Minister of Health Lia Tadesse (MD) has displayed her ambition of rolling out a three-year investment and development roadmap, targeting the rehabilitation of health facilities in regions ravaged by conflicts and wars. With an estimated budget of 16.3 billion dollars, her ambition marks a significant move towards addressing the country's pressing health issues, including rising non-communicable diseases, injuries, and malnutrition, against a backdrop of diminished public health emergency response capacity.

The investment plan with nine targets is critical for Ethiopia, as the country contends with alarming health statistics exacerbated by recent conflicts. A substantial portion of the funding, over 50pc, is expected to come from development partners, while the federal government treasury is to share 19pc, and public-private partnerships are slated to cover 11pc.

This comes as donor contributions have shown a decline, plummeting by up to 241pc over the past two years, primarily due to the conflict. The drop starkly contrasts with the annual pledges of 150 million dollars during the implementation of the second edition of the health transformation plan under the Sustainable Development Goals (SDGs).

Central to the plan, a.k.a Health Sector Development & Investment Plan (HSDIP), is the post-conflict recovery phase, which prioritises restoring damaged health facilities and mobilising a critical health workforce. The plan also emphasizes the importance of providing psychosocial support in zones experiencing wars and ensuring the availability of essential services like water, sanitation, reproductive, neonatal, and nutrition services across all health facilities.

The two-year conflict in the Tigray Regional State and neighbouring states has had a devastating impact on the country's healthcare infrastructure. At its peak, the conflict led to the internal displacement of nearly 5.8 million people in Tigray, Amhara and Afar regional states. The Ministry of Health reported that over 76 hospitals and thousands of health facilities were destroyed, with total damages exceeding 1.4 billion dollars. The destruction has left the health system vulnerable and struggling to cope with epidemics of cholera, measles, meningitis, and acute respiratory infections.

Abraha Gebregziabher (MD), the medical director of Ayder Hospital in Meqelle, expressed the urgent need for government assistance. The Hospital, serving nearly eight million people in the regional state, is overwhelmed with patient influx and limited by inadequate capacity. He noted the dire state of the Hospital's infrastructure and equipment, with crucial facilities like a chemotherapy machine lying unused due to the conflict.

"Several corridors are permanently dark," he told Fortune of the ageing electrical system.

Despite these challenges, Ayder Hospital, with 200 specialist doctors and nearly 2,300 staff, provided 300,000 outpatient services last year. A significant number of these patients were malnourished, demanding care beyond the capabilities of lower-tier medical facilities in the regional state. The Medical Director revealed that while therapeutic foods are in better supply, there is a constant shortage of anti-infection medication for the scores of malnourished patients who come to the hospital.

"It's heartbreaking to tell patients to look for treatment elsewhere," Abraha said. "Most months, we're out of supply".

The recent announcement by USAID to resume food aid throughout Ethiopia offers a glimmer of hope in addressing the severe food insecurity affecting the regional state. However, the health sector's crises are compounded by Ethiopia's low per capita health expenditure, which is less than half of the World Health Organization's recommended 86 dollars. Out-of-pocket health expenses constitute 30pc of the total health expenditure.