Response to crises generated public health emergencies through the provision of essential medicines and medical supplies for selected woredas in Somali, Afar, Oromia and Tigray regions. At least 8.7 million people in Ethiopia are projected to require humanitarian assistance in 2021. This includes an estimated 2 million conflict-related IDPs, of which roughly half have been returned to their place of origin, to destroyed houses and infrastructure, and 1 million climate-related IDPs. The UNHCR estimates that Ethiopia is home to over 700,000 refugees from neighboring countries. IOM estimates that approximately 10,000 migrant workers returned to Ethiopia each month during 2020, many with little to no support systems upon return. Additionally, the anticipated drought presents a looming food shortage for millions and thousands are likely to be affected by infectious disease outbreaks. Most of the key drivers for outbreaks and humanitarian needs remain unaddressed. The national health sector has limited capacity to respond to the vast health-related humanitarian needs in Ethiopia means that humanitarian assistance in the health sector is imperative. WHO will focus on gaps that almost exclusively to relate to her mandate.

Coordination and advocacy: Health sector coordination for humanitarian response has been improving over the past years, especially during 2020. A single national health cluster coordinator (HCC) was in place, bringing stability and continuity. The Global Health Cluster in 2019 conducted the first-ever National HCC training in Ethiopia, training 24 UN, NGO and EPHI staff on principles and practice. This contributed to a stronger sub-national capacity for health sector coordination across the country. Nevertheless, gaps remain in terms of reporting and advocacy and the functions require further support and action, especially at sub-national level.

The establishment of Emergency Operating Centers at national and sub-national levels resulted in improved operational coordination in 2020. National EOCs have shown to be able to operate relatively autonomously during 2020, while EOC established for Tigray responses still required significant infrastructural and technical support.
The findings from the 2018 VRAM indicated that the leading cause of disease outbreaks in the coming years were likely to be Cholera, Malaria, Sever Acute Malnutrition (SAM), Measles, Scabies, Rabies, Ebola Virus Disease (EVD), Yellow fever, Dengue and Meningitis. The 2020 WHO and EPHI surveillance reports indicate that these projections were generally accurate, with the exceptions being that no case of EVD was reported, while the chikungunya fever outbreaks that affected several regions and outbreaks of circulating vaccine-derived poliovirus (cVDPC) in the Somali, Amhara and Oromia region and pandemic COVID19 were not foreseen for 2020. For 2021, the expectation is that there will be no significant difference in risk for disease outbreaks from the 2020 outbreaks, and we expect to see new and continued outbreaks of most of the identified high-risk diseases across the country.
After its re-introduction into Ethiopia in 1993 cholera cases were reported from across Ethiopia during 2020, primarily in the Somali, Oromia and SNNP regions. Large-scale IDP movements resulted in a higher demand for water, sanitation, and hygiene (WASH) infrastructure in already overstretched contexts, further increasing an already high risk for outbreaks of water-borne diseases.

Cholera outbreaks generally follow the Orthodox mass gatherings that occur regularly throughout the year, while the continued identification of new, large internal population displacements, including those due to conflict and floods suggest a continued high risk for outbreaks of water-borne diseases during 2021. Of the bacteriological water quality tests WHO conducted in 2020 in cholera-affected and IDP populations, close to 60% tested positive for fecal contamination.

WHO will support the government to revitalize the health system to be able to provide services to the communities while providing kits for frontline partners.