Tuberculosis in Ethiopia: The Epidemic We Forgot

Zebeaman Tibebu
Apr 9
5 min read

Tuberculosis (TB) is one of the oldest diseases known to humanity, yet it remains a leading infectious killer in the 21st century. Though COVID-19 may have dominated global attention as a respiratory illness in recent years, TB has been devastating communities since ancient times. Especially in Ethiopia, it remains a major public health crisis.

The Scope of the Crisis

Ethiopia is listed among the 30 high TB burden countries globally by the World Health Organization (WHO). In 2022 alone:

An estimated 151,000 people developed TB in Ethiopia.
Around 23,000 people died from the disease — that’s over 60 deaths per day.
Roughly 27,000 cases involved children under 15.
Nearly 12,000 cases were estimated to be drug-resistant TB, with 1,200 confirmed as multidrug-resistant (MDR-TB).
An estimated 20–25% of TB patients were co-infected with HIV, significantly complicating treatment.

But here is the paradox: TB is curable

So, why is Ethiopia losing 60 persons per day?

Because TB is a master of disguise. It’s more than just an infection — it’s a great masquerader. It can not imitate many other illnesses and often goes unrecognized. Even worse, it can lie silently in the body for years as latent TB.

In fact, millions of Ethiopians are living with Latent TB, waiting for the immune system to weaken. Stress, malnutrition, or chronic illnesses (like HIV) will trigger a strike. That is why it is common among debilitated/ weakened individuals. It’s not a new infection — it’s the old enemy returning.

We must understand this: TB is not only a health issue but also a socioeconomic one. It affects the poorest and most vulnerable, often those living in overcrowded homes, malnourished, or with limited access to healthcare. It is a disease rooted in inequality.

Understanding TB: The Biology

TB is caused by the bacterium Mycobacterium tuberculosis. It primarily affects the lungs, but it is capable of attacking virtually any organ. It is mostly spread through airborne particles released when an infected person coughs, sneezes, or speaks.

The good thing is that not everyone who is infected becomes sick. However, one infected person will spread the bacteria to 4 individuals living around him.

Common Symptoms of Respiratory TB include:

🤧 Chronic cough (lasting 2+ weeks)

🌙💦Night sweats

🌡️ Fever and chills

😓 Fatigue

⚖️ Weight loss

🫀 Chest pain and coughing blood (in severe cases)

Why Is TB Still So Prevalent in Ethiopia?

Despite its preventable and curable nature, TB still thrives in Ethiopia. Why?

1. Limited Access to Healthcare

Despite improvements in primary health care coverage, rural and remote communities often lack TB diagnostic labs and trained personnel. Hence, many people are diagnosed late. By then, they’ve already infected others.

2. High Burden of HIV

The burden of HIV in Ethiopia is relatively High. TB often coexists with HIV. It is the leading cause of death among people living with HIV.

3. Multidrug-Resistant TB (MDR-TB)

Due to inconsistent adherence to TB medication, there is a rise in MDR-TB in Ethiopia, which is becoming a major threat in Ethiopia. This happens mostly due to poor health literacy, long treatment duration, or drug run-outs (stock-outs). The management of MDR-TB is more costly and less effective with even more side effects. Hence, the treatment gets complicated.

4. Stigma and Misinformation

There is widespread misinformation about TB disease and its management prevalent among the community. This misinformation breeds mistrust in the healthcare system, in the diagnosis, and the medications themselves. Hence, patients will be reluctant to seek care or lack the commitment to adhere to the medication.

The problem goes even deeper. There is a stigma or social exclusion following the diagnosis of TB. It implores the patients to deny their illness, skip follow-up visits, or abandon treatment.

5. Urbanization and Internal Displacement

The urbanization and rapid population growth visible in contemporary creates slums, and overcrowding. These conditions, alongside the displacement due to conflict or drought, have created fertile ground for airborne diseases like TB.

Progress Made — But Not Enough

Ethiopia has made commendable progress

DOTS (Directly Observed Therapy, Short-course) has been scaled nationwide since the early 2000s.
The treatment success rate stands at 88%, which is above the global average after our treatment strategy.
TB diagnostic and treatment services are virtually found at the Health center level.
Community Health Extension Workers (Health Army) have brought awareness and referrals closer to the household level.

Despite these progresses, the TB case detection remains below the global target. Still, a fifth of the cases are undiagnosed or unreported.

The Good News? Ethiopia Has a Plan. A Bold One.

The Federal Ministry of Health, under the National Strategic Plan (NSP) 2021–2026, has launched a powerful vision to beat TB once and for all.

Here’s what Ethiopia aims to achieve by 2026:

✅Reduce TB incidence from 151 to 91 per 100,000 population.

✅Cut TB deaths from 22 to just 7 per 100,000.

✅Lower catastrophic TB-related costs to ≤ 25% of affected families.

✅Increase DR-TB treatment coverage from 46% to 90%.

✅Raise DR-TB treatment success from 72% to 80%.

To achieve these goals, the Ethiopian Federal Ministry of Health has rolled out a smart, people-centered plan. From door-to-door care and faster testing to one-stop TB/HIV services and engaging all healers (including religious and traditional healers). TB prevention is being prioritized in high-risk settings like schools, prisons, and refugee camps. No one is left behind.

The focus is on reaching high-risk areas, making drug-resistant TB treatment fair and accessible, and using real-time data and local innovation to stay ahead.

Remember this Is Not Just a Government Problem. It’s a National Mission.

Every Ethiopian can play a role in ending TB. Your role includes:

🫁If someone has a cough that has lasted more than two weeks, encourage them to get tested.🔬

🤝If a friend has TB — support them while protecting yourself from TB 💊

📢🏫If you're part of a school, mosque, business, or social groups — share TB facts. 🕌

🌐📲If you're online, talk about it. Make TB visible. Share this post.🌐💬

Last Stop: The Fight is Winnable

TB is not a mystery — we know how it spreads, how to diagnose it, and how to cure it.

Ethiopia has the infrastructure, the policy framework, and the momentum to eliminate TB. This can be achieved only if efforts are sustained, scaled, and supported by the public.