Ethiopia turned a corner several years ago. With a peace agreement with Eritrea, a stable government and steady economic growth, the trajectory over the course of a decade looked promising.
Ethiopia appeared to be on the rise in East Africa, boasting an economic growth rate of 11 percent over the previous decade. The historical hunger challenge was finally receding, and the world celebrated a peace treaty with Eritrea with a Nobel prize.
Then, political tensions led to conflict and that promise rapidly disappeared.
As the northern states again became saturated in conflict, there was a precipitous drop in donor financing and the growth rate plummeted to a mere 3.8 percent for 2021-2022, according to estimates from the International Monetary Fund.
There is hope once more for Ethiopia, thanks to the recently agreed-upon cessation of hostilities, but it is far from assured. Ethiopia’s current challenges — post-conflict reconstruction, cholera and drought — remain significant. The U.S. and other international donors must not lose focus on the need to support Ethiopia’s return to stability. The announcement by U.S. Secretary of State Antony Blinken of an additional $331 million in humanitarian assistance during his visit this week is a strong start.
Conflict ravages health access
In the country’s conflict-affected Afar Region, some of the 1.2 million people displaced by violence are beginning to return. Those returning, however, find destruction and little to no services. The hospital and health center we recently visited were both looted and destroyed, though staff were gallantly struggling to offer minimal services. International humanitarian organizations, including Project Hope, are supporting the few remaining Ethiopian government health staff from both sides of the conflict to provide mobile maternal and child health services to displaced families.
Across Ethiopia, average Global Acute Malnutrition is above 15 percent for children, and 46.6 percent of pregnant and lactating women are acutely malnourished. Additionally, immunization services severely broke down during the conflict and the COVID-19 pandemic; as a result, Project HOPE found that an estimated 33.7 percent of children in hard-to-reach or underserved settings had no immunizations — what we call “zero dose” — and 62 percent were under-vaccinated.
The lack of health services in the region is not only inadequate, it is deadly.
Overall, solidifying the calm following the “cessation of hostilities” is going to require increased engagement and collaboration by the government and donors to re-establish these critical services so that Ethiopians have access to basic health care.
‘Killer Cholera’ and threat of famine
Further south outside the conflict area, the opportunistic epidemic of cholera is hitting many communities when they are at their weakest. The United Nations estimates that more than 1 million Ethiopians are at high risk of the highly contagious disease, noting a 30 percent increase in cases in January. And several areas at risk still have not been reached by cholera services. More organizations are needed to engage in prevention and treatment to contain the outbreak.
Many innovative programs evolved in Ethiopia to greatly reduce what was once the ever-present threat of famine among Ethiopia’s pastoralist communities. Some were so successful, in fact, that they are being emulated around the world.
However, four consecutive failed rainy seasons have resulted in an unprecedented drought, leading to increased displacement and hunger. Now even the best prevention programming is no longer holding the worst hunger at bay. Ethiopia is one of six countries identified by United Nations agencies as requiring humanitarian action to prevent starvation and death. While experts are not yet formally discussing “famine,” it may not be far off without greater interventions. Immediate action is necessary to scale up and sustain humanitarian assistance through at least mid-2023 to avert the risk of famine.
With sustained peace and a return of confidence in its government, Ethiopia could turn the corner once again. Greater engagement is needed now to better ensure that course. As the second largest country on the continent sitting in an already troubled region, Ethiopia’s turn back toward success is vital not only to the 120 million who live there but also to the interests of the U.S. and the world. Seeking to maintain stability in Kenya, reducing the conflict in South Sudan, with the U.S. military engaged in neighboring Somalia, and with numerous refugee populations among nearly every country in the Horn of Africa, the attention of Secretary Blinken and additional funding is more than warranted. The rest of the donor world also needs to step up.
Jed Meline is director of policy and advocacy at Project HOPE. He previously served as director of health and humanitarian assistance at the National Security Council and as a foreign service officer with USAID.
Dr. Dawit A. Tsegaye is the country representative for Project HOPE in Ethiopia, overseeing 70 staff supporting the health systems and providing critical relief throughout the country.