In collaboration with the Ethiopian Ministry of Health and the Ethiopian Public Health Institute (EPHI), Resolve to Save Lives (RTSL), convened national and regional government leaders, public health experts, and partners to reflect on progress from the Epidemic-Ready Primary Health Care (ERPHC) initiative, share key lessons, and chart a path forward for strengthening epidemic readiness at the primary health care (PHC) level in Ethiopia.
RTSL, the Ministry of Health, and EPHI implemented a two-year ERPHC pilot across 197 health centers in Addis Ababa, Sidama, and South Ethiopia regions. The initiative embeds surveillance, case management, and infection prevention and control (IPC) into routine PHC services—enabling facilities to detect and report priority diseases, protect patients and health workers, and maintain essential services during outbreaks.
Key results
The ERPHC program led to measurable improvements in surveillance and IPC performance and readiness. Participating facilities reported suspected outbreaks faster, with 96% of 1,130 suspected cases reported within 24 hours. In Sidama and South Ethiopia, 102 confirmed priority disease cases met 7-1-7 targets for detection and notification.
Facilities also strengthened their use of data for decision-making, with weekly trend analysis increasing from 52% to 100% and accurate determination of epidemic thresholds improving from 58% to 96%. Functional communication systems, rapid response teams, as well as identification of priority disease signs and symptoms also improved significantly across ERPH-supported facilities.
Major gains were also recorded in health worker capacity, with knowledge of establishing isolation and screening areas increasing from baseline levels below 60% to 100%. Correct donning and doffing of personal protective equipment for priority pathogens improved from 33% to 100%, while health worker preparedness for surge response increased from 45% to 90%.
These improvements were supported through structured mentorship, supportive supervision, simulation exercises, and routine data review—strengthening coordination between PHC facilities and broader public health emergency systems.
Reflecting on the project’s impact, Ethiopia’s State Minister for Health, Dr. Dereje Duguma, highlighted its contribution to strengthening resilience and sustaining essential services, adding that “developing a resilient public health system is a priority of the Ministry of Health, and it is through initiatives like ERPHC that we can achieve that resilience.”
ERPHC in action: Ethiopia’s Marburg outbreak response
The strength of the ERPHC approach was further demonstrated during the Marburg Virus Disease outbreak in Ethiopia. Building on strengthened systems, facilities implemented active screening, coordinated with community health workers to detect and verify suspected cases, and maintained daily reporting. ERPHC-supported teams were deployed to regional Emergency Operations Centers, where they contributed to surveillance and IPC response efforts, including facility zoning, workflow optimization, and simulation-based capacity building.
At the national level, RTSL collaborated with the Ministry of Health and EPHI to deliver virtual training sessions on Marburg Virus Disease for healthcare workers, reaching more than 7,000 within five weeks.
Following this experience, EPHI Director General, Dr. Mesay Hailu, noted that “the ERPHC approach has demonstrated that it is possible to protect frontline health workers while effectively managing outbreaks without disrupting the essential services our communities depend on every day.”
Scaling ERPHC nationwide
A dominant theme at the meeting was the need to scale the ERPHC approach nationwide. Discussions highlighted the need for deeper integration within national health systems, sustained frontline capacity through continued mentorship and supervision, and financing to support long-term implementation.
Speaking at the event, RTSL Ethiopia Country Director, Girma Dessie, called on government leadership to drive the scale‑up and integration of the ERPHC approach into routine primary health care systems and national strategies, while urging partners to collaborate and provide the financing needed to support broader rollout. He added that RTSL remains committed to working closely with government and partners to advance scale‑up efforts.
Echoing this, Dr. Dereje Duguma said, “We would like to scale up to all facilities in Ethiopia and would appreciate the continued support of RTSL in championing this effort for the benefit of our communities.” EPHI also reaffirmed plans to expand the approach nationwide, with Dr. Mesay Hailu noting that “EPHI remains committed to scaling these lessons to health facilities across the country and fully integrating the ERPHC approach into the national emergency management framework.”
The meeting closed with a strong consensus that sustained investment in frontline systems will be critical to strengthening detection, notification and response, that will lead to health system resilience in Ethiopia. Participants also emphasized the importance of continued collaboration and financing to support the scale-up of the ERPHC approach and strengthen epidemic preparedness at the frontline.
