C-19 Global South Observatory

ETHIOPIA

Information last updated: May 10, 2020

  • Total population: 109.2 M
  • Population +65 yo: 4%
  • GDP Per Capita: 2,154 USD
  • Informal employment: Not available
  • First registered case: 14 March
  • Hospital beds: .30 (per 1,000 people)

Sources: TheWorld Bank and WHO  (Population over 65 years old, Informal employment, GDP-PPP, Hospital beds).

Status

  • Level of confinement and until when: A state of emergency and partial quarantine measures were announced on April 8th 2020, forbidding gatherings of more than 4 people. Soft of these measures have been eased in the Tigray region.
  • Covid-19 patients in the treatment center: 133
  • Number of laboratory tests conducted: 34,860
  • Confirmed cases: 399. Deaths: 5 (May 21).

Response set up and capacity

The response to the Covid-19 crisis is led by the Council of Ministers. Under its direction, the Federal Ministry of Health (MoH) is responsible for stakeholder engagement throughout the Covid-19 crisis. The State Minister for Programs executes projects as described in the Multi-Sectoral Preparedness and Response Plan. The Grant Management Unit (GMU) is responsible for the management of those activities, as well as the recruitment of additional staff, and may outsource some activities to third parties, upon agreement with the World Bank. The Ethiopian Public Health Institute (EPHI) provides technical support and reports directly to the State Minister. Finally, Regional Bureaus have established task forces to coordinate responses to the Covid-19 at the local level.

Additional actors, such as the WHO, the IMF, the World Bank, and Africa CDC provide technical and financial support to the country. A set of United Nations agencies provide support with regard to prevention measures and awareness campaigns. Finally, institutions such as the WFP provide material support, including food supplies. 

In view of the relatively low capacity of the public health system, the Government of Ethiopia focuses its response on the prevention level, emphasizing the importance of social distancing, sanitary best-practices, and the tracing and isolation of Covid-19 cases. As of May 8th 2020, Ethiopia had tested a total of 0.26 tests per 1,000 people, having performed over 30,000 tests for a total population of over 100 million inhabitants. The health care system in Ethiopia is underfunded and presents disparities between rural and urban areas, making access to healthcare challenging. With only 0.3 hospital beds per 1,000, Ethiopia has one of the lowest hospital beds availability in the world. 

Stakeholder Mapping

Entities / Organizations

• The Council of Ministers

• Federal Ministry of Health (MOH)

• The Ethiopian Public Health Institute (EPHI)

• The Grant Management Unit (GMU)

• Regional Bureaus

Additional actors

• Financial and technical support by International organizations, including the WHO, the IMF, the World Bank, and Africa CDC

• Prevention and awareness activities by the IOM, local leaders, UNICEF, UNDP, ILO

• Further support (e.g. equipment) from the WFP.

Mitigating factors - What is being done?

  • 23 March: Closure of international borders and mandatory 14-day quarantine for those returning to the country.
  • March 12: the Government announces a Br 300 million (USD 8.9 million) package to support the healthcare sector, later increased to to Br 5 bn (equivalent to USD 154 mm).
  • March 31: Parliamentary elections postponed.
  • April 3: The Multi-Sectoral Preparedness and Response Plan is published (USD 1.64 bn to be implemented over 3 months). It includes USD 635 million for food distribution to vulnerable populations, not covered by the national social protection program, USD 282 mm to provide emergency shelter and non-food items, USD 293 mm towards agriculture, nutrition, and protection of vulnerable populations, including refugees and USD 430 mm to the healthcare sector.
  • April 8: The country declares a state of emergency under Article 93 of the Constitution is declared: Schools, bars, and clubs closure; Public gatherings of more than 4 people are prohibited; Ban of inter-regional public transport; Sporting activities are forbidden; Transportation service providers must reduce passenger capacity by 50%; Djibouti’s border remains opened for trade of commercial goods; The government has the power to order companies to manufacture Covid-19 related products; Any person that does not comply to those requirements risks 3 years of imprisonment or a fine up to Br 200,000 (around USD 5,900).
  • April 19: Decisions to relocate Hitsats refugee camp move forward amidst growing concerns. 
  • April 24: Tigray (Northern region of Ethiopia) eases confinement measures. Civil servants return to work; Movements are allowed within the region are allowed (with a 14-day quarantine is implemented in the region for travelers by air or land); Take-away services are allowed in bars and restaurants, but other activities are allowed under strict social distancing measures.
  • April (general): Provision of extra liquidity to private banks by the Central Bank (Br 15 bn, around USD 445 million).

