SUPPORT ETHIOPIA INSIGHT .wpedon-container .wpedon-select, .wpedon-container .wpedon-input { width: 200px; min-width: 200px; max-width: 200px; } How the doctors’ strike exposed Ethiopia’s broken systemA nationwide doctors’ strike in Ethiopia, now in its fourth week since beginning on 13 May, marks an unprecedented moment in the country’s political and social history. Rarely do we see such unity, in a nation riddled with ethnic division. But doctors across the country have joined forces, defying threats and arrests, and refusing to be silenced.Their bold move has unsettled the government, challenged its authority, and raised fears of a ripple effect: other public servants may follow their exampleThis isn’t just about pay. It’s about principle. What began as a call for fair wages is rapidly becoming a broader demand for dignity, justice, and reform. The regime’s discomfort reveals how directly these protests challenge the political status quo.Basic DemandsDoctors are demanding what many would consider fundamental work principles: fair wages, adequate tools, and decent working conditions. The current monthly salary for general practitioners reportedly ranges between 10,000 to 15,000 birr, or roughly $70 to $100. Specialists earn only slightly more. The doctors want a $1,000 monthly starting salary, a figure reflecting the investment in their education and the real cost of living. The strike is not just about money; it is also about worsening work conditions. Most work without adequate supplies, basic medicine, or protective gear. A 2025 study by ActionAid found that 95% of healthcare workers lack essential tools. In conflict zones such as Amhara region, government forces have reportedly destroyed clinics, targeted medical personnel, and carried out attacks on civilians. Doctors offering humanitarian care risk harassment, arbitrary detention, and even extrajudicial execution.Legal Protections Beyond wages and working conditions, doctors want safety. Even before the strike, security forces had mistreated physicians. Since the walkout began, over 200 healthcare workers have been detained. Some have faced harassment; others have been forcibly removed. There have even been deaths. Legal safeguards and freedom from political interference form part of their demands.They want health institutions to be autonomous, run on merit rather than ethnicity. They want the right to professional development, including taking international medical exams in Ethiopia, just as doctors do in Uganda or Kenya. And, importantly, they want the same basic services they provide to be accessible to them: affordable housing, healthcare for their families, and protection from public smearing by state media.These demands paint a picture of a broken system: politicized, neglected, and starved of resources.Fair Pay Logic The doctor’s demands are economically fair and ethically sound. Globally, doctors are among the best-paid professionals for good reason. Medical training involves years of sacrifice. Human capital theory backs higher pay for such careers due to the long-term investment required.Philosopher John Rawls goes further: inequalities in pay are justifiable when they benefit the most disadvantaged. Who better fits that bill than doctors treating the sick and poor? Factor in the physical and emotional stress, exposure to disease, and risks in conflict zones, and the call for better pay becomes unassailable.Yet in Ethiopia, doctors earn far below the average salaries of doctors elsewhere.Poverty-Line ProfessionalsThe numbers are damning. Ethiopia’s per capita income in 2025 is $1,678. A doctor’s average annual income? $1,124. That’s just 67% of the national average. In contrast, in countries like Uganda or Kenya, doctors earn several times more than the average citizen. In Somalia, it’s 28 times more.Worse still, Ethiopian doctors’ income falls below the global poverty line for lower-middle-income countries: $3.65 per day. Many physicians survive on just $3.12 daily. That’s less than what a coffee costs in many parts of the world.The problem is not only economic: it is moral, ethical, and ultimately political.Why are salaries so low? Several structural issues are at play.Ethiopia collects a low amount of tax revenue compared to peers like Kenya. This limits public spending, especially in health. Budget priorities also reveal skewed values: while funds flow to prestige projects, spending on basic services declines. Health expenditure has dipped below WHO recommendations and sits well under Sub-Saharan Africa’s average.Ethiopia’s sprawling bureaucracy and skewed wage structure are part