Review

Interview with USAID mission Director Dr. Denis Weller

The American people, through the U.S. Agency for International Development/USAID, have provided economic and humanitarian assistance worldwide for over 50 years. USAID is a leading convener of public and private sector stakeholders promoting financial inclusion and technology that has the potential for transforming development outcomes. Dennis Weller assumed leadership of USAID Ethiopia on August 31, 2012. Weller was USAID mission director in Rwanda since 2008 where he led USAID’s programs in health, HIV/AIDS and malaria; economic development; and democracy and governance. A career Foreign Service Officer, Weller most recently served as deputy director of the Agency‘s mission in Ghana, where he administered four U.S. presidential initiatives to alleviate hunger, improve education, increase growth and trade, and fight malaria.

Weller has 25 years of experience with USAID, including work in Burma, Pakistan, Kenya and Iraq. Much of his work has focused on providing emergency food aid and improving agricultural growth to avert hunger and ensure economic development. He began his career as a Peace Corps Volunteer in Malaysia. Pharmanet magazine happened to have an interview with Denis Weller on aspects related to USAID. Please follow us

 

 

  1. Pharmanet: As we all know, before you came to Ethiopia you have been working as USAID Mission Director in Rwanda since 2008 where you led USAID’s programs in health, HIV/AIDS and malaria economic development; and democracy and governance. Can you just share your experience and challenges as well as opportunities when you were in Rwanda?

 

Rwanda has many similarities to Ethiopia-leadership and vision, a clear development and growth strategy, and annual sectoral plans with ambitious, but achievable targets. In both countries, there has been strong government ownership in is development pathway and meaningful interaction with development partners. In Rwanda, child mortality was cut in half during the most recent five-year survey period. When I arrive in 2008 we were importing food aid, and when I left in 2012, food aid was no longer needed since Rwanda had become an exporter of food, I see similar progress in Ethiopia, despite the complexity of its much larger size, varying agro-climatic zones, and multi-cultural/ linguistic diversity.

 

  1. Pharmanet: For Many of Us ‘’The United States Agency for international Development (USAID)’’ is the United States federal government agency primarily responsible for administering civilian foreign aid. What about for you, Sir?

 

For me, USAID plays a vital role in American foreign policy and in building relationships with partnering countries. Since USAID’s inauguration in 1961 many goals and accomplishments have been realized around the world:

 In the past 50 years, infant and child death rates in the developing world have been reduced by 50 percent and health condition around the world have improved more during this period then in all previous human history.

In the 28 countries with the largest USAID-sponsored voluntary family planning programs, families have had the knowledge and commodities they need to reduce the average number of children in the their families from 6.1 in the mid-1960s to 4.2 today.

Since 1987, USAID has initiated HIV/AIDS prevention programs in 32 countries, and is the recognized technical leader in the design and development of these programs in the developing world. Over 850,000 people have been reached with USAID HIV prevention education, and 40,000 people have been trained to support HIV/AIDS programs in their own countries.

USAID child survival programs have made critical contributions to a 10 percent reduction in infant mortality rates worldwide in just the past eight years.

I am proud to work for an organization that has such admirable goals as eliminating malaria, an AIDS-free generation, reducing maternal and child mortality, improving incomes and livelihoods through agricultural growth, improving reading and school attendance, and more. We at USAID are committed to helping people all over the world, including Ethiopia, live healthy and productive live.

 

  1. Parmanet: with a population of 84 million, 83% of which live in rural and often remote areas, the challenges of effective health service delivery in Ethiopia are substantial. Almost half of the population is under the age of 15 (45%) and some 25% of the population is women of reproductive age. While the maternal mortality rate (MMR)is going down, due to the significant efforts of the Government of Ethiopia (GOE)and Development Partner (DPs), it is not yet going down fast enough to reach the goal of MIDG5 in 2015. Dennis is there any immediate plan to facilitate this effort on the next two years.?

 

The Ethiopian Government has a plan to improve progress toward MDG5 of which USAID is very supportive. Activities which we support include training additional midwives rolling out a new neo-natal sepsis prevention and treatment intervention that also addresses the health of mothers; and continued funding of government’s rapid expansion of long-term and permanent methods of family planning. In addition, through the President’s Malaria initiative, USAID has supported maternal and child health with interventions such as the introductions of the Rota- virus and pneumococcal vaccines, as well as seen significant reduction in mortality from malaria overall- specifically in children under5.

