Part I: Poverty Wages
By Worku Aberra
(To make it more convenient for readers, the article will be released in three installments)
Introduction
The nationwide strike of doctors that began on May 13 has now entered its fourth week, with no resolution in sight. It is the first such action by professionals in Ethiopia’s recent history and stands as a rare moment of unity in a divided polity. Despite the government’s attempt to divide the doctors, they have maintained a common position in defiance of the country’s ethnically fragmented political system.
The strike is historically significant. Its scale, duration, and unity set it apart from previous labor actions. It directly confronts an authoritarian government and has withstood threats, intimidation, and the imprisonment of its leaders. Public support remains strong, and the strike has come to symbolize the power of collective resistance.
The government is unsettled. It cannot meet the doctors’ salary demands primarily because of political risk. Officials fear that the strike might encourage other public sector workers and weaken political control. The strike carries political weight: when professionals unite around principle, their message exceeds wages and working conditions. What unsettles the regime most is the shift from economic grievance to political defiance.
Salaries and Workplace Demands
The doctors’ demands—adequate pay and functional working conditions—reflect the minimal requirements for professional service delivery. Their salaries have collapsed in real terms, making their demand for higher wages a demand for basic subsistence. Unless their essential needs are met, it is unrealistic to expect them to deliver essential care.
Physicians have demanded a starting salary of $1,000 month, consistent with their training and living costs. Today, most general practitioners earn only 10,000 to 15,000 birr—roughly $70 to $100 USD—while specialists earn marginally more. Doctors also request timely overtime payments and targeted allowances for housing, service in remote areas, and occupational hazards, especially for those harmed while treating others.
The medical system offers neither fair compensation nor the tools required to deliver healthcare services. Doctors face growing difficulty in performing basic tasks because of chronic shortages of equipment and medication. According to a 2025 study by ActionAid, 95% of Ethiopian healthcare workers reported an absence of essential supplies. They are not simply requesting better pay; they are insisting on the ability to serve patients without institutional obstruction, material deprivation, or personal risk.
Political interference and threats to personal safety compound the crisis. In regions affected by conflict, the situation is even more dire. In Amhara region, government forces have reportedly destroyed clinics, targeted health workers, and attacked civilians, according to Human Rights Watch. Crops have been burned, livestock slaughtered, and schools razed. The war between the military and Fano has severely damaged public health. Doctors who attempt to help face harassment, detention, or extrajudicial killing.
Their demands are not aspirational. They are existential. A starving doctor, stripped of medicine and hounded by security forces, cannot save lives. The strike is not a rejection of duty, but a defense of the conditions required to fulfill it.
Institutional and Legal Demands
Equally urgent is the need for legal protection. Since the strike began on May 13, 2025, more than 200 healthcare workers have been arbitrarily detained, according to Amnesty International. Doctors have been harassed, summoned for questioning, and removed from their posts—in some cases, killed before or during the strike. Under these conditions, demands for safety and legal redress are not only legitimate but necessary.
The doctors also seek structural reform. They demand greater autonomy for health institutions, free from political intervention. Leadership based on merit rather than ethnic affiliation remains central to their demands. They are also calling for safeguards against public defamation by state media and officials, who have dismissed the strike as unethical, unprofessional, and unpatriotic, according to Amnesty International.
In addition to better pay, better working conditions, and personal safety, doctors want their basic social needs met. They are asking for free healthcare for themselves and their families, as well as long-term access to low-interest housing loans or subsidized accommodations. These requests reflect the fact that many doctors struggle to access the very services they provide, even as senior government officials enjoy such benefits despite earning more.
Finally, doctors are calling for investment in professional development. This includes access to international medical examinations and certifications within Ethiopia, which would allow international recognition and career mobility, as in countries like Uganda and Kenya.
Taken together, these demands expose a healthcare system in crisis: underpaid, overburdened, neglected, and politicized. This is not merely a labor dispute; it is a national reckoning over the value of healthcare and public service.
The strike may constitute a turning point in Ethiopia’s political trajectory. Physicians from almost all regions and ethnic groups have united in demanding dignity, safety, and institutional reform. The solidarity they have established could extend beyond the medical profession; it could mobilize other workers and the broader public.
Theoretical Justification for Adequate Salaries
There are economic and social reasons why doctors should be paid adequately. In nearly every country, they rank among the highest-paid professionals, a reflection of their vital role and the broad consensus that they deserve appropriate compensation.