of the problem.Recent governments have built an oversized bureaucracy, driven more by ethnic patronage. The result has been widespread overstaffing.With a weak private sector—just 15% of workers earn formal wages—the public sector ends up absorbing more employees than it can reasonably afford. To keep costs down, the government compresses salaries across the board. As a result, doctors—despite years of training and life-or-death responsibilities—earn barely more than junior clerks. The outcome is a demoralized workforce and a healthcare system struggling to retain its most vital professionals.State MonopsonyThe Ethiopian state functions as a virtual monopsony in healthcare employment. Private practice is limited and poorly developed. In 2023, public institutions delivered 80% of tertiary care. Without alternatives, doctors are trapped in low-paying government roles.This lack of competition suppresses wages. Monopsony, the flip side of monopoly, means the employer holds all the cards. Here, that’s the state.Ethiopia’s licensing system further isolates its doctors. As stated earlier, unlike peers in Ghana or Egypt, Ethiopian doctors can’t easily work abroad or take international exams. That barrier lowers their bargaining power and professional mobility.Their association provides very little help. The Ethiopian Medical Association is weak, government-aligned, and ineffective as a negotiating body. Ethnic federalism discourages solidarity across ethnic lines, and existing labor laws restrict union formation. The recent strike is largely grassroots, organized via social media.Inflation PainTo make matters worse, inflation is eating away what little doctors earn. With inflation soaring above 27% in 2024, real wages have plummeted. Prices rise, salaries stay flat, and essential goods take up an increasing share of income. The economic squeeze sharpens the crisis. Doctors work more, face greater risks, and earn less.The government claims it cannot afford pay increases. But the numbers tell a different story. One luxury government vehicle cost as much as 6 million birr—the equivalent of 50 years of a doctor’s salary. The new Chaka Project palace complex reportedly costs $10 billion. At the same time, 30% of the federal budget disappears each year through corruption and mismanagement—$4.5 billion this year alone.Redirecting even a fraction of that spending would allow Ethiopia to raise doctors’ salaries without strain. The problem is not revenue; it is priority.Politics Over PeopleSo why won’t the government budge? Because the issue is political. Meeting doctors’ demands could trigger a broader reckoning: teachers, civil servants, and others might call for fairness too. That threatens the authoritarian model. A single concession risks weakening the government grip over the entire public sector.Doctors, respected, educated, and widely trusted, pose a credible threat. They have united across ethnic lines. Recognizing their demands would legitimize cross-ethnic cooperation, which undermines a political system built on ethnic division.Anti-intellectualism also plays a role. Ethiopia’s leadership has shown hostility toward professionals—journalists, teachers, economists—who question authority. Doctors are just the latest target.Moment of UnityDespite repression, the strike has endured.Medical professionals from Tigray, Amhara, Oromia, and the Southern regions have acted in concert, underscoring the fact that poverty, inflation, state neglect, and professional humiliation are not confined to one ethnic group. This commonality of suffering—economic, institutional, and political—has created a rare moment of collective resistance that transcends ethnic identity.Even limited gains from the strike would mark a victory—not only for doctors, but for every Ethiopian who believes in fairness, dignity, and justice. This is more than a labor dispute. It is a call to rethink what Ethiopia could become. .wpedon-container .wpedon-select, .wpedon-container .wpedon-input { width: 200px; min-width: 200px; max-width: 200px; } Query or correction? Email us window.addEventListener("sfsi_functions_loaded", function(){if (typeof sfsi_widget_set == "function") {sfsi_widget_set();}}); While this commentary contains the author’s opinions, Ethiopia Insight will correct factual errors.Main photo: Medical Staff at Paulos Hospital Hold Protest in Addis Ababa, May 2025Published under Creative Commons Attribution-NonCommercial 4.0 International licence. You may not use the material for commercial purposes.The post Anatomy of Defiance: Ethiopia’s Medics Say Enough appeared first on Ethiopia Insight.