Public Health Situation Analysis: Greater Horn Of Africa – Health and Food Insecurity, January 2023
Countries in the Greater Horn of Africa (GHoA) continue to experience extreme weather events, including the worst drought in 40 years after four consecutive failed rainy seasons. Since October 2020, millions of people across the seven affected countries – Djibouti, Ethiopia, Kenya, Somalia, Sudan, South Sudan, and Uganda – are suffering from the results of extreme weather conditions, subsequent disease outbreaks as well as pre-existing conflicts, and malnutrition. Of the approximately 292 million inhabitants in the GHoA, an estimated 46.3 million people are living in acutely food insecure situations of level three or higher of the Integrated Food Security Phase Classification (IPC). This has been a contributing factor to displacement, with the region currently hosting 4.5 million refugees and 13.5 million internally displaced persons (IDPs).
The GHoA region has experienced various climate-induced crises for some decades now, however, the impact of the current climate events including drought in the arid and semi-arid lands (ASALs) and floodings in other parts of the region have been exceptionally severe. Over the last year, the region has recorded over 39 outbreaks and public health events which is the highest annually reported public health events since 2000. Over the past six months, the risk of malnutrition has increased precipitously as food insecurity continues to deteriorate. In drought-affected areas, pastureland and water sources are facing depletion across the region. Subsistence farmers and rural communities who rely on natural resources have witnessed an unprecedented increase in the death of their livestock and subsequently the loss of their livelihoods. Vast areas used for the production of crops have been destroyed and, in Ethiopia alone, 4.5 million livestock have died since December 2021 due to drought.
Millions of families are being forced to leave their homes in search of food, water, and pasture, heightening the pressure on already-limited natural resources. Kenya recorded less than 55% of the 30-year rainfall average in 2022, according to the Famine Early Warning System Network (FEWSNET). In pastoral areas, poor vegetation and long trekking distances for livestock are causing wasting body conditions and well below average milk production, while in marginal agricultural areas late planting and below-average rainfall are raising concerns that many crops may not reach maturity. Dwindling resources have increased tensions and conflict as pastoralist communities travel further in search of food and water, leading to inter-communal clashes.
In Somalia, protracted drought, a complex social structure encompassing various ethnic minorities, political divisions and the resulting insecurity and conflict continue to drive humanitarian needs and public health concerns. Nearly half (8.3 million out of 16.9 million) of the population is in need of humanitarian assistance according to the Humanitarian Needs Overview 2023.
The rising food insecurity is increasing the health risks and needs of the affected populations, leading to a greater requirement for preventive and curative health care services. Undernutrition and micronutrient deficiencies have become widely prevalent, particularly among at-risk populations such as pregnant and breastfeeding women, new-borns and children, the elderly, and people living with disabilities or chronic diseases (including TB and HIV). The crisis-driven migrations have resulted in mass displacements, leading to millions of refugees and IDPs seeking shelter in camp settings . However, the limited infrastructure in IDP camps together with hygiene and sanitation facilities, has been overstretched due to overcrowding and pressure from the influx of new arrivals, thereby increasing the risk of infectious disease outbreaks. Outbreaks of epidemic diseases, such as cholera and measles, are a major concern in drought- and flood-affected areas, due to low immunization rates and insufficient health service coverage. The severe water shortage in drought affected areas mean restricted access to safe drinking water and sanitation, leading to a deterioration in health conditions and an increase in the risk of disease outbreaks in the affected communities11 . The effect of infection is more severe in malnourished persons due to weakened immune systems12. The loss of livelihoods and food insecurity are also increasing the general risk of morbidity and mortality through risky activities such as underpaid labour, migration and prostitution.
The current public health outlook indicates that the situation is getting worse compared to the first six months of 2022. What is needed is a coordinated effort from all sectors in order to mitigate disease risk, to in turn reduce morbidity and mortality in the affected countries
Source: World Health Organization