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This case study illustrates Eritrea's progress in health. The story describes the nature of the progress, analysis of the factors that have contributed to progress and lessons for policy makers.

Two-thirds of Eritrea’s population lives below the national poverty line, and the vast majority in rural areas. The rugged topography and harsh climate, coupled with the 30-year war of independence, have led to widespread economic hardship and food insecurity. The government maintains a policy of economic autarky, while restricting free enterprise and tightening its control over both the economy and society in general – an approach that has led to accusations of authoritarian and even dictatorial rule.

Nonetheless, Eritrea is one of the few countries expected to achieve the MDGs in health, in child health in particular. Infant and child mortality rates have reduced dramatically; immunisation coverage has rocketed; malaria mortality and morbidity have plummeted; and HIV prevalence has almost halved in a very short period.

This can be attributed to the high prioritisation of health and education and a strong commitment to development among Eritreans, as well as to innovative multi-sectoral approaches to health. Finally, in spite of highly centralised control and relative political isolation, government commitment and ownership have played a key role in successful health outcomes.