A man walks his donkeys around Abrehot Library, Arat Kilo, Addis Abeba’s newly upgraded neighbourhood, where sleek asphalt and modern architecture meet the timeless pace of animal transport. With nearly 10 million donkeys, Ethiopia ranks number one in the world for its donkey population, a testament to their enduring role in the nation’s economy. Modern corridor developments in Addis Abeba, intended for swift motorized transportation, stand in stark contrast to the continued reliance on donkeys for grain transport, a necessity driven by the prohibitive costs of motorized vehicles in both rural and urban areas.
Month: March 2025
FLAT LINES
A man is pouring water on the evenly queued Jerry cans, in the streets of Adey Abeba, around Saris. The city’s 5.2 million residents require a staggering 1.3 million cubic meters of water daily. However, supplies stand at around 800,000 cubic meters. This has young men race door-to-door, selling jerry cans for around 40 Br. While this fills immediate needs, it’s just a quick fix to the city’s deeper water crisis. Recent road development has resulted in water supply interruptions due to pipeline breakage and replacement. Unregulated urban expansion and migration have likely exacerbated the water crisis.
Ethio Telecom Expands Services with DStv Streaming
Ethio telecom enters the entertainment pool with bundled DStv streaming services through high-speed broadband internet and mobile data packages. The partnership with MultiChoice Ethiopia aspires to merge the telecom’s fiber broadband and mobile network with DStv’s content.
Subscribers can access DStv channels through mobile data or fiber broadband bundles, with discounts of up to 35pc through Telebirr or My Ethiotel (*999#) and up to 26.5pc at sales centers for fiber broadband bundles.
According to officials, the Telco’s infrastructure upgrades, including the deployment of Fiber-to-the-Home (FTTH) and Fiber-to-the-Room (FTTR), alongside the expansion of mobile networks, have laid the groundwork for this partnership. They are hopeful these advancements support the growing demand for reliable broadband, facilitating virtual meetings, cloud gaming, online education, e-commerce, and smart home applications.
Ethiopian Airlines to Introduce Electric Air Taxis for City Travel
Ethiopian Airlines has made a 30-million-dollar deal with Archer Aviation to bring electric air taxis to the country. The airline plans to use Archer’s “Midnight” aircraft to create a new, faster way to travel within cities.
The “Midnight” aircraft is a small, electric-powered plane that can take off and land vertically, like a helicopter. It can carry four passengers and is designed for short trips, aiming to cut travel times greatly. Instead of long car rides, passengers could travel across cities in 10 to 20 minutes.
This deal designates Ethiopian Airlines as the second customer for Archer’s Midnight aircraft, following Abu Dhabi Aviation Group.
“It’s a big step,” said Mesfin Tasew, CEO of Ethiopian Airlines Group. “We want to make travel easier and more eco-friendly.”
The companies also plan to explore using the air taxis for tourism. The signing ceremony was held in Addis Abeba last week, while they will now work with the Ethiopian Civil Aviation Authority to launch the service.
Ministry Joins Force with RIDE on Regional Gig Economy Jobs
Ministry of Labour & Skills and Hybrid Designs Plc, the parent company of Ride, have partnered to expand technology-driven transportation services to regional states, creating 300,000 gig economy jobs within five years.
Building on the taxi-hailing company (Ride)’s existing employment of 120,000 Addis Abeba residents, the Memorandum of Understanding (MoU), signed last week by Minister Muferihat Kamil and CEO Samrawit Fikru, aspires to further leverage technology to boost job opportunities nationwide.
“Regional administrations have been directed to support the rollout,” said Muferihat.
Officials believe the partnership contributes to the annual job creation target of two million. The Minister also reported that 3.2 million citizens have secured employment domestically and abroad in the past eight months.
She noted the government’s efforts to improve private sector financial access, resulting in a 70pc increase in job creation compared to previous years. The agreement also includes Ride providing technology-enabled transportation services to the Ministry.
Hibret Bank Partners with Mastercard to Advance Digital Banking
Hibret Bank moves to strengthen its digital banking capabilities, leveraging Mastercard’s expertise, financial and advisory support.
Adualem Hailu, vp of strategy & technology at Hibret Bank, detailed how Mastercard’s financial support will be used. He noted that the funds will be allocated towards capacity building like employee training, technical support, and digital infrastructure by investing in current systems and future technologies.
“We’ll offer Mastercard-branded cards while they earn commissions,” Andualem told Fortune.
The agreement was signed last week between Tsigereda Tesfaye, acting president of Hibret Bank and Mark Elliott, president of Mastercard Africa.
We recognise the necessity of adapting to changes to remain competitive on a global scale,” said Tsigereda.
Mastercard has been actively investing in Ethiopia’s financial sector, focusing on financial inclusion and literacy. Last year, it partnered with Kifiya Finance to launch a 100 million dollar program promoting uncollateralised digital lending for micro, small, and medium enterprises (MSMEs). Partnering with the National Bank of Ethiopia and First Consult under the BRIDGES program, it has also introduced a financial education module to equip young people and MSMEs with essential financial skills.
Mark reaffirmed the company’s commitment to advancing electronic payment adoption in Ethiopia. He underlined ongoing collaborations with financial institutions, including Hibret Bank, to drive digital transactions and enhance the accessibility of electronic payment services.
France Backs Ethiopia’s SOE, Financial Sector Reforms
Around 3.5 million euros worth of technical support is promised by France to advance financial sector reform, state-owned enterprises (SOEs) policy reforms, capacity building, and public-private partnership (PPP) regulatory frameworks in Ethiopia. The assistance, to be implemented under the Ministry of Finance and the National Bank of Ethiopia (NBE), will focus on strengthening key reform initiatives within the Homegrown Economic Reform Agenda (HGER) 2.0.
