16 January 2002



Technical committee prepares requirements for 2002
A technical committee comprising members of the Disaster Prevention and Preparedness Commission (DPPC), the donor community, NGOs and UN agencies was established to examine the humanitarian response in 2001, prevailing conditions and prospects and needs for 2002. The committee, established on 16 November 2001 (USAID, DFID, EU, Swedish CIDA, Canadian CIDA, UNICEF, WFP, EUE, DPPC, American funded NGOs, EU funded NGOs), is preparing assistance requirements and implementation strategy through the activities of four working groups.

The first working group has been dealing with an overview of the disaster and response in 2001, a review of the current situation and assistance requirements for 2002. The second group is formulating an overview of food insecurity and modes of assistance in Ethiopia.  The third working group is covering resource mobilization, implementation strategies, coordination and monitoring activities. Issues and recommendations raised during the weekly meetings of the committee are being incorporated into a consolidated document by the fourth editorial working group. 

The initiative has enhanced collaboration between the DPPC and its partners and provided a forum for exchange of ideas, perspectives and approach emphasizing immediate assistance to those in need, protection of livelihoods and linkages with longer-term development strategies and programmes.

The DPPC report on Assistance Requirements and Implementation Strategy for 2002 is expected for release on 23 January. The figures will be based on the findings of the DPPC-led multi-agency Needs Assessment Mission which took place in late November and early December.

Yemen lift livestock ban from Horn
The Republic of Yemen has lifted its ban on livestock imports from the Horn of Africa that had been in effect since September/October 2000. The ban was imposed following Rift Valley Fever and related deaths in Saudi Arabia and Yemen associated with livestock imported from the Region. The import ban has adversely affected the livelihoods of livestock herders and others in the sub-region, particularly in Somalia and the Somali Region of Ethiopia. Before the ban, the Horn of Africa used to export more than 3 million livestock per year to the Arabian Peninsula. Out of the total number of animals shipped, more than 50 percent originated from Ethiopia, constituting the single most important source of income for pastoralists in the southeastern lowlands of the country. The timing of the lifting of the ban is ideal for the Somali Region where there has been some livestock recovery and consequent build up of herd sizes following the severe drought of 1999/2000.

Ethio-Eritrea border commission heard cases
The border commission charged with reaching mutual agreement between Ethiopia and Eritrea on the demarcation of their common border heard cases of the two countries in the Hague on 10 to 21 December.

The border commission was established following the signing of the peace agreement between Ethiopia and Eritrea as a means of establishing a final and binding agreement on the demarcation of their common border. Both sides have agreed to accept and not in any way challenge the commission’s findings. After the hearings, the border commission will deliver its binding verdict on the boundary by the end of February.

Repatriation of Ethiopians from Eritrea

The International Committee of the Red Cross (ICRC) repatriated 87 Ethiopians from Eritrea via the Mereb River and Rama on 4 January. Upon crossing the border the volunteer returnees received support from the ICRC and the Ethiopian Red Cross Society.

Meningitis cases on the rise
The Ministry of Health is reporting that as of 6 January 2002, there have been a total of 789 cases of meningococcal meningitis since mid-September in five regions in Ethiopia with the majority of cases in the SNNPR. With the number of cases still on the rise, the Ministry warns that the outbreak might not have yet reached its peak. The SNNPR alone has reported 697 cases with Sidama zone the most affected by the epidemic.

Although the number of meningitis cases is increasing, the overall fatality rate remains low at 6.2%. This can be attributed to better local media coverage and education of the population about the symptoms of meningitis resulting in those affected being brought to health care centers sooner. Also keeping the fatality rate low is an emphasis on vaccinating those at risk. In response to the current outbreak, a total of 443,400 people have been vaccinated thus far, major drugs supplied for the treatment of cases and temporary treatment shelters established all at a cost of 370,405 birr (an estimated US$ 43,500). This cost does not include fuel and daily subsistence allowance for those who work at field level.