From an economic perspective, mainstream human capital theory provides a compelling rationale. Individuals who pursue medical careers incur high opportunity costs, foregoing income, investing in education, and sacrificing years of training. Economic reasoning holds that they should receive higher wages to reflect this investment and to maintain incentives for others to enter the profession.
A second rationale comes from philosophical reasoning. The philosopher John Rawls, for example, argues that income disparities are justifiable if they benefit the least advantaged members of society. In this context, higher earnings for doctors are defensible because their services—preserving life, treating illness, and promoting health—deliver benefits to those most in need.
The third justification is based on the risks and working conditions that healthcare workers face. They regularly endure physical and psychological strain, exposure to disease, and, in some settings—such as conflict zones—threats to their safety . This rationale draws on the concept of compensating wage differentials: those exposed to hardship or danger deserve higher pay. The combination of personal risk and demanding work reinforces the case for paying doctors more than the average worker.
Because of these reasons, doctors are typically paid well above the national average income. This global pattern is not universal—but where it breaks down, as in Ethiopia, it signals a deep departure from economic logic and ethical norms.
Medicine as a Poverty-Wage Profession
To assess the relative income of doctors, their average earnings can be evaluated against a national benchmark, for example, per capita income. In April 2025, the World Bank reported Ethiopia’s per capita income to be $1,678. When compared to this figure, the income of medical professionals reveals a substantial disparity. Based on an average monthly salary of 12,500 birr and using the official exchange rate of 133.42 birr per US dollar on April 30, 2025, a doctor’s annual income amounts to $1,124.27, 67% of the national average. Few professions so vital are compensated so poorly anywhere in the world.
Most countries pay doctors multiple times the national average, reflecting their skill and responsibility. Ethiopia defies that pattern. The state’s compensation system undervalues health professionals, revealing a public-sector model that fails ethically and economically. A look at regional comparisons highlights how far Ethiopia has fallen behind.
Comparative Earnings of Ethiopian Doctors
| Country | Annual Doctor Salary (USD) | GDP per Capita (USD) | Doctor Salary as % of GDP per Capita |
| Ethiopia | $1,124 | $1,678 | 67% |
| Kenya | $12,780 | $2,470 | 517% |
| Uganda | $10,540 | $1,340 | 787% |
| Tanzania | $7,043 | $1,270 | 555% |
| Somalia | $21,600 | $766 | 2820% |
Author’s calculation based on the following sources
Salary: Medical Doctor in Addis Ababa, Ethiopia 2025
World Development Indicators | DataBank
To compare the average earnings of Ethiopian doctors to those of neighboring countries, data were obtained from the World Bank, ExchangeRate.org, and Glassdoor. These sources are used to construct the table above.
The table shows that Ethiopia is a regional outlier. With an average annual salary of $1,124, its doctors earn only 67% of per capita income, a reversal of global norms. In Kenya, doctors earn 517% of the national average. In Uganda, the figure rises to 787%. In Somalia, it reaches 2,820%, presumably because of the high risk of working in that country. These disparities reflect policy decisions, not economic constraints.
The reversal of income norms becomes even more stark when assessed against global poverty standards. The World Bank sets the international poverty line for lower-middle-income countries at $3.65 per day. Various sources indicate that the average monthly salary of a medical doctor in Ethiopia ranges between 10,000 and 15,000 birr. Using 12,500 birr as a representative figure, and applying the official exchange rate on April 30, 2025, this amounts to just $93.69 per month, $3.12 per day.
That figure falls below the World Bank’s poverty threshold. By international standards, many Ethiopian doctors—despite extensive training and essential public responsibilities—remain economically marginalized. Their daily earnings, in some cases less than the cost of a cup of coffee in North America, underscore the severity of professional deprivation and a persistent pattern of governmental neglect.
The salaries of doctors in Ethiopia suggest deliberate policy choices. A doctor earns less than the average citizen, far less than peers across the region, and below the international poverty line. This wage structure demoralizes the workforce, triggers professional exit, and degrades the quality of care. In global perspective, Ethiopia’s treatment of medical professionals is economically incoherent and ethically indefensible.
Worku Aberra is a professor of economics at Dawson College, Montreal, Canada.
Editor’s Note : Views in the article do not necessarily reflect the views of borkena.com
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