This agreement, part of a larger 28.5 million euros committed by Agence Française de Développement (AFD), was signed by Eyob Tekalign (PhD), state minister for Finance, and Louis-Antoine Souchet, country director of AFD, last week. About 10 million euros of the planned 25 million euro budget support was disbursed in December 2024. Eyob acknowledged AFD’s sustained support and praised the adaptable nature of the technical assistance program, which accommodates various partners while ensuring efficient resource use.
Souchet indicated that both budget support and technical assistance from AFD will continue in the coming years, with an expanded focus on tax, financial sector, and civil service reforms, as well as critical sectors like energy and logistics.
Global Standards Joint Health Treatment Center
Joint health is a critical element that directly affects quality of life. Disorders in the hip, knee and other joints can negatively affect people’s daily lives and limit their mobility. Acıbadem University International Joint Center was established to provide world-class solutions to such problems. Centrally located in Istanbul, this facility is equipped with the latest technology and its expert staff is a global reference center for the diagnosis and treatment of joint diseases.
𝗘𝘅𝗽𝗲𝗿𝘁 𝗦𝘁𝗮𝗳𝗳 𝗮𝗻𝗱 𝗚𝗹𝗼𝗯𝗮𝗹 𝗘𝘅𝗽𝗲𝗿𝗶𝗲𝗻𝗰𝗲
The International Joint Center stands out as an orthopedic center of excellence, hosting world-renowned experts. Leading physicians such as Prof. Javad Parvizi, Prof. Samih Tarabichi, Prof. Remzi Tözün, Prof. Ibrahim Tuncay, Assoc. Dr. Vahit Emre Özden, Assoc. Dr. Göksel Dikmen, Assoc. Dr. Kayahan Karaytuğ and provide services to patients using the most advanced technologies from the treatment and surgery of joint diseases to the education of the fellows from all around the world. This expert staff is constantly researching and implementing the best treatment methods for the health and well-being of patients, thus making the International Joint Center a global reference point.
𝗘𝘅𝗰𝗲𝗹𝗹𝗲𝗻𝗰𝗲 𝗶𝗻 𝗥𝗲𝘀𝗲𝗮𝗿𝗰𝗵 𝗮𝗻𝗱 𝗘𝗱𝘂𝗰𝗮𝘁𝗶𝗼𝗻
In addition to providing treatment services, Acıbadem University International Joint Center plays an important role in research and education. The Center conducts innovative research into the diagnosis and treatment of joint disease and stays abreast of the latest developments in the field. As a result, patients have access to the latest and most effective treatments.
In addition, orthopedic surgeons and allied health professionals from around the world can learn about the latest treatments and technologies through the Center’s educational programs. This makes the International Joint Center not only a treatment center, but also an information and education center.
𝗪𝗶𝗱𝗲 𝗥𝗮𝗻𝗴𝗲 𝗼𝗳 𝗧𝗿𝗲𝗮𝘁𝗺𝗲𝗻𝘁𝘀
The International Joint Center offers a wide range of services including not only hip and knee disorders, but also shoulder surgery, hand surgery, spine surgery and sports medicine. Individualized treatment plans are offered to patients of all ages with joint problems. In particular, arthroplasty and arthroscopy procedures are among the most common treatments performed at the center and these procedures provide effective results in joint protection and repair.
Arthroplasty procedures involve the replacement or reshaping of joint surfaces. This method offers an effective solution, especially in advanced joint diseases and severe joint damage.
Arthroscopy, on the other hand, is a surgical technique that uses minimally invasive techniques to treat joint problems and is often used for sports injuries and early stages of joint disease.
𝗔𝗱𝘃𝗮𝗻𝗰𝗲𝗱 𝘁𝗲𝗰𝗵𝗻𝗼𝗹𝗼𝗴𝘆 𝗮𝗻𝗱 𝗶𝗻𝗻𝗼𝘃𝗮𝘁𝗶𝘃𝗲 𝘁𝗿𝗲𝗮𝘁𝗺𝗲𝗻𝘁𝘀
The International Joint Center is committed to providing the best service to its patients by using the latest technologies in the diagnosis and treatment of joint disease.
The NanoScope™ technology used at the Center is a minimally invasive imaging system that provides detailed visualization of intra-articular structures. Nanoarthroscopy enables rapid and effective diagnosis of joint disease and offers patients solutions through less invasive procedures. This is particularly beneficial in the treatment of sports injuries and early-stage joint disease.
Robotic Surgery is another advanced technology service offered by the International Joint Center. Robotic systems increase the precision and accuracy of joint replacement surgeries, reducing recovery time and maximizing patient comfort. As a result, patients can return to their daily activities sooner and postoperative complications are minimized.
𝗣𝗮𝘁𝗶𝗲𝗻𝘁 𝗰𝗼𝗺𝗳𝗼𝗿𝘁 𝗮𝗻𝗱 𝘀𝗮𝗳𝗲𝘁𝘆
The International Joint Center is committed to providing patients with a comfortable and safe treatment environment. All necessary measures are taken to ensure that patients feel safe during the treatment process and receive the best service. The center’s professional staff prepares personalized treatment plans according to the patient’s needs and determines and applies the most appropriate treatment methods. In addition, comfortable and modern treatment rooms are provided for patients to have the best experience during the treatment process.