AIDS orphans approaches one million
The Ministry of Health reports that the number of AIDS orphans in Ethiopia has approached the one million mark, placing an even greater strain on the country’s limited and already stretched social services. AIDS orphans face a host of social problems with many of them being forced to live on the street. With Ethiopia’s culture of extended families having proven to be one of the most practical mechanisms in facing the threat, the Ministry urges families to get involved and help these orphans. The Ministry stresses that the problem should not be left solely to Government or non-governmental organizations but be embraced by everyone in the country.

CRDA organizes NGO Day 2001
Christian Relief and Development Association (CRDA) organized a three-day long NGO Day 2001 in collaboration with Action AID Ethiopia, Ireland Aid, PACT Ethiopia and Netherlands Development Organization (SNV) for some 80 NGOs that operate in southern Ethiopia and 25 NGOs working in other regions along with seven Government agencies. The major objectives of the event were to increase the awareness level of all concerned in the role of NGOs, highlight NGO contributions and religious based agencies to the socio-economic development of communities and promote the culture of voluntary humanitarian and development work in the region. Exchange of information and experience, strengthening of the network among NGOs and promotion of the development partnership with Government, donors and other stakeholders also count among the major targets .

The organizing committee announced that the Amharic translation of the NGO code of conduct is ready for distribution to the public. As the majority of the people served by NGOs are Amharic speaking, the committee chairperson underlined that the translation will assist people to evaluate NGOs. The day was observed in Awassa 14-16 December 2001.


Mary Robinson marks human rights day in Addis
The United Nations High Commissioner for Human Rights, Mary Robinson, said that human rights were the key to development in Africa and called on the international community to do more to ensure that the continent can fully implement a human rights-based approach. Mrs. Robinson stressed these issues during an event organized to mark Human Right’s Day in Addis Ababa on 10 December.

Mrs. Robinson also emphasized that "extreme poverty" is the worst human rights problem that the world is currently facing. "Extreme poverty means a denial of the exercise of all human rights and undermines the dignity and worth of the individual". In a special note for Ethiopia, Mrs. Robinson stressed that "we must put people at the centre of that development by having a human rights based approach" as it is the key to both social and economic development and a peaceful and civil society.

UNESCO director general visits Ethiopia
Director General of the United Nations Educational, Scientific and Cultural Organization (UNESCO), Koichiro Matsuura, visited Ethiopia from 6-9 January 2002 on the invitation of the Ethiopian Government. According to a UNESCO press release, The Director General visited the UNESCO World Heritage sites in Lalibela, Axum and Gondar. Minister of Education, Genet Zewdie, who is also a member of the UNESCO Executive Board, accompanied the Director General during his visit to the historical sites. The Director also met President Girma Wolde-Giorgis and ministers concerned with UNESCO activities.


ICRC conducts law of armed conflict workshop
The first national training workshop on the law of armed conflict for senior pilots and operational commanding officers of the Ethiopia Air Force was organized by the international Committee of the Red Cross (ICRC) from December 6 - 9, in Debre Zeit, Air Force Headquarters, Ethiopia.

According to an ICRC press release, officers and pilots will be introduced to the main International Humanitarian Law (IHL) rules governing the conduct of air operations and defense. Key concepts, such as the protection granted to civilian populations and cultural objects, respect for medical personnel and facilities bearing the Red Cross/Red Crescent emblems and existing limitations in the choice of means of combat are covered. The workshop is considered as a first step towards the integration of IHL in the regular training curriculum of the Ethiopian Air Force. The same workshop was organized in Mekele and Bahar Dar Air Force bases from December 13 - 16 and 19 - 22 respectively.

The law of armed conflict is a body of rules enshrined in the four Geneva Conventions of 1949 and their Additional Protocols of 1977 and in various other international treaties regulating the means and
methods of warfare, better known as International Humanitarian Law (IHL).