 

  1. Pharmanet: Last year when President Obama unveiled his fiscal year 2013 budget proposal to cut $ 563 million from the President’ Emergency Plan for AIDS Relief (PEPFAR) program. Global tuberculosis also saw a reduction of 10 percent, with a proposed budget request of $224 million compared to this year’s budget of $249 million cuts of this magnitude could lead to half a million people being denied lifesaving treatment, and counties preventable new infections. What is your belief?

 

in Ethiopia, PEPFAR does not procure the antiretroviral drug for HIV and AIDS patients. This cost is supported by the Global Fund to Fight AIDS, Tuberculosis, and malaria. So even if PEPFAR funding were to be reduced in Ethiopia, critical activities would still continue, and patients would continue to receive medications. The US Government continues to be committed to supporting HIV and AIDS related activities. For tuberculosis, despite cuts in overall funding, USAID Ethiopia’s funding, USID Ethiopia’s funding has increased for fiscal year 2013.

 

  1. Pharmanet: USAID launched a new program called ‘pastoralist areas resilience improvement and market expansion (PRIME)’’ to support pastoralists in Ethiopia. Sir, is there any New Health related project or grant intended to enhance the Community by 2013?

 

There are several health related programs that we hope to launch soon; please stay updated by visiting the federal business opportunities website https://www.fbo.Gov/.

 

  1. Pharmanet: U.S. Agency for international Development works mainly in partner with government by there are a lot of privet sector who had their own strategies and vision to alleviate the current Health challenges of the country. Did USAID have a plan to work directly with the private sector?

 

USAID has engaged significantly with the privet sector and will continue to do so. USAID Ethiopia has developed a Privet sectors Development strategy, which centers on establishing the required ‘’enabling environment’’ to fully promote and sustain economic growth. Within this strategy, privet sector projects will promote the development of public and privet sector actors in the target reform areas of finance, trade, and business capacity. USAID’s strategies are in full alignment with the policy and investment Framework (PIF) AND THE Growth and Transformation Plan. Here are a few example of how USAID programs are working specifically with private entities in the health sector:

  • The USAID Private Health Sector Program (PHSP) works in partnership with the Ministry of Health and regional health bureaus to enable privet health providers to deliver public health services and improve affordability and quality. PHSP assists in strengthening government partnership with privet health service providers through activities in supportive supervision; licensing and accreditation; improving client education and awareness of services available throuth the privet sector; and strengthening referral mechanisms between health providers, both public and privet. The program takes an integrated health systems strengthening approach that values both the public and privet sectors as important elements of the national health system.
  • In addition, since 2004, USAID has worked to improve access to finance and credit through the Development Credit Authority (DCA), a loan portfolio facility. the facility is shared by several commercial banks, Awash International Bank, Zemen Bank, Bank of Abyssinia, Dashen Bank, and NIB international with a 50 percent credit guarantee from USAID . the DCA encourages growth of the private sector and microenterprises by increasing access to short-term marketing credit and medium- term investment capital for small and medium business activity in the health sector. With funding provided by the U.S Government, the DCA will increase lending to privet health sector enterprises enabling providers, particularly those providing HIV/ AIDS and TB

Services, 

 

  1. Pharmanet: is there any Health project or an accomplishment that you are most impressed?

USAID: We have had many successes that we are very proud of. Here are a few examples:

 

The USAID Health Care Finance Reform project, recently completed, successfully enhanced the quality of essential health services through reform and institutionalization of a sustainable health financing system that accommodates alternative financing and management mechanisms. The project worked closely with regional governments, and as a result, 90 (88%) hospitals and 2,151 (79%) health centers in the country are related income generating schemes. Eighty- seven (96%) of the hospitals and 1, 738 (81%) of the health centers used the retained revenue to improve equity and quality of health services. Thirty –eight hospitals have established privet wings as a scheme. To provide efficient services and retain health care providers. The program allowed health facilities to renovate existing facilities, construct additional service provision rooms, and to purchase drugs, pharmaceuticals, and medical supplies, all of which improved the quality of essential health services, increased local ownership, and improved health outcomes at large. A follow- on health sector finance reform program began implementation in August 2013 and will build upon these achievements to further expand access to and quality of essential health services.

To improve access to healthcare across Ethiopia, USAID has supported the training of more than 5,000 health officers through the Government of Ethiopia’s accelerated health provider training programs. These health officers serve as front- line health care providers as well as health service managers in new and renovated health facilities throughout Ethiopia. USAID’s new Human Resources for Health flagship project is working on strengthening the healthcare provider training system as a whole, while supporting accelerated training for the critical carder of mind wives and nurse anesthetists.