𝗜𝗻𝘁𝗲𝗿𝗻𝗮𝘁𝗶𝗼𝗻𝗮𝗹 𝗿𝗲𝗮𝗰𝗵 𝗮𝗻𝗱 𝗮𝗱𝘃𝗮𝗻𝘁𝗮𝗴𝗲𝘀 𝗼𝗳 𝗜𝘀𝘁𝗮𝗻𝗯𝘂𝗹
Istanbul, located in Turkey, is one of the most important cities in the world. Known for its historical and cultural richness, it also stands out as a metropolis offering modern healthcare services. The International Joint Center is centrally located in Istanbul, providing an easily accessible treatment center for patients from around the world. Combined with the high standards of the Acıbadem Healthcare Group, Istanbul has the potential to become a global center for the treatment of joint disease.
The International Joint Center, which is part of Acıbadem Healthcare Group, aims to become a global center for the diagnosis and treatment of joint diseases. It offers the best treatment services to its patients with advanced technology and expert staff in the heart of Istanbul. If you are looking for world-class treatment for joint health, we invite you to step into a healthy future with our innovative treatment methods, expert medical staff, and advanced technology facilities. Make the best decision to regain your health and benefit from quality, reliable, innovative treatment services.
A Trailblazer Returns to Build What Never Was
Brutawit Dawit, a veteran banker with extensive experience in the financial sector, has been appointed to lead Ethiopia’s one of the first investment banks, Wegagen Capital Investment Bank S.C. (WCIB), which received its official license last week.
Aklilu Wubet (PhD), Wegagen Bank’s president and board chairperson of the newly established investment bank, voiced optimism about the WCIB’s potential role in the emerging capital market. According to Aklilu, companies wanting to sell shares publicly need institutions capable of conducting thorough feasibility studies and providing essential advisory services. He disclosed that Wegagen Bank, the only listed company with the Ethiopian Securities Exchange (ESX), plans to leverage these opportunities and establish a presence in every listed company within the nascent capital market.
Aklilu told Fortune, Brutawit was selected for this role because of her foundational contributions and comprehensive financial expertise.
Her career spans noteworthy leadership roles, including leading the founding committee of the Bank of Abyssinia, serving as president of Wegagen Bank for seven years, heading Zemen Bank for two years, and dedicating more than a decade to independent financial consulting.
Widely regarded as a trailblazer for women in the domestic financial sector, Brutawit has over 30 years of experience in finance and international development. She earned an undergraduate degree in management and international trade from Howard University and an MBA from George Washington University, both in the United States. Her professional qualifications include international banking and financial analysis diplomas from the University of Colorado and Cornell University.
Early in her career, Brutawit spent 15 years at the American Bankers’ Association, followed by seven years at the World Bank, cultivating expertise in research, training, and policy formulation. She consulted for prominent institutions such as the National Bank of Ethiopia (NBE) and the African Development Bank (AfDB). Her international background offered Brutawit a perspective on global banking practices, which she brought back to Ethiopia in the mid-1990s.
Upon her return, she made history by becoming the first female president of Wegagen Bank in May 1997. During her seven-year tenure at Wegagen, she was credited for spearheading growth initiatives and introducing new banking practices, including extensive staff training programs and technological enhancements designed to improve customer service.
After leaving Wegagen Bank, Brutawit continued. In 2009, she became president of Zemen Bank, a new entrant targeting corporate and affluent customers. A novel one-branch marked her leadership at Zemen, a technology-focused strategy focusing on tailored financial products and targeted customer service. Brutawit eventually resigned from Zemen during times of regulatory turmoil, as the National Bank of Ethiopia (NBE) suspended Zemen Bank’s board of directors, led by Ermias Amelga.
In 2012, Brutawit, a mother of two, was tapped to lead the formation of Enat Bank, a financial institution dedicated to empowering women economically. Although she was initially nominated as the Bank’s founding president, regulators’ reluctance to approve her nomination led the position to another candidate.
In the mid-2000s, Brutawit expanded her career to include international development roles, serving as the country representative and Chief of Party for ACDI/VOCA, a global non-profit organisation focused on agricultural development and economic cooperation. More recently, Brutawit directed her attention to the microfinance sector, serving as CEO of Lefayda Microfinance, where she used her sector expertise to extend financial services to grassroots communities.
Now at the helm of Wegagen Capital Investment Bank S.C. (WCIB), Brutawit faces the challenge of leading Ethiopia’s one of the first formal investment banking institutions.
WCIB entered the market with an initial capital of 385 million Br, with parent company Wegagen Bank holding a 86pc stake and Africa Insurance controlling an additional five percent. According to Brutawit, the investment bank’s immediate objective is to provide advisory and brokerage services to companies listed in the capital market. She plans to expand into asset and wealth management, a move expected to create job opportunities.
However, given Ethiopia’s limited expertise in investment banking, WCIB will initially recruit expatriate professionals.
Hana Tehelku, director general of the Ethiopian Capital Market Authority (ECMA), stated the significance of Brutawit’s appointment, along with other female executives such as Tewedaj Gezahegn at HST Investment Advisors Plc, calling it “an encouraging development for gender inclusion in the financial industry.”
The Authority granted licenses last week to four additional capital market entities, including CBE SC Capital Investment Bank, Ethio Fidelity SC, Equations Security Advisor Plc, and HST Investment Advisors Plc. According to Hana, the Authority conducted a rigorous licensing process, assessing financial stability, business strategies, risk management, and corporate governance standards.
“Quarterly financial reviews will be implemented to maintain ongoing market integrity,” Hana said.
National Bank of Ethiopia’s (NBE) Governor, Mamo Mihretu, viewed these new licenses as catalysts for boosting domestic capital formation and reducing Ethiopia’s dependence on foreign capital. He announced the Central Bank’s plans to introduce treasury bonds available for public buying, further diversifying investment opportunities for domestic investors.