FAO organizes workshop on community-based animal health
FAO, in collaboration with the Community Animal Health and Participatory Epidemiology Unit (CAPE) of Pan-African Program for the Control of Epizootics (PACE), organized a workshop on the establishment of a veterinary-supervised and sustainable community-based animal health worker’s delivery system in the pastoral areas of Ethiopia. It was held in Addis Ababa from 27 November to 29 November 2001 with support from ECHO and USAID . The overall objective of this workshop was to start a process of sharing experiences in community-based animal health systems, streamline approaches and identify the roles of communities, NGOs, the private sector and Government in these systems. The workshop participants were drawn from a total of 41 veterinary policy makers, regional government decision makers, NGO staff and development professionals.. Recommendations were formulated at the workshop to assist policy makers in planning future community-based animal health worker programs.


Belg Weather Outlook (courtesy of FEWS)
The first half of 2002, including the belg season, is expected to be under a young (developing) El Nino episode. During an El Nino year, belg season rains over Ethiopia are usually abundant. Given, however, that the belg season period would occur during the developing stage of El Nino, the effect would likely be minimal.

A more authoritative long-range weather outlook is expected to be released sometime in February by both the National Meteorological Services Agency (NMSA) and the Drought Monitoring Center (DMC) of Nairobi.

Unseasonable rains

The unseasonable rains that have been witnessed in Addis Ababa in early January and other limited areas are not very strong and have not affected most late harvests from the meher season, as they were already gathered by the end of December. However, the impact of these rains has yet to be checked in all crop-producing areas. These rains, light in nature, have actually been positive for the upcoming belg as they are good for land preparation.

Overview of meher season crop dependent areas

November is normally the harvest season in all meher season crop dependent areas of Ethiopia. In these areas, November is normally dry with occasional showers mainly over the high grounds. Because of the prevalence of cold and dry air during the night, the occurrence of frost is not unusual, sometimes causing significant damages to late-planted crops. However, for the mainly pastoral southern and southeastern lowland areas of the country (South Omo Zone in SNNPR, Borena Zone in Oromiya Region and most parts of Somali Region), November is a period when the short rainy season that extends from late September through the end of November comes to an end. During the past year, rains reportedly ceased in almost all crop dependent areas by mid November, thereby creating better conditions for farmers to carryout normal harvest activities. In livestock-dependent southern and southeastern lowlands, November was dryer than normal with reduced rainfall in many areas. In terms of the overall performance of the short rains this past year, there was below average precipitation in the extreme southern and southeastern pastoral areas of Borena Zone (Oromiya) and Somali Region. This, coupled with poor 2001 gu (March-May) rains, may lead to localized shortages of pasture and water during the ensuing long dry season (December-March) in parts of Borena, Liben, Gode, Afder and Korahe Zones.

Partinium spreads to many parts of Ethiopia

The Ministry of Agriculture reported the spread of partinium, an exotic weed colonizing vast areas of land in Ethiopia first spotted in Ethiopia in the 1970s. The situation is being monitored. Campaigns involving local communities in Tigray, Amhara, Oromiya, SNNP, Harari and Somali Regional States and the Dire Dawa Administration are in progress to control its spread. As partinium, now present in 53 woredas, is a vicious plant that easily propagates itself, more research and funding is necessary to control it.


Tigray/Afar Mine Risk Education activities threatened for Lack of Funds

Mine Risk Education project activities, supported by UNICEF and implemented by RaDO, covering 42 tabias in the 10 war affected districts in Tigray and Afar National Regional States, face imminent reduction in operations and coverage for lack of funds, as announced by UNICEF in late December. Given the continuing risk faced by populations in affected areas, many of whom have recently returned to home villages after several years of displacement, the impact is potentially life threatening.

In the 5th UNICEF/RaDO Tigray Quarterly Mine/UXO Victim Information report for the period July-September 2001, an average of five victims were recorded per month, including eight children – all boys. The incidents occurred in five districts: Erob (1), Gulo Meheda (2), Tahitay Adiabo (11), Afherom (2). This included the injury of five people in a single incident in September in Ditchinma, Tahtay Adiabo district, when a vehicle hit an anti-tank mine. According to data gathered since early 2000, of the seven districts bordering Eritrea, Tahtay Adiabo (41%), Gulomekada (28%) and Afherhom (16%) comprise the majority of reported victims followed respectively by Erob (7%), Merebleke, Lealay Adiabo and Kafta Humera.