 The 2011 Ethiopian Demographic and Health Surveys (EDHS 2011) shows that the contraceptive prevalence rate has almost doubled over the last five years, from 15to 29%,with a decrease of unmet need in family planning from 34% to 25% and a decrease of the total fertility rate from 5.4 to 4.8 children per woman. USAID intervention have significantly contributed to these improvement through our integrated family planning/ reproductive health and maternal and child health service provision throughout Ethiopia as well as other activities.

The government of Ethiopia is a co-convener of the global leader in reduction of under-five mortality; with a 28% decrease in under-five mortality over the past five years (EDHS 2005 and 2011).Ethiopia has not only led efforts to improve child survival, but also attained impressive results. On September 13th 2013 it was announced that Ethiopia achieved MDG4_lowering the number of under five-deaths from 204 per 1,000 live births in 1990, to 68 in 2012, a 67 percent reduction. USAID’s support to the health Extension Program contributed to this achievement through our programs which help to improve integrated management of childhood illnesses, nutrition education, water, sanitation, and hygiene, and immunization rates in rural Ethiopia.

Due in part to the contribution of the U.S President’s Malaria initiative, malaria in- patient admissions of and deaths have declined by threefold (averaging 6.4/10,000 and 2.3 per 100,000per year respectively) between the period of 2005 -2009. Further, the percentage of children under age five with fever who accessed medical care within 24 hours increased from 15% in 2006 to 51% in 2011, significantly contributing to the decline in under- five deaths.

USAID also provides support to Ethiopian’s orphans and vulnerable children strengthening social welfare systems, improving access to social services for OVC and their families and managing data on the wellbeing of vulnerable children. The USAID Yekokeb Berhan Program for highly vulnerable children (HVC) has decreased the number of destitute families among 50,558 households in five regions by 48 percent. From October 2012 to March 2013, 476,490 HVC received at least one care service of seven government standard service areas which is 95% of the total enrolled in the program. In addition about 15,000 HVC were in school this year that were not registered last year. Coordination of care is key to addressing the multifaceted needs of HVC and their families, and Yekokeb Berhan works to ensure that both groups receive age-appropriate, inclusive services, and that children participate in decisions that affect their lives. Linkages are very important in ensuring that HVC access services they need and in the last quarter 40,068 formal referrals were documented and followed –up.

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  1. Pharmanet: Ethiopia is obviously a very strategic country for United States. Can you talk a little about not only its influence in the region, but also about its relationship as an important U ally?

 

Since its inauguration in 1961, USAID has been working with the Ethiopian government. The U.S. Government, through USAID, has associated the Ethiopian government’s development program in numerous activities in the fields of agriculture, Health, Education, relief and rehabilitation, Industry, transportation, public safety and public administration, community development, social welfare and housing, communications, media and private enterprise. From 1951 through September 30, 2011, the U.S. Government provided, through USAID, approximately $10 Billion in economic assistance to Ethiopia (in constant dollars). Ethiopia is important to the success of U.S. initiatives in the greater Horn of Africa because of its size, location, and potential. Ethiopia has been a key player in working with its neighboring countries to prevent conflicts and improve overall food security, in order to avoid the crisis of drought and war which have plagued the Horn. As a result of the enduring collaboration and partnership between our two governments, Ethiopia remains an important U.S. ally.

 

  1. Pharmanet: I know we have been seeing real progress in food security and health. But what are some of the challenges you’re facing? It could be political or non political …

 The global economic downtown has certainly been a challenge for every USAID mission and here in Ethiopia’s well. However, while growth has stalled in many developing countries, Ethiopia has seen an incredible amount of growth in its GDP over the last few years. This is very encouraging and certainly a great indication of Ethiopia’s potential to reach its economic and social development goals.

Pharmanet: Thomas Staal was USAID mission director in Ethiopia before he left to IRAQ. Is there anything you want to share about him?

 Mission Director Staal provided excellent leadership to USAID in Ethiopia and I am thrilled to be working with our great team of professionals here at the Mission and Wish Mr. Staal all the best during his tour in Iraq.

 

  1. Pharmanet: Last year President Barck Obama was planning to Cut PEPFAR budget, Can you tell us little about it?

I believe this question was addressed above.

 

  1. Pharmanet: Sir, Do you have any Final Message?

Thank you for this opportunity to share what USAID is doing in Ethiopia and what some of our Successes are as we work together with the Ethiopian Government, and Ethiopians to improve and save lives.

I believe that a simple and unassuming manner of life is best for everyone, best both for the body and the mind.

Albert Einstein

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