Response to natural and man made public health emergencies through provision of essential medicines and medical supplies Ethiopia was impacted by two years of consecutive drought in 2015/16 as a consequence of the El Niño phenomenon and due to the severe drought conditions there was no recovery and the drought continued in 2017 in lowland, mostly in pastoral areas, rendering hundreds of thousands destitute and displaced. The drought has caused more than 340,000 people to be displaced throughout over 250 sites in Oromia and Somali Regions and the IDP sites with the lack of WASH and health coverage were at higher risk for the AWD outbreak which occurred in 2017.

The AWD outbreak was brought under control in late 2017 through effective leadership by the FMOH and RHBs with technical multi-disciplinary assistance from the UN and NGO partners. However in late September 2017 border conflicts broke out between ethnic Oromos and Somalis which displaced more than 1.1 million people spread out across 370 different new conflict IDP sites. The FMOH and RHBs are overwhelmed with the massive humanitarian needs in providing primary health care services free of charge through temporary clinics and MHNTs.  

The presence of almost 1.7 million IDPs (climate and conflict) mainly in Oromia and Somali region has put a significant strain on the RHBs to provide health services to more than 600 IDP sites, many of which are difficult to access. The concentration of IDPs, often in remote areas, with reduced access to WASH, shelter, food and health services creates multiple risks for another outbreak of AWD or other communicable disease, and increased mortality and illnesses. The present proposal aims to support addressing one of the main constraints of most vulnerable communities affected by drought and conflict access to emergency PHC services, medicines and medical supplies availability. The FMOH and the RHBs in affected areas requested support from the humanitarian community in this specific gaps, as at present in Oromia and Somali region there are almost 690,000  IDPs with no or difficult access to affordable health care. 

Appropriate treatment of cases will promote the interruption of community transmission of the causative agent. This proposal will support procurement of essential medicines, laboratory supplies and other equipment and logistics to support services to vulnerable drought and conflict affected communities. WHO will provide essential medicines and supplies to fill in some of the present gap due to severe under funding, there is no an effective health pipeline. Through the present EHF allocation,  130 revised EDKs out of the necessary 620 kits (to cover until the end of the year) will be procured to ensure continuity of operation of health partners and support to RHBs until August (avoiding also pipeline break)and distributed to the health partners  running MHNTs (46 are at present in stock rupture) and RHBs in Oromia, Somali, SNNPR, Afar.  The distribution of supplies will be agreed upon through cluster mechanism and support of technical working groups based on the epidemiological situation development, gap identification and prioritization. At present, medicines for the treatment of about 8,000 cases of severe dehydration are in country and prepositioned in high risk areas medicines for about 6000 additional cases (severe and moderate dehydration) will be procure to complement the contingency stock for AWD. The project will also support the Information Management (IM), data collection, monitoring and quality assurance capacity at zonal hubs.
The procurement will be done at the begining of the project period through a combination of local (faster) and international modalities in two batches. The project period is 8 month to allow the clearance of the international procurement encumbrances in the last 1-2 months.