The project is cooperating with EMAO-led survey teams currently establishing priorities for recently trained humanitarian de-mining teams. In Tigray, the Bureau of Education has offered its support to the development of a special module for the 62 schools covered by the MRE project and will second technical staff to assist in this process. In Afar, Mine Agents have been trained and deployed to the three districts covered by the project in Elidaar, Dalol and Berhale. In January 2002, as part of the continuing project cooperation, UNICEF supplied RaDO with communications, data processing and transport equipment. A total of $575,000 is urgently required to sustain current MRE project activities through July 2002.

Support to post-drought nutritional monitoring and care in Somali Region

With general improvement in conditions across Somali National Regional State in 2001, buffered in the last quarter by good rains in most zones, UNICEF and other aid agencies continue to shift focus from the provision of emergency assistance towards more sustainable programming. This takes into account key lessons learned from the 1999-2000 drought such as the need to enhance baseline data, to develop more appropriate early warning systems and standard nutrition surveillance capacities and provisions for the care of severely malnourished children. These initiatives have been undertaken within a difficult operating environment, exacerbated by a lack of trained government health staff.

In 2001, UNICEF supported the training of regional and zonal health staff in nutrition surveys and methodology, data input and analysis, management of severe malnutrition and record keeping. Anthropometric tools and data processing equipment, printed materials and vehicles were provided along with financial support for surveys and running costs for feeding centres. In Jijiga, a monthly health and nutrition task force group was formed, led by the Health bureau including DPPB, UN agencies and NGOs operating in the region. Through support from ECHO, the Netherlands government and other donors, a core nutrition surveillance and management capacity was established. In October/November a second-round Measles/Vitamin A campaign was conducted, targeting more than 600,000 children under five. According to the regional health bureau, the campaign achieved 82% overall coverage for the Region’s nine zones.

Across the region, nutritional levels have generally improved although the situation remains fragile. The local NGO, Mother and Child Development Organisation (MCDO), is currently the only organisation operating feeding centres in the region, in Hartisheikh and Fafan IDP camps (Jijiga zone). In Gode zone, MSF-B closed its nutrition activities in Denan in October while CCM closed feeding centres in Kelafo in November. The MCDO feeding programs will continue until a planned, follow-up survey demonstrates an acceptable level of improvement. Elsewhere, it is hoped that good rains in Fik and Degebur zones will ameliorate conditions of IDPs and local communities.

Close monitoring in parts of Somali Region, including Denan

Areas of special concern within Somali Region remain the southern parts of Afder and Liben zone, parts of Gode zone and pocket areas in Korahe zone, due to poor deyr (short season) rains. In Gode zone, a mission composed of a WFP monitor, Save the Children US, and zonal health authorities has been investigating reports of nutrition-related deaths among children in Denan, the site of some 8,000-12,000 drought displaced people (estimates vary), with a resident population of some 14,000. General food distributions, including supplementary food, resumed in January after a break in distributions of three months. Supplementary and therapeutic feeding centres run by Medecins Sans Frontieres Belgium (MSF-B) were closed in October after a survey showed an improvement in the nutritional status of children at that time. Recommendations linked to the feeding center closure emphasized the need for continuation of general food rations. During the visit, it was observed that the health facility records the deaths of a total of 45 children in Denan (20 children from diarrhoea, 12 from malnutrition and 13 from pneumonia) over the past two months. The combination of a large, non-sustainable displaced population in the town and near depletion of seasonal water sources, already of poor quality, are believed to be major factors contributing to the poor health situation. While there is concern about avoidable child deaths, without a clear indication of the total population figures it is hard to say whether these deaths are significantly higher than usual for this season. Based on these reports, consultations involving zonal and regional health authorities and UNICEF are taking place towards a technical assessment mission.

In neighboring Gode town, a nutrition referral unit has been established within the zonal hospital intended to benefit severe cases from outlying districts, including IDPs. Since its establishment in December 2001, with UNICEF technical and financial support, the unit has trained 24 local health staff in the management of malnutrition. Four cases have been admitted as of mid-December.

