Objective This session aims at describing progress and challenges towards the achievement of MDGs in Ethiopia, in the context of the implementation of the fourth phase (2010/11-2014/15) of the national Health Sector Development Programme (HSDP IV). Rationale Ethiopia is making substantial progress towards the achievement of MDGs. In particular, a consistent decline was observed in under 5 mortality rate (from 204 to 88 per 1000 live births between 1990 and 2011, being on track to achieve MDG4 by 2015) as well as a general increase in coverage of key MDG-related interventions, with mixed progress in different areas. To explain these patterns, it is important to note that HSDP is focused on increasing access to primary health care and strengthening health systems. The key strategy is the implementation of the Health Extension Program (HEP), with over 34,000 female health extension workers (HEW) being already trained and deployed in health posts in rural areas, therefore reaching the complete coverage of the country. HEWs are the first point of contact of the community with the health system, delivering integrated preventive, promotive and basic curative health services, with a special focus on maternal and child health. While service coverage has improved over time, the performance has not been uniform across programs. Interventions that can be routinely scheduled, such as antenatal care and immunization, had much higher coverage than those that rely on functional health systems and 24-hour availability of clinical services, such as skilled care at birth. Therefore increasing service coverage and strengthening health systems are interrelated, and cost-effective interventions that can avert much of the burden of maternal and child disease and death require functioning health system to have an impact at the population scale. It is for this reason that HSDP IV is focusing on high-impact and cost-effective health interventions and on health systems strengthening. Progress has also been made in developing partnership and increasing resource mobilization and utilization. Health has moved over the years from underinvestment, to single disease focus, and now to increased funding, harmonisation between FMOH and partners, and a systemic approach. The key principle underpinning the process of harmonization and alignment is the establishment of “One-Plan, One-Budget and One-Report” to provide coordinated and effective efforts and predictable funding in support of results-oriented national plans and strategies. Conclusion The abstract session will give the opportunity to share achievements and challenges in Ethiopia as well as to learn more from other countries’ experiences. This will provide important hints to guide policies, strategies and programmes to be implemented in the next years to achieve MDGs by 2015. Organization The convener will be in charge of the subtopics 1 (Introduction) and 6 (Conclusion), while different presenters will be in charge of the topics from 2 to 5. The presentation of each subtopics will last 10 minutes, with 30 minutes left for discussion, for a total of 90 minutes. The audience will include any participant to the Congress who may be interested in this open discussion and experience-sharing opportunity.