CBE SC Capital Investment Bank (CBE-CIB), another momentous entrant, begins operations with an initial capital of 100 million Br, slated to rise to 200 million Br upon obtaining a custodial license. The Bank is majority-owned by the state-run Commercial Bank of Ethiopia (CBE), with Dalol Capital holding a 30pc stake. Zemedeneh Negatu, CEO of CBE-CIB, described the licensing process as detailed and thorough, taking five months to complete.
According to Zemedeneh, his institution prepares to provide an extensive array of services, including brokerage, underwriting, prospectus preparation, equity trading, fixed-income bond issuance, and treasury services.
CBE-CIB plans to offer advice on mergers and acquisitions, private investments, and foreign direct investment portfolio management. Its ambitious growth plans include securing custodial services and raising the Bank’s capital to 300 million Br within three years. The operation intends to integrate artificial intelligence (AI) to enhance its efficiency and effectiveness. Zemedeneh pledged to employ 100 professionals within two years and anticipates interest from the global diaspora community, exceeding three million individuals, who could potentially become key investors in the capital market.
“I’m happy to do it while I am still productive,” Zemedeneh told Fortune.
He has been an ardent advocate of a capital market for Ethiopia for over two decades. He aspires to replicate CBE SC Capital Investment Bank’s model across other Eastern African countries, tapping into the region’s growing financial markets.
Another entrant, HST Investment Advisors Plc, begins operations with capital exceeding regulatory requirements. Tewedaj Gezahegn, with 15 years of auditing and finance experience, leads the advisory firm, which launched with 1.5 million Br, triple the regulatory minimum of half a million Birr. Tewedaj hopes to raise public awareness and increase community participation in the emerging financial market.
HST, predominantly owned by HST Consulting Agency, has majority stakes in the advisory company, including by Tewedaj herself.
Ethio-Fidelity Securities S.C., Ethiopia’s first securities dealer, commenced operations with 50 million Br paid-up capital, far surpassing the Authority’s 10 million Br minimum requirement. The company has 40 shareholders from diverse sectors, including finance, banking, insurance, and import-export businesses. Prominent founding members include board chairman Abebaw Zewedu, Yima Shewa Siyum, Abebaw Molla, Zelalem Werku, and Mesfin Zeberga, each investing between one and five million Birr.
Ethio-Fidelity currently employs seven professionals under its new CEO, Desalegn Wendale, and operates from its offices on Ras Abebe Aragay St., in the Sengatera area, a.k.a Addis Abeba’s Wall Street.
Abebaw Zewedu, Ethio-Fidelity’s board chairman and a known figure in founding several banks, including Bunna, Tsehay, and Ahadu banks, stated the urgent need to list manufacturing and commercial companies. However, he voiced concerns about the limited availability of skilled human capital necessary for rapid sector growth, advocating immediate capacity-building initiatives.
ECMA officials have confirmed plans to issue additional licenses to promote fair trade practices and broaden the financial market base, mirroring optimism about substantial growth potential in investment banking. Ethiopia currently boasts 32 commercial banks, 17 insurance companies, over 30 microfinance institutions, and approximately 350,000 retail investors, which experts believe sets the stage for rapid capital market expansion in the near future.
For Dakito Alemu (PhD), assistant professor of accounting and finance at Addis Abeba University, companies’ readiness to list publicly has much to desire, noting that preparations could require six months to two years. Companies are required to develop comprehensive financial reporting, governance frameworks, internal control mechanisms, and corporate governance structures, areas where many firms currently lag.
“I don’t believe many of them are ready,” Dakito told Fortune.
Dakito raised concerns about the long-term sustainability of employing foreign expertise, arguing for the necessity of domestic capacity building to ensure sector growth. Capital market authorities recently established a digital academy to address workforce challenges and educate future capital market professionals.
For Brutawit, leading WCIB represents a historic achievement and an opportunity to influence the evolving financial sector.
“It’s a privilege,” Brutawit told Fortune.
“No Child Should Die Waiting”
Five neatly arranged children’s beds lie in a small, dimly lit room inside Tikur Anbesa Teaching Hospital, on Yared St. Each was occupied by young patients undergoing long-term recovery following complex surgeries. The space buzzes quietly with gentle conversations, parents murmuring comfort, and doctors softly explaining treatment plans.
Near the entrance, on the left side, rests a notably small girl with a thin tube running beneath her nose. Her large eyes, stark against her frail frame, seem to say everything her voice cannot. This is Belena Asnake, a 10-year-old second-grader who has spent the last month and a half in the hospital after kidney surgery. The operation intended to repair kidney damage instead left her unconscious for seven anxious days. Her mother, Adena Ayele, now waits anxiously for another surgery, as the first failed to produce positive results.
Belena’s experience with illness has been painfully long. She was first admitted eight years ago, and for the past six years, her condition has stagnated at stage three kidney disease. Life worsened dramatically when her father died from malaria last year, leaving a vacuum both emotional and financial. Adena, once a clothes vendor in Asko Lomi Meda, had to abandon her work, while Belena’s elder sister sometimes misses school to assist at the hospital.
“I can’t let her remain alone,” Adena said softly, a statement filled with resolve and quiet despair.
Though the hospital and health insurance cover much of the medical costs, essential medications often remain unavailable, forcing Adena to depend on charity from relatives and friends. Belena’s kidney troubles trace back to a nerve disorder diagnosed when she was only two.