These initiatives will be sustained in 2002 and are expected to gradually complement the DPPB/SCF-UK pilot early warning initiative that is intended to enhance early warning systems tailored to the pastoralist livelihoods practiced widely in the region. However, a continuing caseload of an estimated 50,000 to as high as 90,000 drought displaced, remain dependent on relief assistance and close monitoring. The Somali regional administration is presently finalising a proposal to register and provide support to those IDPs able to resettle in their home districts in 2002.


Food Aid

Food distributions throughout the country declined over November and December, as planned, as the new harvest became available.

Distributions are continuing in Somali Region, where 9,000 tons of WFP food was available for December for around 720,000 people. There was a break in distributions in this Region of three months, while approval was sought for an allocation list; however, the overall situation in Shinille, Jijiga, Fiq, Degehbour, Warder and Kebre Dehar is normal with little signs of acute food insecurity except in the drought displaced settlements (in Fafen, Hartisheik and Aware). Food for the drought displaced in Gunegedo in Degehbour zone has been provided over recent months by the NGO Ogaden Welfare Society using DPPC/WFP food. Deyr rains in the southern part of the Region in October/November were uneven and in places insufficient, and a negative impact on grazing and thus on livelihoods of the people is reported from areas close to the Somali border. There are no carryover contributions to meet current needs in the region and food distributions need to be accelerated, as was confirmed by the DPPC-led Needs Assessment Teams, who recommended that food aid distributions continue in the region in the early months of 2002. New pledges are thus urgently required.

Insecurity continues to limit the movement of UN personnel within certain parts of Somali Region.

As described in previous section, a close watch is being kept on southern parts of Afder and Liben zone, parts of Gode zone and pocket areas elsewhere in Somali Region.

Conditions in the lowlands of Western and Eastern Hararghe in Oromiya Region continue to be monitored closely, as there have been very poor crops in these areas. Other areas of concern are Wag Hamro, South Wollo, the Tekeze Basin (North Gonder) and the Abay Gorge (East Gojam) in Amhara Region. Food aid requirements in areas of chronic needs, as in much of Tigray Region, are expected to remain substantial.

Refugee operations

As described in a recent UNHCR press release, repatriation of Somali refugees from camps in eastern Ethiopia resumed in December. UNHCR, in co-operation with the Ethiopian Government's Administration for Refugee and Returnee Affairs (ARRA), repatriated the last group of Somali refugees from Daror camp to Northwest Somalia. The last two convoys moved from Daror camp to Northwest Somalia on 28 and 30 of December with 2,412 persons. A total of 25,628 persons were repatriated from Daror camp to Northwest Somalia since August 2001.

Daror camp, located in the Somali National Regional State (SNRS), established since May 1988 became the third of eight eastern camps to be closed this year after Teferiber and Darwanaji. At its peak in 1994, Daror hosted over 49,350 Somalis of the Issak clan from Burao area (Toghdeer Region of Northwest Somalia).

During 2001, a total of 50,216 Somalis from Camaboker, Darwanaji, Daror, Rabasso and Teferi Ber camps voluntarily repatriated to NW Somalia and 3,731 Ethiopians of Somali ethnic origin were dispersed to their areas within SNRS. Since 1997, over 187,500 individuals have left the camps around Jijiga in eastern Ethiopia.

The UN World Food Programme has been providing a nine-month allowance of food as part of the overall reintegration package.

Close to 66,900 refugees are left in the five eastern camps of Hartisheik, Kebribeyah, Camaboker, Rabsso and Aisha. 35,000 are expected to repatriate to NW Somalia by mid 2002. The remaining refugees, mostly from southern Somalia, will be provided with continuing care.

The population of Somali refugees peaked at more than 500,000 in mid 1990s. Most of the Somali refugees had fled fighting and civil disorder in Somalia following the fall of the Siad Barre regime.

Ethiopia still hosts a sizeable population of 160,941 refugees. The majority of them have crossed the border for neighbouring Sudan, Somalia and Eritrea.

