Response to public health emergencies created by displacement through early warning and rapid response mechanisms and provision of medicines and medical supplies The outbreak response elicited by the El Niño started in 2015 in Addis Ababa and rapidly spread to Somali, Afar, Amhara, Benishangul Gumuz, Dire Dawa, Gambella, Harer, Oromia, SNNPR, and Tigray regions of Ethiopia. The swift surge in the number of cases of AWD in early 2017 with more than 4000/week reported from mid-April to end May brought about significant mobilization of resources by the FMOH/PHEM and partners for saving lives through access to treatment and the control of community spread. By the end of 2017 the outbreak was brought under control in the most heavily affected regions including Somali, Oromia, Amhara, and Tigray. The resurgence in early January 2018 in Dire Dawa, Somali and Tigray as well as the outbreak in Afar in May were rapidly controlled because the strong early warning and rapid response mechanisms which were established during the peak of the outbreak, led by PHEM/RNOH/RHB and supported by WHO covered most of at the high risk regions/zones/woredas. 

The health determinants and triggering factors for outbreaks have remained unchanged, or in some regions degraded further due to additional internal massive displacement. Access to safe drinking water, poor sanitation and hygiene behaviors, wide-spread food insecurity with general poor nutrition and increasing SAM incidence, along with cross-border movements, large numbers of internally displaced people in the context of an overburdened local health system creates an impeding risk for AWD and other water borne diseases outbreak resurgence especially in Aug and Sept.

The aim of the project is to support maintaining a strong and rapidly scalable early warning/surveillance and Rapid Response capacities to effectively cover the high risk populations. Immediate investigation, confirmation of alerts and rapid response mechanisms along with improved access to appropriate treatment of cases (case management/IPC) are essential for the control of community spread of diseases with high epidemic potential. The EHF funding will enable maintaining the WHO epidemiologists, surveillance and environmental health officers presence in the high risk regions to continue to providing technical, information management, and coordination support at regional and zonal levels along with logistic and operational support for the Rapid Response Teams of the RHB for the next 7 month.  

Controlling health threats and outbreaks is a multi-disciplinary (water quality, case management, risk communication, surveillance, IPC) and multi-sectorial (WASH, Nutrition, shelter, logistic) effort, as a front line rapid response to contain the sources of potential outbreaks. The activities are complementing other WHO field programs in coordination with the FMOH, RHBs and humanitarian partners’. This intervention will ensure timely detection of disease alerts/outbreaks and rapid, efficient response and as a result will help to contain the outbreaks locally and keep monitoring the epidemiological trends, in line with the requirements of International Health Regulations (IHR). In addition, the project includes procurement of medicines and medical supplies for PHC clinics run by NGOs and RHBs for the IDPs, and some AWD kits, complementing other available resources. Still, even with USD 2,1  received/committed  (EHF, CERF) so far, the gap in medicines and medical supplies remains significant at USD 6,4.