In the last decade, the private health sector has experienced unprecedented accelerated growth in many developing countries, particularly in Ethiopia. Not only has the number of different caliber private health facilities caught up with that in the public sector, but in fact, in many cases private health facilities provide more types of health services to more and more people than do the public health facilities, and experiencing less stock outs. Unfortunately, commensurate recognition has not yet been acknowledged and government policy still remains unclear in guiding and taking advantage of the breadth of what the private health sector capacity can deliver in the way of public health services, and extend access to more people than is covered by the public sector, in both urban and rural areas. Through a strengthened public-private partnership, the private health sector is in a position to increase its support of the public health sector with key public health services, providing more service delivery points to cover an increasing number of people in rural and urban settings, with subsequent increases in service utilization, all of which will result in improved health outcomes of the general population. There remain concerns, even from staunch supporters of the private sector, about ensuring that the private health sector providers follow standard regulations and be licensed and accredited. Unregulated, the private health sector may cause greater damage than good and therefore, all the more reason to ensure official recognition and inclusion of the private sector as part of a whole national health system. In some areas, the only option for the general public is a private provider, whom clients often believe provides greater confidentially and respect and better service than the public sector. Thirty seven (37%) of the health care expenditures in Ethiopia is financed out of pocket (FMOH and Abt Associates 2010, Report of the Fourth Round of National Health Accounts in Ethiopia). Twenty-five percent (25%) of Ethiopia’s 2,085 physicians and twenty percent (23%) of specialists (in Addis Ababa, Harari and Dire Dawa) work in the private sector. Surprising to most, the population served by the private sector is 45% rural and 42 % urban and 44% lowest income quintile and 48% highest income quintile (World Bank 2006). This evidence illustrates that the private sector is serving the poor and rural populations. Urban public health facilities are often overstretched (2000 HIV clients on ART per physician) and overloaded. It will take an estimated 13 to 16 years to enroll all HIV patients in ART if the public sector is the only source of such services and only 4.2 years if both the public and private sectors combine efforts (sources: 1. Addis Ababa City Administration Health Bureau statistics, 2. JAIDS, Dec.2011). As the global response to HIV evolves from emergency relief to more sustainable programs, it is important to understand the current and potential private sector role in mitigating HIV/AIDS as well as in other emerging/re-emerging diseases. Thirty one Private Health Sector Project (PHSP) supported private facilities in Amhara Region alone account for twenty four percent (24%) of the total regional TB detection. It is only in TB that the government has issued a guideline on Public-Private Mix-DOTS. Unfortunately, to date there is apparent resistance against the engagement of the private sector in the provision of other key public health services continues.