Four years ago, I watched a pharmacist in Addis Ababa pull a spreadsheet from her desk, turn to a printed forecast from 2019, and manually reconcile them every quarter. She had the data. She had the competence. She didn't have a tool that made sense.
That moment crystallized something I'd been thinking about for years: most of the software that enters health systems in Africa is built for the Global North. It doesn't account for how actual ministries work—their planning cycles, their data pipelines, their institutional commitments. So we either reject the software, or we distort ourselves to fit it.
In 2022, I started Opian with one conviction: software should make the existing process faster and measurably better, not ask people to learn a new way of working.
What we've learned from four years in Ethiopia
ForLab+ is now used by ~7,000 users across 5,100 health facilities in Ethiopia. Every quarter, planners open the system to forecast supply needs. Clinicians use it to check stock levels and manage shortages. Logisticians coordinate delivery in real time. That's not projection—it's what happens 250 times a week in Ethiopia right now.
Running at national scale teaches you things you cannot learn at pilot stage. You learn that data quality is not a technical problem but an operational one. You learn that change is slower than strategy assumes, but that persistence in a aligned direction compounds. You learn that the value of a tool is not what it does, but what the people using it do with it. The longer Opian runs, the more the ministry's planners understand their own data. That is the intelligence story—not algorithms, but user capability deepening through interaction.
What "decision quality at scale" actually means
Our mission is not to replace human judgment. It's to make each decision slightly better than the last—by automating the mundane (data consolidation, consistency checks, re-keying), freeing up time for strategy and exception handling. When a facility reports a stockout, the system flags it. But the planner decides what to do. When forecasting yields an unusual spike, the system alerts the team. But the epidemiologist investigates. We give people better ground to stand on.
At scale—5,100 facilities, 7,000 users—that compounds. Each quarter, the system learns from how planners actually correct forecasts, how supply moves in reality, how demand clusters. The next forecast is slightly better. The next planning cycle is slightly faster. That is the vision.
What's next for Opian
Ethiopia is anchor, not ceiling. We have a pipeline of nine countries across Sub-Saharan Africa—Phase 1 (Nigeria, Tanzania, Uganda, Mozambique) launching now, Phase 2 (DRC, Kenya, Senegal, Zimbabwe) in 12–18 months. Each comes with its own supply chain logic, its own ministry workflows, its own data challenges. The principles stay constant: align with existing process, keep data sovereign, build measurable value. The implementation is always specific.
Simultaneously, we're taking Link—our clinical decision system—into production. Link gives health facilities the workbench they need to manage patient flow, pharmacy stock, clinical referrals, and reporting. Like ForLab+, it's built on clinical workflows, not on what systems vendors think workflows should be. It's offline-capable because health centers don't always have power. It's modular because one facility uses some modules while another uses different ones. Version 1.0 is in testing now. By end of 2026, we'll be deploying across Ethiopian hospitals.
Who we're looking for as partners
We work with three kinds of partners. First, ministries of health who own the data and set the priorities. Second, implementation partners—WHO, EPSS, NGOs, local teams—who know the political landscape and can train, change-manage, and embed systems locally. Third, funders—Gates Foundation, Global Fund, World Bank, bilateral donors—who align resources with ministry-led plans.
If you fit one of those roles and care about health systems that actually work for the people they serve, I'd like to talk. We don't have all the answers, but we have a track record of shipping value, listening to feedback, and sticking with the long game.
Opian exists because I believe that software is not destiny—it's a tool. And tools work best when they're made for the specific hands that hold them.
Zelalem Gizachew Belachew
Founder & CEO.
Addis Ababa
April 2026