A few beds away, five-year-old Leul Alemayehu tried to find relief after two intense days of hospital care. Leul’s kidney failure began at age one due to an untreated urinary infection. His mother, Lekeshen Gebremikael, recounted her battle against mounting medical bills, which worsened after she was compelled to close her small hair salon to care for him. Leul’s father, a government employee, now shoulders all household financial responsibilities.
“There are medicines and laboratories that are simply unavailable,” said Lekeshen, detailing expenses of about 1,200 Br daily on medicines, on top of fortnightly medical costs.
The common tragedy linking Belena and Leul is dialysis, a life-saving treatment both urgently require but seldom receive.
According to Handsome Dakisios (MD), a paediatric kidney specialist at the hospital, each month, upto three children tragically die due to insufficient dialysis access. Tikur Anbesa sees around 25 new child kidney failure cases annually; last week, more than 20 have been subjected to intense follow-ups. The lack of adequate equipment and specialist doctors compounds their vulnerability.
“The most heartbreaking aspect is the situation facing adults,” Handsome said grimly. “People appeal for financial assistance as there is some hope, yet nobody does so for children as there is little belief in their chances.”
Handsome hopes to see enhanced facilities and equipment in the sector. He recounted instances where doctors had left paediatric kidney specialities feeling helpless. Alarmingly, he noted that the number of children identified as needing emergency dialysis has increased from 22 over three years to 11 in the last six months. Clinical practice focuses on emergency treatments rather than a sustainable approach to dialysis.
At Tikur Anbessa, 77 patients have been admitted for kidney failure treatment, while the outpatient section has recorded 1,957 patients for consultations, including many repeat visits, over the past six months.
“I can’t fault those doctors who have left the field,” he said. “They don’t wish to bear the burden of delivering bad news.”
Children with kidney failure frequently suffer from congenital issues or genetic conditions. Yet, an already dire situation worsens amid the ongoing economic downturn, which has inflated import prices and medical costs. Dialysis, requiring disposable materials, has become prohibitively expensive, with private centres now charging 3,000 Br to 6,000 Br a session, while vital medications such as blood thinners surged fivefold in price.
Mesfin Aseres, president of the Tesfa Kidney Patients Association, shared an especially harrowing story. He helplessly watched a child die awaiting dialysis, despite preparations for a transplant abroad.
“He died before my eyes,” Mesfin recounted, recalling the brutal reality faced by many.
Hope briefly emerged with a new law permitting organ donation from deceased persons, but complications persist due to limited public awareness and inadequate family matching. Organ donations still largely rely on immediate family, leaving many patients without viable matches.
Esayas Welda, a 24-year-old kidney patient, described the harsh reality of managing dialysis sessions amid spiralling costs. Recommended three times a week, financial pressures have stretched his treatments to every 10 or 12 days, leading to severe toxin buildup and emergency fluid removal procedures from his lungs.
“The worst part is that after the procedure, the toxins return in increased quantity,” Esayas confided, frustrated.
For Wongel Tena (MD), a surgical physician at Jimma University, the catastrophic health impacts of intermittent dialysis or medication gaps post-transplant potentially lead to organ rejection or permanent dialysis dependence. She advised preventative care, urging annual kidney assessments for patients with diabetes and hypertension.
Nationally, only 1,132 patients underwent dialysis in 2022, far fewer than international averages, partly due to cost barriers. Privately, dialysis sessions cost about 2,300 Br each, with annual expenses reaching approximately 8,000 dollars, an insurmountable burden given Ethiopia’s per capita income of about 1,272 dollars in 2023, according to the World Bank.
The country’s nephrologist-to-population ratio is alarmingly low at 0.26 a million, with 80pc concentrated in Addis Abeba, leaving rural populations deeply underserved.
Dialysis costs for Esayas surged from 2,500 Br to 3,300 Br a session. Public pharmacies once providing medications for 400 Br now face shortages, forcing Esayas to buy them privately for triple the price. He moved from his hometown in Butajera to Asela, Oromia Regional State, to support his mother financially after dropping out of school in 10th grade, but now even basic survival has become challenging.
Yewendwesen Tadesse(MD), another kidney specialist at Tikur Anbesa, advocates for comprehensive research on kidney diseases. Globally, around 850 million people suffer kidney problems, often driven by non-communicable diseases like hypertension and diabetes. The World Health Organisation (WHO) estimates that 16pc of Ethiopian adults have hypertension, with diabetes affecting three percent, contributing heavily to kidney disease prevalence.
“It is common to see cases in hospitals, particularly in intensive care units (ICU),” he said.
When he first opened a dialysis unit in 2000, no patients sought treatment. As of 2021, the number of individuals undergoing dialysis was estimated at 2,000, growing to 3,500 nationally. However, he believes this figure remains low relative to the total population. The rise in patients goes with growing population size and lifestyle-related diseases, such as diabetes, hypertension, and obesity, as well as enhanced diagnostic capabilities.
“The current patient count is much lower than in other countries, suggesting the need for enhanced preventative measures,” Yewendwesen told Fortune.
Despite increased awareness, treatment facilities lag significantly. Thirty-two public and 24 private dialysis centres operate nationwide, but the treatment facilities remain insufficient. Abiy Dawit, representing the Ministry of Health, confirmed ongoing issues despite recent regulatory improvements permitting broader organ donation to alleviate the crisis.
Kidney transplants offer life-saving alternatives but bring their own complications. To date, Ethiopia has recorded 175 transplants domestically and 544 in overseas.
Patients like Desu Antawiw, who underwent a transplant in India at the cost of 2.6 million Br, now face acute medication shortages back home. Without consistent immunosuppressive drugs to prevent organ rejection, Desu faces immense risks, borrowing pills or buying them from the underground market at inflated prices.
