Over the last two decades, Ethiopia has registered fast economic growth which has led to significant national poverty reduction. However, there were significant differences in the pace and nature of poverty reduction across Ethiopia’s regions, according to a new World Bank Group rural poverty assessment study.
The report entitled Ethiopia Regional Poverty Report – Promoting Equitable Growth for All Regions was prepared in partnership with the Planning and Development Commission of Ethiopia (PDC), and complements the National Poverty Assessment produced earlier this year. The study also aims to evaluate regional patterns and inequalities in non-monetary welfare, including health, education, ownership of consumer durables, and access to basic services such as electricity and water. Furthermore, it discusses trends and allocation of public expenditure across regions, and examines how allocation of public funds affects regional variance in monetary and non-monetary welfare.
“This is a very important study as it seeks to create regional poverty profiles and help to better understand why some regions registered fast poverty reduction while others did not and why living standards across regions vary,” said Ousmane Dione, World Bank Country Director for Eritrea, Ethiopia, South Sudan and Sudan. “Identifying the key factors which contribute to fast and sustainable poverty reduction can provide useful insights on how to accelerate it for lagging regions,” he added.
According to the study, across Ethiopia’s regions, poverty declined at a much faster pace in urban areas than in rural areas. Inequality, measured by the Gini coefficient, increased in almost all regions from 2011 to 2016 generally as a result of stronger growth for relatively better-off households. This inequality hampered overall progress in poverty reduction.
The report, which complements the country’s National Poverty Assessment, provides poverty profiles for each region and aims to shed some light on why some regions registered fast poverty reduction between 2011 and 2016, while others did not. Although national poverty reduced from 30% to 24%, there were strong differences in the nature of poverty reduction in urban versus rural areas. Nearly all 10 regions experienced strong poverty reduction in their urban areas, while only the Somali and the Southern Nations, Nationalities, and People’s regions saw significant reductions in rural poverty.
“Poverty in urban areas fell from 26% in 2011 to 15% in 2016,” said Arden Finn, an economist in the World Bank’s Poverty and Equity Global Practice, and co-author of the study. On the other hand, there was limited progress in rural areas, where poverty decreased from 30% to 26% over the same period.”
Predominantly urban areas such as Addis Ababa, Dire Dawa and Harari have better outcomes in general, according to the study. Among the mainly rural regions, Gambella fares better when it comes to indicators such as education and preventing child stunting, while Tigray has better health indicators, including reductions in infant and under-five mortality, increased immunization and improved health facility delivery.
Despite strong reduction in monetary poverty, the predominantly pastoral regions of Afar and Somali lag in non-monetary welfare. Circumstances such as location, gender, and household wealth play a role in determining primary school completion rates, secondary school enrollment rates, and access to electricity. Within each region, the location of households generally explains these differences.
“In order to accelerate poverty reduction and reduce inequalities more investment is needed in rural areas, especially in key areas such as agriculture, human capital and jobs,” said Arden Finn.
Ethiopia achieved positive poverty reduction but inequalities persist
New survey finds millions of people affected by tuberculosis still diagnosed and treated with outdated tools
The Stop TB Partnership (STBP) has released Step Up for TB 2020, a new report prepared with Médecins Sans Frontières (MSF), which reveals both progress and shortcomings in the alignment of national tuberculosis (TB) policies with the latest international recommendations. The report finds that significant policy gaps risk undermining progress in the fight against TB, one of the world’s leading infectious killers, a situation that is further exacerbated by the negative impact of the COVID-19 pandemic on people affected by TB.
Global efforts to end TB received a boost in 2018 during the United Nations High-Level Meeting on TB, when world leaders agreed on a set of ambitious targets to be reached by 2022. However, progress on implementation of the 2018 UN Political Declaration on TB has stalled and even rolled backwards in the context of COVID-19. The new report calls on countries to urgently update their TB policies and recommendations as a crucial first step towards ensuring the funding, scale-up and implementation of comprehensive TB responses.
Step Up for TB 2020 examines the national policies of 37 countries with a high burden of TB, assessing the extent to which they align with World Health Organization (WHO) guidelines and international recommendations. With an estimated 7.7 million people developing TB each year, these 37 surveyed countries represent 77% of the global TB burden and 74% of the estimated burden of drug-resistant TB.
“Earlier this year, the COVID-19 pandemic hit the world with devastating impact, and governments around the world quickly adopted new policies and laws in response,” said Dr. Lucica Ditiu, STBP Executive Director. “Meanwhile, TB remains the top infectious disease killer, even though it is preventable and curable. To make matters worse, most countries still use outdated policies, practices, tools and treatment regimens. Our survey, which is conducted regularly, shows improvements every year, but we have a long way to go. We all must ensure that every single person affected by TB is diagnosed and treated using the latest available international guidelines and tools.”
Previously known as Out of Step, this fourth edition in the series covers a larger set of countries and additional policies and practices related to four key areas: diagnosis, treatment, prevention and medicines procurement.
On diagnosis, the report finds that many of the surveyed countries still have outdated testing policies that may lead to inadequate TB prevention and care. Around 347,000 people who develop TB each year in the 37 surveyed countries have a form of the disease that is resistant to existing treatments. Of them, only 1% can hope to access comprehensive universal drug sensitivity tests, as just six of the 37 countries (18%) have introduced the necessary policies.
TB is the most common cause of death among people living with HIV, more than 28 million of whom live in the 37 surveyed countries. But a mere 14% of those countries have put policies in place that allow for the use of lateral flow urine lipoarabinomannan assay (LAM) testing for TB, which has been internationally recommended since 2015. This leaves more than 17 million people living with HIV without access to a rapid, affordable and life-saving TB diagnostic tool.
There is, however, some positive news on diagnostics policies. Countries made progress on certain key indicators since 2017 when the last report in this series was published. For example, 80% of surveyed countries—with more than 1.5 billion inhabitants—indicate that they are now able to use rapid molecular TB tests as the initial test for people with symptoms of TB, finally moving away microscopy. However, most countries do not seem to have implemented this policy at scale; this should be a priority.
Alarmingly, when it comes to treatment, nearly 39% of countries are likely to still use injectable medicines to treat drug-resistant TB (DR-TB) among adults, having failed to update the relevant policies in line with the latest international guidance. STBP calls for an immediate halt to the use of TB treatment involving injectables; oral medicines should be used instead, as recommended by WHO since 2018.
