Interview of Dr. Meseret Zelalem Tadesse, the Lead Executive Maternal, Child and Adolescent Health in the Ministry of Health of Ethiopia. Dr. Zelalem is engaged with several advisory boards at national and global levels, including WHO Technical Advisory Team for the African region. Prior to her current role, she served as the Chief of Staff in the Office of the Minister at the Ministry of Health and the Medical Director of the Gondar University Hospital, as well as the Chair of the University Institutional Review Board, among other positions. Dr. Zelalem obtained her Medical Degree and specialty in Paediatrics from University of Gondar, where she was recognised as a best female leader in the student graduation ceremony.
1. What are the greatest health impacts of climate change that you are witnessing in Ethiopia?
Climate change is not only affecting Ethiopia, but it hugely affects the global community. The climate has really changed, we can definitely observe it. Whether it is directly or indirectly, climate change affects our health and wellbeing, because of the extreme weather events, such as extreme heat, rising sea levels, floods, extreme rains, storms and locust invasions.
These climate change-induced natural disasters are directly related to our livelihood. They affect our food security and the entire food system, as well as the availability of clean water. Increasing rates of waterborne, tropical infectious and vaccine preventable diseases can also be attributed to climate change as they increase when floods, droughts and displacement occur. Climate-induced displacement can also have a strong impact on health service delivery, for both the host and the displaced community.
The delivery of healthcare services can be greatly impacted by the lack of clean water, sanitation and electric power, which are often the consequences of extreme weather events. Those majorly affected are breastfeeding mothers, pregnant women and children under five-years-old. Power outages can have a strong impact in health service delivery, especially in reproductive health.
2. Can you share some concrete policy actions that have been put in place in Ethiopia, which have had a significant impact in tackling both health and climate change issues?
My government, especially in the health sector, is already formulating policies and developing strategies to overcome the health impacts of climate change. This issue is well addressed and articulated in Ethiopia’s plans, including the 10-year development plan, a health sector development plan and a national adaptation plan.
When climate change-induced natural disasters occur, sexual and reproductive health (SRH) services are hugely impacted. We work hard to ensure that reproductive health services are delivered to those in need, by better linking the development and emergency nexus. We give due priority to the delivery of minimum service packages for SRH and also provide shelter, protection, water, food and clothing. We work closely with UN agencies to provide menstrual hygiene management services, which is an important component for protecting girls and women.
The Ministry of Health is working closely with other sectors, including agriculture, water, energy and, especially with the National Disaster Risk Commission. We are also using renewable energy, in particular to increase access to vaccine refrigerators in lowland and hard-to-reach areas in Ethiopia.
Beyond the emergency response, we need to better implement our national adaptation plan to ensure we mitigate the impacts of climate change on health, to ensure we have climate resilient SRH services, climate-resilient health care centres and research centres. We must proactively design climate policies in our development agenda, not only address it as an emergency.
We are taking great opportunities that the government is providing, such as the Green Legacy Initiative, rooted in a vision of building a green and climate-resilient Ethiopia. The Initiative targets planting 20 billion seedlings during a four-year period, at the beginning of the rainfall season. This is one of the commendable actions that my government is taking, in line with the global and regional commitments, that is supporting our mitigation efforts. This flagship initiative is at the top of the national agenda and it is being implemented at all levels, with highest political leadership and community mobilisation. It is important to better connect the nexus between reproductive, maternal, newborn, child, adolescent and youth health and climate change, especially because these are the segments of the population that are most affected.
3. This year, for the first time, COP28 will have an official day dedicated to health. What do you expect from this day? What would success look like for you?
I greatly appreciate the fact that there will be a day dedicated to health, this is a big success, a big point of departure. I expect that health will be prioritised in the climate agenda because we cannot separate health from climate action, or health from climate impact. We can better respond to climate change as a whole-of-government approach, and I feel health can be the denominator, the centre of gravity for dialogue. Whatever the case, the impact of climate change is absorbed by the health care system.
Therefore, I expect that Heads of States and Governments to be more committed to zooming into health, into the key elements impacting health. At this critical point in time, climate change is one of these key impacting elements. I expect a pledge, a political commitment from Heads of State and Government to give due attention to health. More funding should also be expected for mitigation, and to respond proactively through a whole-of-government approach.