The expense associated with a single transplant ranges from 17,000 to 20,000 dollars; following forex alterations, the price has effectively doubled when paid in Birr. A transplant that previously cost roughly 1.14 million Br now exceeds 2.5 million Br.
Biniyam Abera, president of the Ethiopian Kidney Transplant Association, blamed chronic drug shortages, forcing patients into risky parallel-market solutions or rationed dosages, causing severe health repercussions.
“There is no consistent supply,” he explains.
The Ethiopian Blood & Tissue Bank Service, headed by Ashenafi Tazebew (MD), views recent organ donation laws optimistically. Ashenafi urged more efficient procurement strategies and sustained funding, advocating for a collectively financed fund involving public-private partnerships to ease dialysis and transplant expenses.
St. Paul’s Hospital Millennium Medical College, on Swaziland St., the country’s primary transplant centre, suffers similarly. Over the past nine years, the transplant unit has successfully conducted 120 surgeries in the first four years. Despite a capacity for 60 to 100 transplants annually, shortages of critical supplies and skyrocketing costs limit operations immensely. Transplants previously costing about 1.14 million Br have now soared past 2.5 million Br. Its Director, Tsegaye Berhanu(MD), described supply constraints and import challenges as major constraints, noting that even critical diagnostic reagents have doubled in price, severely limiting the hospital’s output.
Solomon Negusse of the Ethiopian Pharmaceuticals Supply Services (EPSS), a federal agency, acknowledged recent medication shortages, blaming procurement complications for delays. The agency has tried addressing this by establishing longer-term international contracts, yet logistical and financial barriers persist. EPSS supplies over 800 medicines to public hospitals, some distributed based on contractual agreements. These pharmaceuticals reach St. Paul Hospital as part of specific contracts.
Solomon disclosed that shortages have arisen from procurement issues similar to those affecting cancer medications. In response to this predicament, the Service has established long-term contracts with various companies in India and Europe. It has imported a year’s supply of Mycofit 500mg and Ciclosporin in three variations.
“We currently have full stock of all required medications,” Solomon told Fortune.
According to Solomon, a recent importation of essential drugs will bring relief, but admitted pricing instability remains despite substantial state subsidies.
Customs policies and economic volatility further complicate the medical import market.
Yididya Seleshi, a medical equipment importer, blamed crippling customs duties for inflating prices dramatically, discouraging imports despite their life-saving necessity. A piece of dialysis equipment that previously cost 800 dollars now runs approximately 3,500 dollars in import duties, exacerbating shortages.
Yet, amid bureaucratic promises and plans, hundreds like Belena and Leul cling precariously to life, their families trapped between soaring medical bills and inadequate healthcare infrastructure. Belena’s mother, Adena, continues waiting, hoping desperately for a miracle, while Leul’s parents struggle daily, seeing an uncertain medical future.
Logistics Shake-Up Lets Rivals In But Leaves ESL Steering the Ship
The opening of the logistics sector to multimodal operations has come with tight restrictions, reserving key strategic commodities and trade routes exclusively for the state-owned giant, the Ethiopian Shipping & Logistics (ESL).
Federal government officials expect the partial liberalisation to boost efficiency in a logistics sector that has been long criticised for poor performance and high costs. A recent World Bank report ranked Ethiopia poorly, with a logistics performance score of 2.94 out of five.
Djibouti has served as Ethiopia’s main gateway for two decades, handling 95.1pc of its imports during the first half of this year. Djibouti relies heavily on the Suez Canal, which accounts for about 30.6pc of global container traffic, facilitating the movement of over one trillion dollars worth of goods annually. According to the UN COMTRADE, Ethiopia’s imports from China reached 5.57 billion dollars in 2023, while imports from the UAE totalled 578 million dollars.
Multimodal logistics involves handling cargo through various transportation methods, vessels, railways, and trucks. ESL, a state-owned enterprise managing roughly 90pc of cargo traffic bound for Ethiopia, monopolised this sector entirely. ESL controls critical routes and commodities, particularly bulk shipments like fertilisers and capital goods, essential to the national economy. Six companies were allowed to enter the market in an unprecedented policy shift to increase competition and efficiency.
However, two of Ethiopia’s largest import markets — China and the United Arab Emirates (UAE) — are reserved exclusively for ESL, sharply limiting opportunities for incoming competitors. Bulk cargo shipments, too, remain off-limits to these companies.
According to Yalew Tesfaye, a senior official at the logistics administration of the Ethiopian Maritime Authority (EMA), multimodal operators could generally handle imported cargo, yet bulk cargo remains strictly under ESL’s control.
“The state-owned enterprise has to be protected,” said Yalew.
While the logistics corridor was slowly opening for competition from the private sector, safeguarding ESL appears to be a priority for policymakers. Under the new policy, multimodal operators should establish their own expansive terminals or lease from eight dry ports owned by ESL, or other companies.
ESLSE operates eight dry ports nationwide, notably the Modjo terminal in the Oromia Regional State, built in 2009. It covers 150hct and handles approximately 78pc of the country’s imports.
Berisso Amalo, CEO of ESL, cautioned against renting the company’s dry port spaces to competitors, anticipating detailed studies to determine the advantages.
“We can’t just say yes,” Berisso told Fortune. “It’s a competition after all.”
He also recognised the new entrants as an opportunity for ESL rather than a threat, seeing competition as a driving force to improve his company’s operational capabilities.
“We’re already improving our infrastructure and technology in preparation for competition,” Berisso said.
