholders, trained over 3,000 health workers in different short course programs, offered a unique opportunity to residents of Addis including the international community to pursue their graduate studies through our successful Public Private Partnership with Jimma University. ABH has also undertaken implementation of selected public health implementation programs working closely with regional health bureaus and international partners. We have continue to develop ABH to be the public health knowledge hub in Ethiopia.

Ethiopia is seen as one of the exemplary nations when it comes to its improvement of public health in the country. As a medical professional, what are some of the areas the country has made great strides in?   

Well as physician and public health specialist, I can tell that Ethiopia has made significant strides in improving the health outcomes and wellbeing of its people as evidenced by the achievement of the Millennium Development Goals (MDGs) ahead of time implementing successive health sector development plans. However, Ethiopia still needs a lot of work when it comes to ensuring universal health coverage, addressing high morbidity and mortality, improving quality of service and ensuring healthcare financing. As a private sector player, I have noted that Ethiopia has not made use the private sector even though this is improving these days. 

Let's talk about medical schools. There is notion that the local medical teaching institutions lack resources and the capacity to teach. What is your take on that? 

I am an old school guy and I am not a fan of the flooding strategy our county has implemented to address its human resource challenges.  I would say the quality of education has deteriorated in both public and private schools. In fact, it would be difficult to agree to this notion without objective assessment. Fortunately the admission criteria for both public and private medical schools is the same and is determined by Ministry of Science and Higher Education. When it comes to implementation with resources, the over 40 public and private medical schools in Ethiopia have varying commitment and compliance to standard. The good thing now is that we will soon have a market that would reject incompetent graduates who wouldn’t pass the standardized board exam that just started. The government is no more seeking mandatory service requirement for most health science graduates and I hope training institutions and candidates will start to respond to this.

Since your return, you have branched out to private medical service, Washington Medical Center. What do you think are the real contributions to such institutions to Ethiopia, where medical tourism continues to be the choice of many?

The private health sector including those run by diaspora play a significant role in meeting the big gap our country has to quality secondary and tertiary care. Washington Medical Center, which is owned by a group of diaspora physicians including myself, is currently largely a secondary healthcare facility making transition to build a tertiary care hospital. We have been in a learning phase of trying to understand what it takes to do such a large scale project in Ethiopia. Doing business in Ethiopia is quite challenging despite the recent promises of easing the bureaucracy.

In just the last four years, Washington Medical Center has offered service to more than 75,000 patients that included residents of Addis, patients from regional states and the expat community working at various international organizations. The demand for specialized healthcare in Ethiopia is very large and the availability of such facilities is limited and it is expected that many patients would continue to fly out to medical tourism destinations.

However small and fragmented it is, the current private sector in Ethiopia is playing its part in addressing this. I hope the government will play a more active role in engaging the emerging private health sector and that Ethiopia would also be a destination, not a source, of medical tourism.

Ethiopia is attempting to lure such diaspora to the country. How are we doing on that front?

While the reform in Ethiopia and the excitement that followed has already started to attract some of the Ethiopian diaspora, a lot of work is remaining to ensure meaningful attraction of the diaspora in different economic sectors. It is one of the untapped potential of Ethiopia if it is supported with a more properly formulated road map and policy. Ethiopia is yet to unleash the potential of engaging the diaspora which has the capital, knowledge, experience and network in different economic sectors. However, Ethiopia must first be business friendly to domestic investors before it can lure the diaspora meaningfully.

In reflection to the slew of reforms taking place in the country, what has impressed you most?

Personally I am very much encouraged by the reform that is unfolding beyond my imagination and probably the expectation of many realistic observers. The leader of the reform, PM Abiy Ahmed, has inherited tons of complex problems that he started to address with his power message of reconciliation, synergy and looking forward with grand vision despite the enormous challenges. I am more impressed by the work in progress as part of the reform in building democratic and strong institutions, the release of political prisoners and the significant improvement in freedom of speech. However, I am mindful of the complexity and delicacy of the challenges ahead as expectations are not consistent and as we make a transition to a democratic country.

You have been involved in volunteerism and you are also a visible supporter of having corporate responsibility within your institutions.  How important is that to you and share with me some of the areas you have been involved in?

I firmly believe that we should give back to the very society which has given us what it has and can afford. I also believe that we have to support each other as it is probably a matter of chance that we are not on the side. Sides change too. As Ethiopians we were, at some times in our history, able to aid needy European and Asian countries. But that culture of giving back should be strengthened and sustained back home too however our economic status has deteriorated.

At ABH Partners and Washington Medical Center, we have tried to integrate corporate social responsibility to get the opportunity of addressing our societal and environmental needs. As such we support schools, youth clubs, renovation of homes for the elderly and the needy, orphanages, needy students and others. We have spent a significant amount of resources trying to do our part of giving back. I look forward to the opportunity of institutionalizing such support from my own organizations and fellow companies.