WFP IDP operation - Tigray

WFP's food assistance to IDPs is continuing with a significantly reduced caseload of about 75,000 beneficiaries or 25 percent of the former caseload. While there are sufficient cereal stocks to meet needs to end February 2002, there are no additional pledges in the pipeline to ensure continued distributions beyond that period. Vegetable oil is particularly short, with no distribution since November 2001 due to lack of resources. The pipeline for pulses is also a cause for concern, with insufficient stocks available to meet needs beyond January 2002.


The WFP airbridge for Somali Region ended on 31 December 2001. Donor contributions to the WFP airbridge totalled $1.6 million. Flights started in April 2000 with a locally contracted Abyssinia light aircraft. In September 2000, a second light aircraft availed by ECHO was added. A light helicopter service was operated from July 2000 to end of June 2001. The air operation accessed to up to 27 locations (with airstrips) and another 86 otherwise difficult to access locations by helicopter. By the end of August 2001, 10 locations were served on a regular basis. The service enabled humanitarian agencies to access needy populations. The service also allowed for expanded monitoring in the Somali region, increasing the information available on humanitarian interventions. Additionally, the air service was vital in ensuring the security of personnel in the field and allowing for medical evacuations. Between April 2000 to December 2000, the service moved 1,600 passengers from UN agencies and international and local NGOs. During the same period, 17,000 kg of cargo was moved. This consisted of medicines and urgent provisions for staff working at field locations. In 2001, forty-four agencies used the service, with 1,800 passengers moved. International NGOs were the highest users representing 50% of the passengers for this period.

At the end of October, WFP ended its deployment of short haul trucks in Somali Region. The 140 Short-Haul Fleet was put in place by the joint agreement of WFP and DPPC in April 2000. Following the visit of Ms. Catherine Bertini, the Special Envoy of the Secretary General of the UN for the Horn during the height of the crisis in the Horn, WFP sought to augment the efforts of DPPC in distributing food to the most difficult locations of Ethiopia. All the 140 trucks were contracted by WFP Logistics from abroad for exclusive use of relief food delivery in Ethiopia's Somali Region and other in accessible areas. The fleet consisted of 70 DAF 4X4 and 70 IVECO 2X4 heavy-duty trucks (9 and 7.5 tons respectively). Over the period of September 2000 to October 2001, these trucks delivered about 65,000 tons of relief food to six zones in Somali Region, two zones in SNNPR, and Bale zone in Oromiya Region, successfully augmenting the effort of the Federal DPPC to distribute humanitarian food in the most difficult locations and circumstances withover 250 destinations reached.


Effects and impact of forest fires in Ethiopia

The UN Emergencies Unit for Ethiopia (UN-EUE), aided by an intern from Brown University (Providence, Rhode Island, USA), conducted a study in different parts of Ethiopia to assess the effects and impact of the forest fires in Ethiopia. Given the severity of the forest fires in 2000 , it was deemed important to gain a better understanding of the causes, examine the effectiveness of the response and gauge the preparedness of Government and communities in responding to similar fires in the future. Another objective of the study was to move the discourse surrounding forest fires in Ethiopia away from a focus on training and tools and towards a greater emphasis on fire as a reflection of the social and political processes of the country. The study aimed to understand perceptions and concerns at grass root levels of forest fire experience and to gain the necessary knowledge to prevent and efficiently fight future forest fire disasters through discussions with farmers and government officials in informal interviews and observations at fire sites.

The 2000 forest fires started at the end of January and raged for about three months. They were a synthesis of human interference and exacerbated by a prolonged dry spell. Ethiopian fire cycles normally center in lowland or midland areas. Unlike in the past, the 2000 fires were concentrated in the highlands and high forests. Among the places where forest fires broke out in 2000 were parts of Oromiya, Benishangul Gumuz, Gambella and SNNPR. It is estimated that over 100,000 ha were affected, amounting to around US$ 39 million in damages, in Bale and Borana zones alone.