Cosmos Multimodal Plc,, Tikur Abay Transport Plc, Panafric Global, Ethio-Djibouti Railway S.C., Ethio-Rail Logistics Plc, and Gulf Ingot FZC Multimodal Operator have received authorisation to operate. Authorities have set rigorous conditions for their market entry, including appointments of boards of directors with at least five years of relevant industry experience, developing or leasing terminals covering at least five hectares, operating a minimum fleet of 30 trucks, and maintaining warehouse facilities of at least 30,000Sqm, built from concrete.
“They’ve gone through strict requirements and have proved their capability,” said Yalew.
He anticipates more operators might join if authorities deem additional entrants feasible. Officials from his Authority are coordinating closely with the National Bank of Ethiopia (NBE) and the Ethiopian Customs Commission to facilitate customs clearances and banking procedures for the new operators.
“Companies have received all approvals to start operation,” Yalew told Fortune.
Yet industry veterans have expressed scepticism about the reform’s limited scope. Daniel Zemichael, former president of the Ethiopian Freight Forwarders & Shipping Agents Association (EFFSAA) and general manager of Freighters International, pointed out the limitations new entrants face. With about 70pc of imports sourced from China and the UAE, the newcomers will only have access to about 20pc of the market.
ESL’s dominant position, managing over 80pc of Ethiopia’s trade, presents tough competition for incoming companies seeking substantial market share.
“This shows that multimodal operation is still monopolised,” said Daniel.
ESL operates with a fleet of 11 vessels capable of carrying over 25,000 containers, providing negotiation power internationally. It earned more than 14.4 billion Br in profits, prompting criticism about its monopolistic position and the tariffs imposed on customers lacking alternative choices.
“New operators should build networks from scratch,” Daniel said. “Profits will come gradually for the new entrants.”
He believes while they might initially struggle, increased competition could eventually improve service standards, pricing, and efficiency.
Ethio-Rail Logistics Plc, one of the newly licensed operators, illustrates the cautious optimism within the industry. Formed through a joint venture between the state-owned Ethiopian Railway Corporation and GetAs International Plc, the company has a paid-up capital of 350 million Br, with the state corporation owning a majority stake. It plans to begin operations at two of its six dry ports — Endode and Dire Dawa — within six months and intends to charter vessels from international shipping giants such as Maersk and MSC.
“We plan on cooperating with ESL,” said Gashaw Haile, CEO of Ethio-Rail Logistics with over three decades of experience.
Despite his willingness to cooperate, Gashaw criticised the authorities’ decision to exclude the new operators from bulk shipments and key markets, arguing that genuine liberalisation should permit unrestricted competition.
“We’re not here for some markets but all,” Gashaw told Fortune. “It’s a liberalised market.”
He urged the authorities to reconsider their protective posture toward ESL.
Another newcomer, Cosmos Multimodal Plc, formed by merging Gada Transport & Logistics S.C., Tradepath International Plc, and Awash Transport, is preparing to enter the market with a 15hct dry port in Mojo. Backed by a capital investment of 350 million Br, its CEO, Getu Hunduma, could not conceal his disappointment over the recent discovery of the authorities’ decision to reserve important markets for ESL.
“We thought we had been allowed to reach all markets,” Getu said, concerned about limited opportunities.
Cosmos plans to explore alternative rental options rather than leasing ESL’s dry ports and wants to negotiate to address the restrictive decisions. Despite initial hurdles, Getu voiced optimism.
Gulf Ingot FZC Multimodal, another entrant, is a subsidiary of Dubai-based Gulf Ingot FZC Plc, a conglomerate founded in 1995 with diverse interests in manufacturing, construction, and transportation. The firm, currently operating with a fleet of 160 vehicles providing unimodal services, is preparing its first multimodal dry port in Dire Dawa, covering 50,000Sqm. It plans to acquire four ships and intends to cooperate with international shipping companies and the Ethio-Djibouti Railway Corporation.
“We’ll be cooperating with other giants,” Yitbarek Zewde, board chairman of Gulf Ingot, said.
Despite current restrictions, he hopes to build a customer base in what he believes are “There are untapped opportunities beyond the restricted markets,” He told Fortune.
Industry expert Mathiwos Ensermu (PhD) voiced cautious optimism about the potential for improved logistics efficiency through competition. Drawing parallels to the banking industry, Mathiwos argued that private-sector competition has historically improved performance over time.
“There will be cooperation as much as a competition between ESL and the new entrants,” Mathiwos said.
Stating the necessity for negotiation alongside competitive dynamics, he criticised the restrictions placed on critical routes and commodities, emphasising that fair competition should define market structures.
“Authorities should rethink the strategy,” said Mathiwos.
Authorities’ Bid for Digital Quality Sparks Fury Among Cash-strapped Businesses
The Institute of Ethiopian Standards has introduced revised fees and new product marking systems targeting quality, accountability, and revenue collection. Its authorities say digital transformation is critical to improving product quality and traceability and addressing ongoing issues that persist despite existing manual watermark protections.
“We’re currently building a system to introduce that,” said Oliyad Lencho, the lead executive responsible for scheme and standard mark administration.
According to Oliyad, manual marking systems previously used were insufficient to distinguish quality goods from counterfeit and substandard products, enabling illicit trade networks to flourish.
“Digitising these marks with scannable technology will enable consumers to verify authenticity and make informed purchasing decisions,” he said.
Under the new regulatory framework, data-encoded digital marks will soon become mandatory for all essential products. The Institute is partnering with the Ethiopian Artificial Intelligence Institute (EAII) to launch the digital system in the coming fiscal year.
