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Readiness and early response to COVID-19: achievements, challenges and lessons learnt in Ethiopia

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Betty Lanyero, Zewdu Assefa Edea, Emmanuel Onuche Musa, Shambel Habebe Watare, Mayur Lalji Mandalia, Martin Chibueze Livinus, Faiqa Kassim Ebrahim, Abiy Girmay, Aggrey Kaijuka Bategereza, Aschalew Abayneh, Boureima Hama Sambo, Ebba Abate


Declaration of the novel coronavirus disease as a Public Health Emergency of International Concern necessitated countries to get ready to respond. Here, we describe key achievements, challenges and lessons learnt during the readiness and early response to COVID-19 in Ethiopia. Readiness activities commenced as early as January 2020 with the activation of a national Public Health Emergency Operations Centre and COVID-19 Incident Management System (IMS) by the Ethiopian Public Health Institute. The COVID-19 IMS conducted rapid risk assessments, developed scenario-based contingency plans, national COVID-19 guidelines and facilitated the enhancement of early warning and monitoring mechanisms. Early activation of a coordination mechanism and strengthening of detection and response capacities contributed to getting the country ready on time and mounting an effective early response. High-level political leadership and commitment led to focused efforts in coordination of response interventions. Health screening, mandatory 14-day quarantine and testing established for all international travellers arriving into the country slowed down the influx of travellers. The International Health Regulations (IHR) capacities in the country served as a good foundation for timely readiness and response. Leveraging on existing IHR capacities in the country built prior to COVID-19 helped slow down the importation and mitigated uncontrolled spread of the disease in the country. Challenges experienced included late operationalisation of a multisectoral coordination platform, shortage of personal protective equipment resulting from global disruption of importation and the huge influx of over 10 000 returnees from different COVID-19-affected countries over a short period of time with resultant constrain on response resources.

Summary box

  • Operational readiness to respond to an emergency is a critical element of the emergency management cycle.

  • The setup of an incident management system (IMS) to support readiness actions for an emergency. Ordinarily, an IMS is set up to support response activities; however, in this situation, it was set up to support readiness actions given the imminent threat of importation of COVID-19.

  • High level of political commitment to coordinate response actions enabled a progressive multidisciplinary engagement of non-health sectors and private partnerships such as education, trade and industries, transport, culture and tourism and law enforcement bodies.

  • Multisectoral collaborations and private partnerships have been vital to getting the country ready. Efforts to strengthen and maintain the collaboration and partnership are encouraged Strengthening country core capacities for health emergencies including pandemics in line with the International Health Regulations is essential.