Risks, vulnerabilities, obstacles

  • Migrants (returnees): In the past weeks, thousands of Ethiopian migrants have been deported from Saudi Arabia, Djibouti, Somalia, Sudan, and other countries. Currently, IOM is assisting over 9,400 returnees residing in Ethiopian quarantine facilities, and is supporting the Government in its response to the needs of those migrants, ensuring food security, medical care and shelter. Furthermore, most migrants reside in rural areas, where IOM is collaborating with local leaders to raise awareness and to implement prevention measures. 
  • Refugees: Continued insecurity in neighboring states, such as South Sudan, Eritrea, Somalia etc. drives flows of refugees into Ethiopia. UNHCR estimates that there are around 758,000 refugees in the country. UNHCR cooperates with Regional Health Bureaus and other local partners to provide access to healthcare to refugees, especially in Somali and Tigray regions. Social distancing and sanitary measures are undertaken in refugee camps to decrease the risk of contamination. This is however a great challenge due to overpopulation of camps and the lack of WASH facilities.
  • Food security: 30 million people may suffer from food consumption gaps in Ethiopia, as a result of Covid-19. Humanitarian organizations in coordination with local authorities are working towards providing humanitarian assistance, which is however being delayed due to movement restrictions and quarantine measures. Funding has been allocated by the Ethiopian Government, the World Bank, and other organizations, and cover around 30% of the food needs of the country. Food security is further threatened by the presence of swarms of desert locust in the region, which decimates crops. Due to heavy rain, floodings are also expected in late May, endangering food supplies and vulnerable population groups.
  • Access to healthcare: Access to healthcare in the country is limited, especially in rural areas, where 80% of the population lives. Ethiopia has 0.3 hospital beds per 1,000 people, a rate over ten times lower than the average in OECD countries. Lack of medical supply is also an obstacle faced by Ethiopia, exposing front-line workers to increased risks of contracting the disease.
  • Education: In line with the Covid-19 response of the Government of Ethiopia, schools have been closed and movements are restricted. These measures impact children’s routine and social support, as well as increase the risks of domestic violence and psychological distress. The Ministry of Education is preparing podcasts on the radio to provide educational content to students, while a multi-actor approach is undertaken to spread awareness on the virus, deliver educational content, and mitigate the risks of child abuse and domestic violence. In the medium-run, the economic downturn is expected to impact government revenue and external assistance from donor countries, in turn affecting the funds and assistance provided to children, for instance regarding nutrition, schooling, and preventions of other diseases (e.g. pneumonia, diarrhea, measles, polio).
  • Elections: On April 1st, the National Electoral Board of Ethiopia decided to postpone the elections, initially planned for August 2020. Freedom House raises concerns that this decision, coupled with increased authority of the Executive branch due to the State of Emergency, may lead to greater political instability in the country, in its efforts to build a democratic regime. Hence, this may lead to greater difficulties to rally the nation and to provide a unified response in its fight against Covid-19.
  • Economic environment: Ethiopian Airlines, the largest air provider in Africa and large contributor to Ethiopia’s economy, is experiencing a downturn which highly exposes the country to adverse shocks. The company has been subject to decrease demand and suspended dozens of flights. Additionally, prices on key export commodities, such as coffee and oil seeds, have been negatively affected while on the opposite Ethiopia could benefit from the drop in oil prices.

Potential actions and demands

  • The postponement of the elections raised concerns for opposition leaders in the country, fearing that the current Prime Minister would restrict political space. Nevertheless, opposition parties accepted the State of Emergency and the need to provide the necessary tools to the Government to tackle the Covid-19 crisis. 
  • The State of Ethiopia is taking a multi-dimensional approach to respond to the pandemic, involving Regional Bureaus, Unions and Humanitarian actors. 
  • IOM is urging the Government to prioritize and protect the most vulnerable and for the Government to include migrants in its response plans.
  • Ethiopia is in urgent need for medical and food supplies, especially for the most vulnerable populations, and is urged to provide an appropriate response to the economic and social needs of the country in the short- and medium-run.
  • While already massively present in the country, humanitarian actors’ potential support is being limited by the fear of contagion from foreigners, the limited availability of humanitarian staff, as well as the undifferentiated enforcement of travel restrictions on the ground. 

Key resources

Contributor(s): Sarah Bodart.

The C-19 Global South Observatory is a collaboration between