The authorities disclosed that new certification categories such as Diamond, Import, Halal, Green Product, and Organic are being introduced alongside digital marking. The Diamond mark will display the highest product standards, while the Import mark will be introduced by the end of the current fiscal year. Other categories will gradually follow.
However, financial constraints presented limitations to the ambitious implementation plans.
“All our plans require financing, which we currently lack,” said Oliyad.
The Institute, operating on an annual budget of 70 million Br, plans to generate over 100 million Br annually through fees collected from businesses.
The Institute oversees a comprehensive database comprising over 11,000 standards and 395 mandatory products, including edible oils, flour, salt, and beverages. Its authorities argue that the regulatory overhaul addresses long-standing inefficiencies. The new regulation revises legislation from two decades ago, when fees based on annual sales were first collected. After the Ethiopian Quality and Standard Authority split into four entities, including the Institute and the Ethiopian Conformity Assessment Enterprise, fee collection became inconsistent and disorganised, prompting the authorities to reinstate and expand fee coverage.
Companies will be required to remit up to 0.5pc of their annual gross revenue. The fee structure categorises industries into 10 groups covering manufacturing, agriculture, and services. Sectors such as leather, textiles, medical supplies, engineering, steel, construction, and chemicals will pay rates ranging between 0.1pc and 0.5pc. Alcoholic beverages will face fees of 0.5pc, non-alcoholic beverages of 0.4pc, and edible oil products of 0.1pc.
The industries’ responses have been mixed, with the Ethiopian Beverages Association voicing its concerns. Ashenafi Mered, the Association’s general manager, argued that the industry was caught off guard, with many companies already struggling financially unable to handle additional fees. Representing 134 companies, the Association is negotiating for lower remittance rates, hoping to reduce bottled water fees by half from 0.4pc and non-alcoholic beverages down to 0.1pc.
Leaders of the Ethiopian Edible Oil Producers & Manufacturers Association (EOPMA) warned that additional financial burdens from regulations could devastate the already struggling edible oil industry. The number of fully operational edible oil factories has sharply declined by half from 60 three years ago, and many operate irregularly due to financial pressures.
“Manufacturers cannot afford any additional payments,” said Mohammed Yusuf, chairman of EOPMA.
Mohammed blamed tax burdens and unfair competition from duty-free imports as problems his industry faces. Price hikes and input shortages have compounded the industry’s difficulties.
“It’s fuel to fire,” Mohammed said, noting companies already face severe material shortages.
An example of the dire situation is Abay Edible Oil, a bottler based in Bahir Dar, in Amhara Regional State. Employing more than 450 workers and capable of producing 200,000Ltrs of oil daily, the company faces security problems, regular power outages, and rising costs. Deputy Manager Yeshambel Mengesha cautioned that escalating payment requirements from multiple regulatory bodies are draining the company’s capital and forcing layoffs.
“We’re a few steps away from shutting down,” Yeshambel said.
Quality assurance responsibilities span several agencies. The Ethiopian Conformity Assessment Enterprise handles inspections, testing, and certification, enforcing standards through extensive laboratory capabilities. According to Tekea Berhane, communications director of the Enterprise, testing procedures are initiated upon requests from regulatory agencies such as the Ethiopian Food & Drug Authority (EFDA) and the Ministry of Trade & Regional Integration.
“Only products that comply with mandatory standards can enter the market following rigorous testing,” said Tekea.
The Enterprise, equipped to test over 4,000 product types and maintain a database of around 4,000 parameter standards, prevented close to 880tns of substandard products from entering the market last year, leading to the closure of about 15 domestic manufacturers. However, it does not pursue legal action in cases of false certifications, which creates a gap in regulatory enforcement.
Another federal agency, the Ethiopian Food & Drug Authority, has also increased mandatory requirements, recently enforcing the fortification of edible oils with vitamins and minerals.
Yet, industry representatives argue such mandates further exacerbate operational pressures.
Kalessilassie Agmus, quality assurance manager at Agrifood, accepted rigorous testing as essential for ensuring product safety.
“Our role in ensuring quality products is vital,” he said, urging regulatory bodies to expand mandatory quality standards and clarify production specifications.
Bless Food Laboratory, established in 2011 and co-owned by Belete Family (51pc) and Onyx Development, affiliated with French firm Nutriset, represents private-sector involvement in quality assurance. Operating advanced labs in Legetafo, on the northern outskirts of Addis Abeba, Bless Food inspects over 100 product types weekly across 1,000 parameters, issuing certifications critical for agricultural and processed products.
Experts say regulatory efforts alone cannot ensure market-wide quality improvements without consumer participation.
Michael Haileselassie, a quality consultant and deputy manager at Indigo Quality Management & Consultancy Plc, argued that Ethiopia faces systemic challenges such as weak regulatory enforcement, inadequate consumer awareness, and unfair competition. He believes consumer behaviour in developing markets often prioritises cost over quality, differing markedly from developed markets where quality standards influence purchasing decisions.
“There is a lack of consumer awareness about quality,” he said. “Historical regulatory lapses have cultivated tolerance toward substandard practices.”
Technological advancements like digital marking could ensure product authenticity and traceability, but Michael warned that their success would depend heavily on effective regulation and consistent enforcement. He called for empowered inspectors and stronger oversight and urged a shift in consumer behaviour.
“Consumers need to hold businesses accountable,” Michael said. “A cultural shift is essential.”
The Institute of Ethiopian Standards officials acknowledge these issues but maintain that spreading financial responsibilities across businesses is necessary to achieve broader accountability and quality.
Oliyad echoed this viewpoint.
“Burdens need to be shared,” he told Fortune.