These fires affected many of the Priority Forest Areas (PFAs) designated by Government as especially important to Ethiopia’s national economy and environment. Fires in these areas represent a serious threat to the country’s most vital natural resources. During visits to many of these fire areas, secondary succession has begun, but this succession is primarily composed of tree species with less commercial value and bushy species different from the original ones. What a fire may destroy in a matter of minutes may be impossible — or take hundreds of years — to replace.

The fires further manifested the complex problems in Ethiopian development as they touched nearly all parts of Ethiopian society, from ethnic tensions to land tenure insecurity to socio-economic status. The ramifications of the fires even extended beyond Ethiopia’s borders, alerting the international community about the potential devastation of precious land and endangered, indigenous species.

Because the causes of Ethiopia’s forest fires are attributable primarily to humans, the prevention of future fires is a difficult, daunting task. Fires will continue to burn the precious remaining forests unless there is a fundamental and dramatic alteration in the way people relate to the land, in the way the government manages and protects it and in the type of value the nation as a whole places on the environment.

The study suggested sustainable recommendations focusing on improving the quality of life for those who interact most with the land, giving attention to the interests of farmers and rural communities. These stakeholders are not principally concerned with environmental conservation. They do not perceive the problem of the 2000 fires as poor forest management and irresponsible fire use. Those at the local level are rather frustrated that they see few benefits from the land on which they work, for example sharing benefits from income generated from tourism. The reduction of future fire emergencies depends upon sensitivity to community ideology and a strengthening of traditional practices that have succeeded in the past. To prevent fires similar to those in 2000 and to reduce the pace of environmental degradation, more attention needs to be given to the issue and community benefits from the land on which they live.

The full study is available at or for further information contact Dechassa Lemessa, UN-EUE, 251-1-44 41 48).



The Global Polio Strategic Plan, launched in 2000 and led by WHO, is designed to achieve global certification of polio eradication in 2005. This refines the current successful strategy and builds upon the global partnership. It requires high quality intensified eradication efforts to interrupt transmission in all remaining reservoir countries by the year 2002, and subsequent surveillance to ensure certification. Ethiopia remains a global reservoir for wild poliovirus and is still striving to reach certification quality surveillance. Delay in action will increase the cost of achieving eradication and undermine past achievements.

In the past, polio was a major cause of disability and death worldwide. As there is no cure for polio, prevention is the only strategy. An easily administered inexpensive oral vaccine is available for this purpose.

Polio eradication requires high quality implementation of proven technical strategies. For each strategy, standardized indicators have been established to monitor the quality of implementation. The strategies include high routine infant immunization coverage, supplementary immunization activities in countries with low routine coverage (i.e National Immunization Days, and Sub-National Immunization Days); acute flaccid paralysis (AFP) surveillance and "mopping-up" immunization when surveillance is sensitive enough to identify focal areas of transmission.

Routine immunizations

The Government of Ethiopia established the Expanded Programme on Immunization in 1980 with the goal of reaching 100% coverage against the six childhood killer diseases by 1990. This program goal has largely remained unrealized. At the end of 2000, EPI coverage was estimated at BCG-51%, DPT3-42%, OPV3-42%, Measles-37%, and TT2 (pregnant women)-32%. EPI Reviews of 1995, 1998, 2001 identified the same major shortcomings of under funding, poor program management and supervision at all levels, inadequate logistic and cold chain maintenance, insufficient human resources as well as high staff turnover, sub-optimal community awareness on the benefits and meaning of immunization, and missed opportunities contributing to high drop-out rates to name a few. With support from partners, particularly WHO, UNICEF, USAID and JICA, the Government has started to address the situation. In December 2001, Ethiopia was informed that it has been awarded support from the Global Alliance for Vaccines and Immunizations (GAVI) to strengthen routine immunization services. GAVI is an alliance of organizations involved in global immunization efforts. Ethiopia has been awarded $964,000 USD each year for the next 2 years. These resources will be invaluable in strengthening routine immunization services and move the country towards its’ goal of attaining 80% DTP3 coverage by 2006.

Acute Flaccid Paralysis (AFP) surveillance

The surveillance for acute flaccid paralysis (AFP) cases is the systematic collection of information and stool specimens from all cases under 15 years old and which fit the epidemiological case definition for AFP. Cases of AFP might occur due to poliomyelitis or a number of other infectious agents like CoxSackie viruses and non-infectious diseases like Guillain-Barre syndrome, all of which present in clinically similar modes. AFP surveillance started in Ethiopia in 1997 and has shown steady progress to date. In 2000, 346 cases of AFP were reported from all parts of the country, and this number increased to 546 in 2001. Of the 546 cases in 2001, only 47% of AFP cases have 2 stool specimens collected within 14 days of paralysis onset, meaning during the peak period of expected viral shedding in polio cases. The target set for this parameter is 80%. The ability of the surveillance system to detect any circulating poliovirus thus relies on its ability to catch cases within the first 14 days after onset of paralysis. Those cases detected late will have to be classified as polio or non-polio according to a clinical scheme, which makes use of the clinical findings after 60 days of paralysis onset. Cases that are found to have died or still have some residual paralysis after 60 days or those who can no longer be located are classified as clinically polio, while late cases with no residual paralysis are classified as non-polio (as having occurred due to other causes). Of the cases so far classified in 2001, we have only 1 laboratory confirmed case and 78 clinically confirmed cases of polio (cases that could have been virologically or laboratory confirmed as polio or non-polio had the specimens and case reports arrived within the 14 day period).

In 1999 and 2000 four wild polio cases were detected. The last laboratory confirmed wild poliovirus was isolated from a child in Kambata (SNNPR) in January 2001. Nationally, the non-polio AFP rate was 0.7 per 100,000 children <15 years of age in 2000 and improved to 1.58 per 100,000 children <15 years of age (target 1/100,000) in 2001, but this rate hides the disparity of surveillance performance between zones, some of which are doing well, others poorly. Ethiopia still has 7 zones with non-polio AFP rates less than 1.0/100,000, of which, 4 are "silent zones" that have not reported any case of AFP in the last year. Despite these improvements, however, the quality of disease surveillance still has not reached certification level standards for several indicators. Ethiopia will remain a reservoir for wild poliovirus until surveillance reaches a high enough level of sensitivity to show that virus transmission has been interrupted. WHO has increased the number of surveillance officers working in the field from three in mid 2000 to 18 in early 2002 in an effort to reach certification standards. The 546 case reports have come at an average rate of 36 cases a month all throughout 2001, with a large number of case reports (about 140) coming in November during the first round of the house-to-house NIDs. Patients that have not sought treatment in health facilities or had been unreported for a number of reasons were picked up during this campaign after they had been paralyzed for weeks, thus indicating the inability of the surveillance system to detect cases as early as they occur.

Supplemental immunization campaigns

In 1996, Ethiopia held itsユ first Sub-National Immunization Days (SNIDs) in nine large cities of the country. More than a quarter of million under five children were reached in both rounds as planned. Between 1997 and 2000 three National Immunization Days were held consisting of 2 rounds each. SNIDs were conducted in 2000 and 2001 in selected areas. Selection for SNIDs was based on previous NIDs performance and the probability of wild poliovirus circulation based on the presence of other wild virus isolated.

The results of both NIDs and SNIDs are shown in Table 1 below.

Table 1: RESULTS OF NIDs AND SNIDs, 1996 - 2001


Target 5yrs Popn.


Round I

Round II







98 %

107 %



101 %

107 %

















*SNIDs (April-May)

Though the coverage has remained high, reviews and assessments of the previous NIDs and SNIDs have indicated that there are still areas poorly covered or totally un-reached. Experience in Ethiopia and from other countries has shown that house-to-house immunization, though it costs more, is the best strategy to reach all children under five years of age in difficult and hard to reach areas. For this reason, Ethiopia used the house-to-house strategy in the 2001 National Immunization Day’s, the largest vaccination campaign ever held in the country, in effort to immunize every child <5 years of age against poliomyelitis. About 51,000 vaccination teams took part in the two rounds of the vaccination using mule, boat, helicopter, and foot to ensure every child under 5 years of age was reached.